Risk of new‐onset psychiatric sequelae of <scp>COVID</scp>‐19 in the early and late post‐acute phase

Coleman, Benjamin; Casiraghi, E.; Blau, Hannah; Chan, Lauren; Haendel, Melissa; Laraway, Bryan; Callahan, Tiffany J; Deer, Rachel; Wilkins, Kenneth J.; Reese, Justin; Robinson, Peter N.

doi:10.1002/wps.20992

Cited by 19 publications

(30 citation statements)

References 10 publications

(15 reference statements)

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“…However, the absolute risk of experiencing a psychiatric disorder decreases sharply after the first month, 27 and two studies suggest the risk returns to baseline after 120 days. 8,11 We cannot determine the degree to which the observed increased risk is specifically related to PASC. Anxiety, depression, and post-traumatic stress disorder may be observed in individuals following critical illness.…”

Section: Discussionmentioning

confidence: 99%

“…P-values were adjusted using Bonferroni correction. 8 To focus on COVID-related psychiatric disease, we only considered the first occurrence of any psychiatric disease in the early post-acute phase. HPO-encoded PASC manifestations were only included if they occurred in the early post-covid phase and prior to the outcome of psychiatric disease (if any).…”

Section: Discussionmentioning

confidence: 99%

“…FIve studies, including our own, have performed large-scale EHR analyses that show significant and consistent but modest associations between SARS-CoV-2 infection and increased rates of psychiatric disorders. 7,8,11,27,28 Differences in cumulative risk between patients who had COVID-19 and those who had other respiratory tract infections persist for at least 12 months. However, the absolute risk of experiencing a psychiatric disorder decreases sharply after the first month, 27 and two studies suggest the risk returns to baseline after 120 days.…”

Section: Discussionmentioning

confidence: 99%

“…For this study, we chose a definition that is consistent with our prior work on the psychiatric sequelae of COVID-19. 8 To determine whether this had a large effect on our results, we repeated our regression analysis using the alternative definitions of 21 days after initial diagnosis for outpatients and 21 days after discharge for inpatients, and 14 days after diagnosis for both inpatients and outpatients. 2…”

Section: Sensitivity Analysesmentioning

confidence: 99%

“…Additionally, comorbidities were only considered if they were recorded in the pre-covid phase. The early post-acute phase (21-120 days after diagnosis) represents the period when most patients would have recovered from acute COVID-19 but are at the highest risk for newly diagnosed psychiatric disease 8. To focus on COVID-related psychiatric disease, we only considered the first occurrence of any psychiatric disease in the early post-acute phase.…”

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confidence: 99%

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Post-COVID Phenotypic Manifestations are Associated with New-Onset Psychiatric Disease: Findings from the NIH N3C and RECOVER Studies

Coleman

Casiraghi

Callahan

et al. 2022

Preprint

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Acute COVID-19 infection can be followed by persistent or newly diagnosed manifestations in many different organ systems, referred to as Post Acute Sequelae of SARS-CoV2 Infection (PASC). Numerous studies have shown an increased risk of being diagnosed with new-onset psychiatric disease in the first 21-120 days following a diagnosis of acute COVID-19. However, it was unclear whether non-psychiatric PASC-associated manifestations (PASC-AMs) are associated with an increased risk of receiving a diagnosis of new-onset psychiatric disease following COVID-19. Here, we perform a retrospective electronic health record (EHR) cohort study to evaluate whether non-psychiatric PASC-AMs can predict whether patients will receive a diagnosis of new-onset psychiatric disease. Data were obtained from the National COVID Cohort Collaborative (N3C), which has EHR data from 65 clinical organizations which are harmonized using the Observational Medical Outcomes Partnership (OMOP) data model. Non-psychiatric PASC-AMs were recorded 21-120 days following SARS-CoV-2 diagnosis and before diagnosis of new-onset psychiatric disease. OMOP codes were mapped to 178 Human Phenotype Ontology (HPO) terms that represent PASC-AMs. Logistic regression was applied to predict newly diagnosed psychiatric disease occurrence based on age, sex, race, pre-existing comorbidities, and PASC-AMs in eleven categories. The cohort of 1,135,973 individuals with acute COVID-19 had a mean age of 40.5 years and included 56.0% females. We found a significant association for seven of the HPO categories with newly diagnosed psychiatric disease, with odds ratios highest for neurological (2.30, 2.24-2.36) and cardiovascular (1.77, 1.69-1.85) PASC-AMs. Secondary analysis revealed that the proportions of 95 of 154 individual phenotypic features differed significantly among patients diagnosed with different psychiatric diseases (anxiety, mood disorders, dementia, and psychosis). Neurological, pulmonary, gastrointestinal, endocrine, cardiovascular, constitutional, and ENT PASC-AMs are each associated with an increased risk of newly diagnosed psychiatric disease. This suggests that the total burden of PASC-AMs influences the risk of receiving a diagnosis of a new-onset psychiatric disease. This finding may be used to inform psychiatric screening following acute COVID-19 by identifying high-risk patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Sensitivity Analysesmentioning

confidence: 99%

mentioning

confidence: 99%

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Post-COVID Phenotypic Manifestations are Associated with New-Onset Psychiatric Disease: Findings from the NIH N3C and RECOVER Studies

