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Illness severity and risk of mental morbidities among patients recovering from COVID-19: a cross-sectional study in the Icelandic population.
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.
  • Saevarsdóttir KS; Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland.
  • Hilmarsdóttir HÝ; Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland.
  • Magnúsdóttir I; Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland.
  • Hauksdóttir A; Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland.
  • Thordardottir EB; Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland.
  • Gudjónsdóttir ÁB; Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland.
  • Tomasson G; Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland.
  • Rúnarsdóttir H; Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland.
  • Jónsdóttir HL; Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland.
  • Gudmundsdóttir B; Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, School of Health Sciences, Reykjavik, Iceland.
  • Pétursdóttir G; Faculty of Psychology, University of Iceland School of Health Sciences, Reykjavik, Iceland.
  • Petersen PH; Faculty of Medicine, University of Iceland School of Health Sciences, Reykjavik, Iceland.
  • Kristinsson SY; Institute for Sustainability Studies, University of Iceland, Reykjavik, Iceland.
  • Love TJ; Faculty of Medicine, University of Iceland School of Health Sciences, Reykjavik, Iceland.
  • Hansdóttir S; Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland.
  • Hardardóttir H; Faculty of Medicine, University of Iceland School of Health Sciences, Reykjavik, Iceland.
  • Gudmundsson G; Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland.
  • Eythorsson E; Faculty of Medicine, University of Iceland School of Health Sciences, Reykjavik, Iceland.
  • Gudmundsdóttir DG; Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland.
  • Sigbjörnsdóttir H; Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland.
  • Haraldsdóttir S; Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland.
  • Möller AD; Faculty of Medicine, University of Iceland School of Health Sciences, Reykjavik, Iceland.
  • Palsson R; Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland.
  • Jakobsdóttir J; The Directorate of Health, Reykjavik, Iceland.
  • Aspelund T; The Directorate of Health, Reykjavik, Iceland.
  • Valdimarsdottir U; The Directorate of Health, Reykjavik, Iceland.
BMJ Open ; 11(7): e049967, 2021 07 23.
Article in English | MEDLINE | ID: covidwho-1322824
ABSTRACT

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 5.8%; aRR 6.42, 95% CI 2.77 to 14.87), among patients confined to bed for 7 days or longer compared with those never confined to bed (33.3% vs 10.9%; aRR 3.67, 95% CI 1.97 to 6.86) and among patients hospitalised for COVID-19 compared with those never admitted to hospital (48.1% vs 19.9%; aRR 2.72, 95% CI 1.67 to 4.44).

CONCLUSIONS:

Severe disease course is associated with increased risk of depression and PTSD among patients recovering from COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Etiology study / Prevalence study / Randomized controlled trials / Risk factors Topics: Long Covid Limits: Humans Country/Region as subject: Europa Language: English Journal: BMJ Open Year: 2021 Document Type: Article Affiliation country: Bmjopen-2021-049967

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Etiology study / Prevalence study / Randomized controlled trials / Risk factors Topics: Long Covid Limits: Humans Country/Region as subject: Europa Language: English Journal: BMJ Open Year: 2021 Document Type: Article Affiliation country: Bmjopen-2021-049967