Illness severity and risk of mental morbidities among patients recovering from COVID-19 : A cross-sectional study in the Icelandic population

• Published in: BMJ Open
• Main Authors: Saevarsdóttir, Karen Sól, Hilmarsdóttir, Hildur Ýr, Magnúsdóttir, Ingibjörg, Hauksdóttir, Arna, Thordardottir, Edda Bjork, Gudjónsdóttir, Ásdís Braga, Tomasson, Gunnar, Rúnarsdóttir, Harpa, Jónsdóttir, Harpa Lind, Gudmundsdóttir, Berglind, Pétursdóttir, Gudrún, Petersen, Pétur Henry, Kristinsson, Sigurdur Yngvi, Love, Thorvardur Jon, Hansdóttir, Sif, Hardardóttir, Hrönn, Gudmundsson, Gunnar, Eythorsson, Elias, Gudmundsdóttir, Dóra Gudrún, Sigbjörnsdóttir, Hildur, Haraldsdóttir, Sigrídur, Möller, Alma Dagbjört, Palsson, Runolfur, Jakobsdóttir, Jóhanna, Aspelund, Thor, Valdimarsdottir, Unnur
• Other Authors: Faculty of Medicine, Internal Medicine and Emergency Services, Faculty of Psychology, Mental Health Services, Cancer Center, Other departments, Office of Division of Clinical Services I, University of Iceland
• Format: Article in Journal/Newspaper
• Language: English
• Published: 2021
• Subjects: COVID-19; Faraldsfræði; Lýðheilsa; Geðheilsa; epidemiology; mental health; public health; SARS-CoV-2; Anxiety/epidemiology; Cross-Sectional Studies; Depression/epidemiology; Humans; Iceland/epidemiology; Morbidity; Medicine (all); Iceland
• Online Access: https://hdl.handle.net/20.500.11815/3103; https://doi.org/10.1136/bmjopen-2021-049967

Funding Information: Funding This study was supported by grants from the Icelandic government and NordForsk (Mental morbidity trajectories in COVID-19 across risk populations of five nations, grant 105668, Dr. UV). The funding sources had no role in the design and implementation of the study; in data collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Publisher Copyright: © Objective To test if patients recovering from COVID-19 are at increased risk of mental morbidities and to what extent such risk is exacerbated by illness severity. Design Population-based cross-sectional study. Setting Iceland. Participants A total of 22 861 individuals were recruited through invitations to existing nationwide cohorts and a social media campaign from 24 April to 22 July 2020, of which 373 were patients recovering from COVID-19. Main outcome measures Symptoms of depression (Patient Health Questionnaire), anxiety (General Anxiety Disorder Scale) and posttraumatic stress disorder (PTSD; modified Primary Care PTSD Screen for DSM-5) above screening thresholds. Adjusting for multiple covariates and comorbidities, multivariable Poisson regression was used to assess the association between COVID-19 severity and mental morbidities. Results Compared with individuals without a diagnosis of COVID-19, patients recovering from COVID-19 had increased risk of depression (22.1% vs 16.2%; adjusted relative risk (aRR) 1.48, 95% CI 1.20 to 1.82) and PTSD (19.5% vs 15.6%; aRR 1.38, 95% CI 1.09 to 1.75) but not anxiety (13.1% vs 11.3%; aRR 1.24, 95% CI 0.93 to 1.64). Elevated relative risks were limited to patients recovering from COVID-19 that were 40 years or older and were particularly high among individuals with university education. Among patients recovering from COVID-19, symptoms of depression were particularly common among those in the highest, compared with the lowest tertile of influenza-like symptom burden (47.1% vs ...