Association of Long COVID with mental health disorders: a retrospective cohort study using real-world data from the USA

Objectives Mental health disorders (MHD) rank third for US adult hospitalisations. Given the substantial prevalence of ‘Long COVID’ in SARS-CoV-2 survivors, this study aims to assess its association with increased MHD risk using extensive real-world data.Design A retrospective cohort study with prop...

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Main Authors: Yue Zhang, Vernon M Chinchilli, Paddy Ssentongo, Djibril M Ba
Format: Article
Language:English
Published: BMJ Publishing Group 2024-02-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/14/2/e079267.full
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author Yue Zhang
Vernon M Chinchilli
Paddy Ssentongo
Djibril M Ba
author_facet Yue Zhang
Vernon M Chinchilli
Paddy Ssentongo
Djibril M Ba
author_sort Yue Zhang
collection DOAJ
description Objectives Mental health disorders (MHD) rank third for US adult hospitalisations. Given the substantial prevalence of ‘Long COVID’ in SARS-CoV-2 survivors, this study aims to assess its association with increased MHD risk using extensive real-world data.Design A retrospective cohort study with propensity score matching was conducted. We used the International Classification of Diseases, 10th Revision codes to identify individuals with Long COVID status and COVID-19 histories. Multivariable stratified Cox proportional hazards regression analysis was conducted to determine the association of Long COVID status with MHD.Setting Data were sourced from the TriNetX database, spanning records from 1 October 2021 to 16 April 2023.Participants Two distinct cohorts were established: one comprising individuals diagnosed with Long COVID and another comprising individuals with no history of Long COVID or COVID-19. At the start of the study, none of the participants had a recorded MHD.Primary and secondary outcome measures The main outcome of interest was a composite diagnosis of MHD. Secondary outcomes were individual mental health conditions.Results The study included 43 060 control participants without Long COVID and 4306 Long COVID participants, demonstrating well-balanced distribution across all covariates. After adjusting for 4 demographic factors and 10 comorbidities, Long COVID was associated with MHD (adjusted HR, aHR 2.60; 95% CI 2.37 to 2.85). In subgroup analysis, Long COVID was associated with major depression disorder (aHR 3.36; 95% CI 2.82 to 4.00) and generalised anxiety disorder (aHR 3.44; 95% CI 2.99 to 3.96).Conclusions In this retrospective large real-world cohort study, Long COVID was associated with an increased risk of incident MHD. The MHD impact is significant considering the vast number of patients with Long COVID. Enhanced MHD screening among COVID-19 survivors should be a priority.
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spelling doaj.art-6f324f41879c480cace70047f9627f812024-03-06T23:35:08ZengBMJ Publishing GroupBMJ Open2044-60552024-02-0114210.1136/bmjopen-2023-079267Association of Long COVID with mental health disorders: a retrospective cohort study using real-world data from the USAYue Zhang0Vernon M Chinchilli1Paddy Ssentongo2Djibril M Ba3Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USADepartment of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USADepartment of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USADepartment of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USAObjectives Mental health disorders (MHD) rank third for US adult hospitalisations. Given the substantial prevalence of ‘Long COVID’ in SARS-CoV-2 survivors, this study aims to assess its association with increased MHD risk using extensive real-world data.Design A retrospective cohort study with propensity score matching was conducted. We used the International Classification of Diseases, 10th Revision codes to identify individuals with Long COVID status and COVID-19 histories. Multivariable stratified Cox proportional hazards regression analysis was conducted to determine the association of Long COVID status with MHD.Setting Data were sourced from the TriNetX database, spanning records from 1 October 2021 to 16 April 2023.Participants Two distinct cohorts were established: one comprising individuals diagnosed with Long COVID and another comprising individuals with no history of Long COVID or COVID-19. At the start of the study, none of the participants had a recorded MHD.Primary and secondary outcome measures The main outcome of interest was a composite diagnosis of MHD. Secondary outcomes were individual mental health conditions.Results The study included 43 060 control participants without Long COVID and 4306 Long COVID participants, demonstrating well-balanced distribution across all covariates. After adjusting for 4 demographic factors and 10 comorbidities, Long COVID was associated with MHD (adjusted HR, aHR 2.60; 95% CI 2.37 to 2.85). In subgroup analysis, Long COVID was associated with major depression disorder (aHR 3.36; 95% CI 2.82 to 4.00) and generalised anxiety disorder (aHR 3.44; 95% CI 2.99 to 3.96).Conclusions In this retrospective large real-world cohort study, Long COVID was associated with an increased risk of incident MHD. The MHD impact is significant considering the vast number of patients with Long COVID. Enhanced MHD screening among COVID-19 survivors should be a priority.https://bmjopen.bmj.com/content/14/2/e079267.full
spellingShingle Yue Zhang
Vernon M Chinchilli
Paddy Ssentongo
Djibril M Ba
Association of Long COVID with mental health disorders: a retrospective cohort study using real-world data from the USA
BMJ Open
title Association of Long COVID with mental health disorders: a retrospective cohort study using real-world data from the USA
title_full Association of Long COVID with mental health disorders: a retrospective cohort study using real-world data from the USA
title_fullStr Association of Long COVID with mental health disorders: a retrospective cohort study using real-world data from the USA
title_full_unstemmed Association of Long COVID with mental health disorders: a retrospective cohort study using real-world data from the USA
title_short Association of Long COVID with mental health disorders: a retrospective cohort study using real-world data from the USA
title_sort association of long covid with mental health disorders a retrospective cohort study using real world data from the usa
url https://bmjopen.bmj.com/content/14/2/e079267.full
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