an increased risk of developing mental disorders, even after a year

⇧ [VIDÉO] You might also like this partner content (after ad)

According to a new study of millions of health records in the United States, over the course of a year, people who have contracted COVID-19 may be at increased risk for anxiety and depression, sometimes up to to suicide. As the COVID-19 pandemic enters its third year, consideration of long COVID must be effective.

More than 403 million people worldwide, including 77 million in the United States, have been infected with the virus since the start of the pandemic. There is evidence that COVID-19 can induce neurological complications, which vary from person to person. Studies so far have been limited in terms of the mental disorders taken into account (only depression and anxiety) and by a maximum follow-up of six months. A full assessment of mental health manifestations in people with COVID-19 at one year has not been undertaken. These disorders include anxiety, depression, and suicidal ideation, as well as opioid use disorders, illicit drug and alcohol use disorders, and sleep and cognition disorders.

It therefore seems essential, in the face of the resurgence of long-term COVIDs and their constellation of neuropsychiatric symptoms, to improve our understanding of the long-term risk of mental health disorders in people infected with the virus.

After the physical consequences, the mental sequelae…

In a large analysis of mental health outcomes, the team of Ziyad Al-Aly, a clinical epidemiologist at the University of Washington, tried to estimate the risks of these incident disorders in people infected with SARS-CoV-2. .

The researchers compiled data from 154,000 patients from the US Department of Veterans Health Care System (Veterans Health Administration) who had had no treatment or diagnosis for a mental disorder in the two years preceding their infection. They compared them to two control groups of more than 5 million individuals each: a contemporary group with no sign of SARS-CoV-2 and a “historical” control group, prior to the COVID-19 pandemic. They also specified the care setting during the acute phase of infection, i.e. whether or not there was hospitalization during the first 30 days of COVID-19. Ziyad Al-Aly, the lead author of the study, said in a statement: We know from previous studies and personal experiences that the immense challenges of the last two years of the pandemic have had a profound effect on our collective mental health. “.

Flowchart showing cohort selection (VHA = Veterans Health Administration). © Z. Al-Aly et al., 2022

Despite evidence showing that the burden of mental health disorders may have increased in the general population during the COVID-19 pandemic, researchers found that mental disorders occur within a year of recovering from infection in people with serious and mild infections.

Compared to those in control groups without any infection, people who contracted COVID-19 were 35% more likely to suffer from anxiety disorders. They were also almost 40% more likely to suffer from depression or stress-related disorders affecting behavior and emotions. This coincided with a 55% increase in the use of antidepressants and a 65% growth in the use of benzodiazepines to treat anxiety. There is also the use of non-opioid substances such as alcohol and illicit drugs.

Similarly, people who had recovered from COVID-19 were 41% more likely to have trouble sleeping and 80% to experience neurocognitive decline. This refers to forgetfulness, confusion, lack of concentration, and other impairments commonly referred to as “brain fog.”

Much more than a flu…

To better understand whether the increased risk of mental health disorders is specific to the SARS-CoV-2 virus, the researchers also compared COVID-19 patients with 72,207 influenza patients, including 11,924 hospitalized, from October 2017 to February 2020. People admitted to hospital for COVID-19 showed increased risks of mental health disorders on one side compared to those admitted to hospital for any other cause (between 27% and 45%), and of the other compared to those who were not admitted to hospital (nearly 86%). Note that sequelae have also been observed in people who have had a mild form of the disease.

Hope this dispels the idea that COVID-19 is like the flu said Al-Aly. ” It’s so much more serious “.

The authors raise an interesting point regarding a bidirectional link between COVID-19 and mental health disorders. In other words, it would appear that people with mental health disorders are at an increased risk of being infected with SARS-CoV-2 and having serious consequences. A better understanding of the interplay of mental health disorders both as a risk and a sequela of COVID-19 is needed.

The multitude of possible causes of mental disorders

The mechanism(s) for increased risks of mental health disorders in people with COVID-19 are not entirely clear.

Several potential mechanisms are being investigated, including peripheral T cell infiltration in brain parenchyma, microglia, and dysregulated astrocytes; disturbances in synaptic signaling of upper layer excitatory neurons. All of these causes generally overlap with the manifestations of genetic diseases associated with impaired cognition, depression, and other neuropsychiatric disorders.

Other probable mechanisms include a potential role of angiotensin-converting enzyme-mediated neuroinflammation and the indirect effect of a dysregulated immune response on the central nervous system.

Our results suggest a specific link between SARS-CoV-2 and mental health disorders “, continues Z. Al-Aly. ” We don’t know why, but one of the main hypotheses is that the virus can enter the brain and disrupt cellular and neural pathways, leading to mental health disorders. “.

However, the influence of non-biological mechanisms (changes in employment, financial problems, social isolation, trauma, grief, changes in diet and physical activity) on people with COVID-19 should not be diminished compared to to their contemporaries.

The authors of the study thus call for “greater medical attention” for long COVIDs in order to better understand this phenomenon and prevent it. ” It’s not just a respiratory virus. It is a systemic virus that can cause cognitive impairment and decline “, conclude the authors.

Research like this shows the clear need to follow patients in the weeks and months after even mild COVID-19 diagnoses. The integration of mental health care must be considered as a central element of post-COVID-19 care strategies. International agencies, national governments and health systems must develop and implement strategies to identify and treat those affected early, as society will have to deal with this emerging problem in the months and years to come. to come.

Source: The BMJ

Leave a Comment