According to research that looked
at millions of health records in the US over a year, having Covid-19 puts
people at a significantly higher risk of developing new mental health issues,
potentially adding to existing crises of suicide and overdoses.
The long-term effects of having Covid are still being discovered,
and among them is an increased chance of being diagnosed with mental health
disorders. Depression, anxiety, stress, and an increased risk of substance use
disorders, cognitive decline, and sleep problems are among them — a marked
difference to those who felt the pandemic's stress but were not diagnosed with
the virus.
"This is telling us that millions and millions of people
infected with Covid in the United States are experiencing mental health
problems," said Ziyad Al-Aly, senior author of the paper and chief of
research and development at the VA St Louis Healthcare System. "That makes
us a nation in distress."
He is especially concerned about the higher risk for mental health
disorders, such as suicidal ideation and opioid use.
"This is almost a perfect storm brewing right in front of our
eyes," Al-Aly added, "for another opioid epidemic two or three years
down the road, for another suicide crisis two or three years down the
road."
These unfolding crises are "quite a big concern," said
James Jackson, director of behavioral health at Vanderbilt University's ICU
Recovery Center, who was not involved with this study. He's also seeing people
whose which was before conditions, such as anxiety, depression, and opioid use
disorder, have worsened due to the pandemic.
According to the experts, research like these shows the need to
follow patients in the weeks and months after even mild Covid diagnoses and
seek prompt medical attention for any emerging disorders. "We may save
lives if we pay attention to it now and nip it in the bud," Al-Aly added.
According to the study published on Wednesday, more than 18
percent of Covid patients suffered mental health problems, compared to only 12
percent of individuals who did not have Covid.
The researchers compared the health records of more than 153,000
patients who tested positive for Covid in the Veterans Affairs health system
between March 2020 and January 2021 with those of 5.8 million people who did
not test positive during that time but encountered the same pandemic stress and
5.6 million patients seen before the pandemic.
Covid patients were significantly more likely than non-Covid
patients to develop cognitive problems (80%), sleep disorders (41%), depression
(39%), stress (38%), anxiety (35%), and opioid use disorder (34%), among all
patients who developed new mental health problems during the pandemic.
The study only looked at people who had not had a mental health
diagnosis in the past two years. It compared the results of patients
hospitalized for Covid to those hospitalized for other illnesses, as well as
thousands of flu cases. Demographics, various health issues, and other factors
were all considered in this study.
The results were precise: Covid has a marked effect on mental
health.
Those with more severe cases of Covid, especially those who
require medical attention, are at a higher risk. Even those with mild or
asymptomatic signs were more likely to receive a mental disorder diagnosis.
"Individuals who were hospitalized had it worst," Al-Aly
added, "but the risk in non-hospitalized [patients] is significant and not
small – and that represents the majority of people in the US and the
world."
The study had some limitations, such as the fact that most of the
participants were older white men. But controlling for race, gender and age
found no changes in risk.
Other research has shown that coronavirus can be found in the
brain. "We can see the virus in the amygdala and the hippocampus, which
are the very centers responsible for regulating our moods and emotions,"
Al-Aly explained.
According to Jackson, the finding adds to other research that
shows "mental health difficulties are a big worry" after Covid. And
the results line up with what he sees among patients.
"We're finding out that Covid could be far more harmful and
impactful than we expected," Jackson added.
The experts said that early treatment of patients facing new or
additional mental health challenges after Covid could make a crucial
difference.
"The objective here is to identify patients' data early on in
the process, hopefully avoiding this from becoming a much larger problem down
the road," Al-Aly explained. "If you ignore a sickness, it will only
become worse."
However, the longer the virus is spread, the more long-term
difficulties it may cause, putting even more strain on healthcare systems.
"As a result of Covid and the epidemic, a wave of people with
mental health disorders is going to hit the clinics in the next year or two or
three," Al-Aly warned.
And many mental health practitioners don't accept insurance,
creating a significant stumbling block for patients, while others have long
waiting lists.
"This is a gigantic problem, and I'm not sure what we're
going to do about it," Jackson said. "The needs are vastly greater
than the resources."
Jackson has set up peer support groups to counsel patients dealing
with long Covid – brain fog, cognitive impairment, memory problems, feelings of
inadequacy. Patients from all over the country can join the groups because they
are held on Zoom.
"We need to pay attention to the long-term consequences of
Covid," Al-Aly said. "If we only consider the immediate consequences,
such as the first 30 or 90 days, we are completely missing the larger
picture."
"The pandemic itself caught the US unprepared, and we're going to be caught unprepared again for long, Covid," Al-Aly said. "The reality is that Covid is producing long-term consequences, and we cannot just wish it away or sweep it under the rug or not deal with it."