- Status:
- Preprint
- Posted:
Impact of COVID-19 on mental illness in vaccinated and unvaccinated people
This study examined associations of COVID-19 with subsequent mental illness in the pre-vaccination period of the pandemic and for unvaccinated and vaccinated people after vaccination became available.
Abstract
Background
COVID-19 is associated with subsequent mental illness in both hospital- and population-based studies. Evidence regarding effects of COVID-19 vaccination on mental health consequences of COVID-19 is limited.
Methods
With the approval of NHS England, we used linked electronic health records (OpenSAFELY-TPP) to conduct analyses in a ‘pre-vaccination’ cohort (17,619,987 people) followed during the wild-type/Alpha variant eras (January 2020-June 2021), and ‘vaccinated’ and ‘unvaccinated’ cohorts (13,716,225 and 3,130,581 people respectively) during the Delta variant era (June-December 2021). We estimated adjusted hazard ratios (aHRs) comparing the incidence of mental illness after diagnosis of COVID-19 with the incidence before or without COVID-19.
Results
We considered eight outcomes: depression, serious mental illness, general anxiety, post-traumatic stress disorder, eating disorders, addiction, self-harm, and suicide. Incidence of most outcomes was elevated during weeks 1-4 after COVID-19 diagnosis, compared with before or without COVID-19, in each cohort. Vaccination mitigated the adverse effects of COVID-19 on mental health: aHRs (95% CIs) for depression and for serious mental illness during weeks 1-4 after COVID-19 were 1.93 (1.88-1.98) and 1.42 (1.24-1.61) respectively in the pre-vaccination cohort and 1.79 (1.68-1.91) and 2.21 (1.99-2.45) respectively in the unvaccinated cohort, compared with 1.16 (1.12-1.20) and 0.91 (0.84-0.98) respectively in the vaccinated cohort. Elevation in incidence was higher, and persisted for longer, after hospitalised than non-hospitalised COVID-19.
Conclusions
Incidence of mental illness is elevated for up to a year following severe COVID-19 in unvaccinated people. Vaccination mitigates the adverse effect of COVID-19 on mental health. Funding: Medical Research Council (MC_PC_20059) and NIHR (COV-LT-0009).
- Venexia Walker, Praveetha Patalay, Jose Ignacio Cuitun Coronado, Rachel Denholm, Harriet Forbes, Jean Stafford, Bettina Moltrecht, Tom Palmer, Alex Walker, Ellen Thompson, Kurt Taylor, Genevieve Cezard, Elsie Horne, Yinghui Wei, Marwa Al Arab, Rochelle Knight, Louis Fisher, Jon Massey, Simon Davy, Amir Mehrkar, Seb Bacon, Ben Goldacre, Angela Wood, Nishi Chaturvedi, John Macleod, Ann John, Jonathan Sterne