Coleman

Casiraghi

Callahan

et al. 2022

Preprint

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Association of Recent SARS-CoV-2 Infection With New-Onset Alcohol Use Disorder, January 2020 Through January 2022

et al. 2023

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ImportanceThe COVID-19 pandemic affects many diseases, including alcohol use disorders (AUDs). As the pandemic evolves, understanding the association of a new diagnosis of AUD with COVID-19 over time is required to mitigate negative consequences.ObjectiveTo examine the association of COVID-19 infection with new diagnosis of AUD over time from January 2020 through January 2022.Design, Setting, and ParticipantsIn this retrospective cohort study of electronic health records of US patients 12 years of age or older, new diagnoses of AUD were compared between patients with COVID-19 and patients with other respiratory infections who had never had COVID-19 by 3-month intervals from January 20, 2020, through January 27, 2022.ExposuresSARS-CoV-2 infection or non–SARS-CoV-2 respiratory infection.Main Outcomes and MeasuresNew diagnoses of AUD were compared in COVID-19 and propensity score–matched control cohorts by hazard ratios (HRs) and 95% CIs from either 14 days to 3 months or 3 to 6 months after the index event.ResultsThis study comprised 1 201 082 patients with COVID-19 (56.9% female patients; 65.7% White; mean [SD] age at index, 46.2 [18.9] years) and 1 620 100 patients with other respiratory infections who had never had COVID-19 (60.4% female patients; 71.1% White; mean [SD] age at index, 44.5 [20.6] years). There was a significantly increased risk of a new diagnosis of AUD in the 3 months after COVID-19 was contracted during the first 3 months of the pandemic (block 1) compared with control cohorts (HR, 2.53 [95% CI, 1.82-3.51]), but the risk decreased to nonsignificance in the next 3 time blocks (April 2020 to January 2021). The risk for AUD diagnosis increased after infection in January to April 2021 (HR, 1.30 [95% CI, 1.08-1.56]) and April to July 2021 (HR, 1.80 [95% CI, 1.47-2.21]). The result became nonsignificant again in blocks 7 and 8 (COVID-19 diagnosis between July 2021 and January 2022). A similar temporal pattern was seen for new diagnosis of AUD 3 to 6 months after infection with COVID-19 vs control index events.Conclusions and RelevanceElevated risk for AUD after COVID-19 infection compared with non–COVID-19 respiratory infections during some time frames may suggest an association of SARS-CoV-2 infection with the pandemic-associated increase in AUD. However, the lack of excess hazard in most time blocks makes it likely that the circumstances surrounding the pandemic and the fear and anxiety they created also were important factors associated with new diagnoses of AUD.

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Acute stress symptoms in general population during the first wave of COVID lockdown in Italy: Results from the COMET trial

Carmassi,

Sampogna,

Di Vincenzo

et al. 2023

Brain and Behavior

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BackgroundThe coronavirus disease of 2019 (COVID‐19) pandemic is an unprecedented traumatic event that has severely impacted social, economic, and health well‐being worldwide. The COvid Mental hEalth Trial was specifically designed to evaluate the impact of the COVID‐19 pandemic and its containment measures on the mental health of the Italian general population in terms of COVID‐19‐related acute stress disorder (ASD) symptoms.MethodsThe present cross‐sectional study is based on an online survey carried out in the period March–May 2020. Italian general adult population was invited to compile an anonymous survey, which included the severity of acute stress symptoms scale/National Stressful Events Survey Short Scale to investigate the occurrence and severity of ASD symptoms.ResultsThe final sample consisted of 20,720 participants. During the lockdown, subjects with pre‐existing mental health problems reported a statistically significant higher risk of acute post‐traumatic symptoms compared to the general population (B: 2.57; 95% CI:2.04–3.09; p < .0001) and health care professionals (B: .37; 95% CI: .02–0.72; p < .05). According to multivariate regression models, the levels of acute post‐traumatic symptoms (p < .0001) were higher in younger and female respondents. Social isolation and sleep disorder/insomnia represented positive predictors of acute stress (B = 3.32, 95% CI = 3.08–3.57).ConclusionsConcerns about the risk of infection as well as social isolation caused a higher incidence of acute post‐traumatic stress symptoms that may predict the subsequent development of post‐traumatic stress disorder symptoms in the long term.

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Risk of new‐onset psychiatric sequelae of COVID‐19 in the early and late post‐acute phase

Cited by 19 publications

References 10 publications

Post-COVID Phenotypic Manifestations are Associated with New-Onset Psychiatric Disease: Findings from the NIH N3C and RECOVER Studies

Post-COVID Phenotypic Manifestations are Associated with New-Onset Psychiatric Disease: Findings from the NIH N3C and RECOVER Studies

Association of Recent SARS-CoV-2 Infection With New-Onset Alcohol Use Disorder, January 2020 Through January 2022

Acute stress symptoms in general population during the first wave of COVID lockdown in Italy: Results from the COMET trial

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