Newly Diagnosed Anxiety, Mood, and Trauma-Related Disorders Following COVID-19 Infection Among U.S. Military Beneficiaries

Abstract

The long-term neuropsychiatric effects of COVID-19 are still unclear. Various mental health conditions are known to be influenced by biopsychosocial factors. We sought to investigate whether COVID-19 infection increases the risk for newly diagnosed anxiety, mood, or trauma and stressor-related disorders in individuals ages 12–64 years. We performed a retrospective cohort study using data from the Military Health System database (2018–2022). A propensity score match pairing each person with a COVID-19 diagnosis to two uninfected individuals was implemented, balancing matches across 1852 different variables representing medical records of procedures, diagnoses, and prescriptions in the year prior to COVID-19 infection. Exact matching was performed on sex, age in years, beneficiary type and month of entry into the cohort. We calculated the hazard ratios (HR) and Bonferroni-corrected confidence intervals (BoCI) for new mental health diagnoses using the Cox proportional hazards models. The initial matched cohort included 788,185 individuals. COVID-19 significantly increased the risk for newly diagnosed mental health conditions. The effect was strongest for trauma and stressor-related disorders (HR, 1.29; BoCI, 1.22–1.37), followed by mood disorders (HR, 1.22; BoCI, 1.15–1.30) and anxiety disorders (HR, 1.16; BoCI, 1.12–1.21). COVID-19 infection is associated with the subsequent diagnosis of a new mental health condition, including depressive, trauma and stressor-related, mood, and anxiety disorders. Our findings suggest that screening for mental health conditions should be a key part of post-COVID-19 care, and more work is needed to understand the biological reasons for this connection and consider the role of vaccines for prevention.