New research has revealed a concerning link between severe cases of COVID-19 and an increased risk of mental health disorders, with unvaccinated individuals being particularly vulnerable. According to a study published in JAMA Psychiatry, those who have not received a COVID-19 vaccine are at a significantly higher risk of developing conditions such as depression, anxiety, and post-traumatic stress disorder (PTSD) after contracting the virus.
The study highlights that while the incidence of mental health issues surged following a COVID-19 diagnosis, the risk was notably reduced in individuals who had been vaccinated. Among the unvaccinated, the elevated incidence of mental illnesses persisted for up to a year following severe COVID-19.
The research also underscores the heightened vulnerability of those hospitalized due to COVID-19, with the risk of mental health conditions being particularly pronounced in these cases. The study found that older adults and men were more likely to experience these adverse outcomes compared to younger individuals and women.
Dr. Jonathan Sterne, a professor of medical statistics and epidemiology at the University of Bristol Medical School and one of the study’s authors, noted in an email that “the main surprise was that the association of COVID-19 with subsequent mental ill-health appeared restricted to severe COVID-19 that led to hospitalization. There was little association of COVID-19 that did not lead to hospitalization with subsequent mental ill-health.”
The study involved analyzing electronic health records of three groups of adults in England, covering the period from January 2020 to December 2021. It compared mental health outcomes among those diagnosed with COVID-19 before vaccines were available, those who were unvaccinated but later contracted the virus, and those who were vaccinated at the time of infection.
Overall, depression emerged as the most common mental health condition post-COVID-19. The study found that the incidence of depression in the four weeks following a COVID-19 diagnosis was nearly twice as high among those who contracted the virus before vaccines were available and significantly higher among the unvaccinated compared to the vaccinated group.
For individuals hospitalized with severe COVID-19, the risk of depression was starkly elevated. Among those who had COVID-19 before vaccines, the likelihood of developing depression was 16.3 times higher if they were hospitalized, compared to a 1.22 times increase without hospitalization.
Dr. Venexia Walker, a senior research fellow in epidemiology at the University of Bristol and one of the study’s lead authors, emphasized the public health implications of these findings, stating, “Our findings have important implications for public health and mental health service provision, as serious mental illnesses are associated with more intensive healthcare needs and longer-term health and other adverse effects.”
The timing of this study is particularly relevant as the U.S. faces a significant COVID-19 wave, with wastewater data indicating the highest levels of viral activity recorded during a summer surge since July 2022. Meanwhile, the U.S. Food and Drug Administration is expected to authorize updated COVID-19 vaccines for the upcoming fall and winter seasons.
However, Dr. Dan Barouch, director of the Center for Virology and Vaccine Research at Beth Israel Deaconess Medical Center, who was not involved in the study, cautioned that the findings may not fully apply to the current situation. “This study looks at individuals from 2020 and 2021, before the Omicron variant and widespread vaccination. The population now has much higher immunity, either from vaccination or prior infection,” Barouch explained.
The study’s findings align with previous research indicating that COVID-19 can have lasting effects on the brain, leading to various mental health disorders. Dr. Ziyad Al-Aly, a clinical epidemiologist at Washington University School of Medicine in St. Louis, who has studied mental health outcomes in COVID-19 patients, noted that the results reinforce the understanding that COVID-19 can leave a “mark on the brain” in the form of mental health issues.
Al-Aly further elaborated that the increased incidence of mental illness in severe COVID-19 cases could be due to the virus itself or the general stress and challenges of hospitalization. He pointed out that while hospitalization for any severe illness can elevate the risk of mental health problems, COVID-19 appears to have a uniquely strong impact.
In a separate study published last year in The Lancet Infectious Diseases, Al-Aly and his team found that patients hospitalized with COVID-19 had a much higher risk of developing neuropsychiatric disorders compared to those hospitalized with the flu. “It’s very clear that something about COVID-19 generates a higher risk of neuropsychiatric problems,” he said.
As the pandemic evolves and vaccination rates increase, understanding the long-term mental health implications of COVID-19 remains crucial, particularly for those who experienced severe illness before vaccines were widely available. The study’s findings serve as a reminder of the ongoing need for mental health support and resources for those affected by the pandemic.