Paris, France — While anxiety and depression are more common in people who have experienced symptoms of Covid-19, infection with the SARS-CoV2 virus is not in itself a risk factor for impaired mental health . This is revealed by a French study, which analyzed data from more than 40,000 participants from the national cohort. EpiCov (Epidemiology and living conditions linked to Covid-19) .
Published in the JAMAthe results show that there is no association in the general population between a positive serology for SARS-CoV2 and the risk of developing anxiety or depression eight months later.
“What challenges is that the association is observed in people who report symptoms of Covid-19, but who have negative serology”, commented to Medscape French editionthe Pre Alexandra Rouquette (Center for Research in Epidemiology and Population Health, Inserm 1018), main author of the study.
Depression and anxiety up 25%
The Covid-19 pandemic has led to a deterioration in mental health manifested by the appearance of depressive and anxious symptoms, as well as sleep problems and suicidal thoughts. According to’World Health Organization (WHO), cases of depression and anxiety have increased by 25% worldwide due to the pandemic.
Isolation, fear of infection and suffering for oneself and loved ones, as well as successive restrictions have been all stress factors that have favored the rise of anxiety and depression in the population. general. Infection, particularly when it is persistent and manifested by severe symptoms, is also mentioned as a risk factor for the deterioration of mental health.
The High Authority of Health (HAS) has also recently published a sheet devoted to the psychiatric and psychological disorders associated with the prolonged symptoms of Covid-19. The document characterizes the main disorders (depressive, anxiety, post-traumatic stress, etc.) and offers recommendations regarding their diagnosis and treatment.
“In patients with prolonged symptoms after an episode of Covid-19, anxious and depressive symptoms concern approximately 15% of patients who have been hospitalized and 30% of patients who have not been hospitalized”, notes the HAS.
In this new study, Pr Rouquette and her colleagues from Center for Research in Epidemiology and Population Health (CESP) wanted to study the link between the symptomatology of Covid-19 reported by patients and the development of anxiety or depression and then analyze this association by comparing it with the serology of individuals.
8% depression at eight months
The study was carried out using data from the national cohort in the general population EpiCov (Epidemiology and living conditions linked to Covid-19) which has been monitoring the state of health of more than 85,000 people since May 2020. In total, the data chosen and analyzed concern more than 45,000 volunteers who accepted a blood sample to determine if there has been contact with the virus.
Randomly selected to have a cohort representative of the general population, the volunteers were asked to answer a questionnaire, in particular to report any symptoms suggestive of Covid-19: sudden or unusual loss of taste or smell, occurrence of an episode of fever associated with coughing, difficulty breathing, shortness of breath, or chest tightness.
Serology was also performed to look for the presence of antibodies against the SARS-Cov2 virus, which is considered indicative of contact, even asymptomatic, with the virus. Without this serology, “it was not possible to certify that the symptoms reported were indeed linked to an infection with the virus”, commented Pre Rouquette.
At eight months, the rates of depression and anxiety for the entire cohort are 8% and 5.3% respectively. The analysis shows that people who reported Covid-19-like symptoms had a 57% increased risk of anxiety (OR=1.57, 95% CI, [1,29-1,92]), while the risk of developing depression is increased by 70% (OC=1.70, 95% CI, [1,45-1,99]), compared to those who did not report symptoms.
By comparing with serology, there does not appear to be a significant increase. In other words, a positive or negative serology is not correlated with an increased risk of anxiety or depressive disorder. In this cohort, “SARS-CoV2 infection does not appear to be a risk factor for depression or anxiety”, comment the authors.
Identify risk factors
If exposure to the SARS-CoV2 virus does not seem to have an impact on the risk of anxiety or depression, the study shows on the other hand that the fact of feeling symptoms suggestive of Covid-19 is an aggravating factor which exposes more to this risk in the months that follow, whether or not the person has been in contact with the virus.
“We found the association between the symptoms of Covid-19 and the risk of anxiety and depression in the positive serology group and in the negative serology group, which makes it possible to say that there are other factors than the infection by SARS-CoV2 to explain this association between symptoms and anxiety or depression”, underlined the Pre Rouquette.
This association could also vary depending on the severity and nature of the symptoms. “In the case of the long Covid, several studies have shown that the anxiety-depressive symptoms are not necessarily linked to the infection, but rather to certain symptoms, such as intellectual fog, fatigue or respiratory disorders reported by patients” , specifies the epidemiologist.
“These results suggest that SARS-CoV2 infection is not a risk factor for long-term mental health impairment. However, research is needed to identify factors other than SARS-CoV2 infection involved in the association between Covid-19-like symptoms and mental health problems,” the authors concluded.
After identification of the risk factors, these could be the target of preventive measures to limit the psychological consequences in people who experience this type of symptom, even without having been infected with SARS-Cov2.
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