An interesting article published in The Lancet by Taquet and others November 9, 2020 look at the adverse mental health consequences of COVID-19, including anxiety and depression to evaluate whether there was an increased psychiatric risk from infection.

They studied electronic health records from 69 million individuals, 62,354 who had had a diagnosis of COVID-19, they assessed whether a diagnosis of COVID-19 compared with other health events was associated with an increased rate of subsequent psychiatric diagnosis, and whether patients with a history of psychiatric illness were at a higher risk of being diagnosed with COVID-19.

They used an analytics network known as TriNetX, which is a global federated network that captures anonymised data from electronic health records in 54 healthcare organisations within the United States and that is totalling 69.8 million patients.

This included the 62,354 patients diagnosed with COVID-19 between January 20 and August 1, 2020.

They measured the incidence of hazard ratios for psychiatric disorders, dementia and insomnia, during the first 14 to 90 days after diagnosis with COVID-19.

In patients with no previous psychiatric history, a diagnosis of COVID-19 was associated with increased incidence of a first psychiatric diagnosis in the following 14 to 90 days compared with six other health events.

The greatest were anxiety disorders, insomnia and dementia. They observed similar findings although with a smaller ratio when relapses and new diagnosis were measured.

The incidence of any psychiatric diagnosis in the 14 to 90 days after COVID-19 diagnosis was 18.1% including 5.8% that were a first diagnosis. The incidence of a first diagnosis of dementia in the 14 to 90 days after COVID-19 diagnosis was 1.6% in people older than 65 years old.

A psychiatric diagnosis in the previous year was associated with a higher incidence of COVID-19 diagnosis.
This risk was independent of known physical health risk factors for COVID-19 but could not exclude possible residual confounding by socioeconomic factors.

They concluded that survivors of COVID-19 appear to be at an increased risk of psychiatric sequalae, and a psychiatric diagnosis might be an independent risk factor for COVID-19.

The London General Practice believes that the follow-up of individuals who have had COVID-19 or who have suffered with mental health problems is paramount in ensuring that all aspects of this pandemic and patient suffering can be alleviated.

Dr Paul Ettlinger
London General Practice

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