The mental health burden of post COVID-19 condition: a Belgian population-based cohort study 3 months after COVID-19 infection

Details

Supervisors

Smith, Pierre

Faculty

Faculté de santé publique

Degree label

Master [120] en sciences de la santé publique, à finalité spécialisée

Abstract

Background: Since the onset of the COVID-19 pandemic, most research has focused on the pathophysiology and management of the acute symptoms of COVID-19, yet some people tend to experience symptoms beyond the acute phase, that is, Post COVID-19 condition (PCC). This study aimed (1) to assess the impact of a COVID-19 infection and PCC on anxiety and depression at the time of infection and after 3 months and (2) to identify the factors associated with a(n) (un)favorable evolution of the symptoms of anxiety and depression. Methods: This is a longitudinal cohort study of Belgian adult population with recent COVID-19 infection confirmed via a molecular test. A total of 3127 people were followed-up between the time of their infection and 3 months later (from April 2021 to January 2022). The study included two online questionnaires: a baseline questionnaire to assess the health status during the acute phase of the infection, and a follow-up questionnaire sent three months later. Anxiety and depression were assessed at the two stages of the study using the GAD-7 (Generalized Anxiety Disorder) and the PHQ-9 (Patient Health Questionnaire). Results: Three months after infection, people with PCC (50% of the sample) were significantly more likely to have an increase over time in depressive (β=0.76, p<0.001) and anxiety symptoms (β=0.84, p<0.001). The proportions of depressive and anxiety disorders were 19% and 11% in people with PCC, compared to 4% and 4% in people without symptom after 3 months. In the non-COVID matched control group, these proportions were 10% and 5%. Other factors were associated with worsening mental health over time in people infected with COVID-19, such as having at least one acute COVID-19 symptom (β=1.11, p<0.001), being fully vaccinated at the time of infection (β=0.47, p=0.006), experiencing financial loss following their infection (β=0.57, p<0.001), and different PCC symptoms (i.e. exhaustion, sleeping problems, dizziness, and memory problems). Conclusions: This study showed that three months after a COVID-19 infection, one in two people suffer from PCC with significant consequences for their mental health. This emerging health issue must therefore be taken into account in the organization of care and mental health care.