Association of post-COVID phenotypic manifestations with new-onset psychiatric disease

Jun 8, 2024Translational psychiatry

New mental health problems linked to physical symptoms after COVID

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Abstract

Among 2,391,006 individuals with acute COVID-19, significant associations were found between non-psychiatric Post Acute Sequelae of SARS-CoV2 Infection (PASC-AMs) and newly diagnosed psychiatric disease.

Five categories of non-psychiatric PASC-AMs were significantly associated with an increased risk of new-onset psychiatric disease.
The highest odds ratios for psychiatric disease were linked to neurological (1.31), cardiovascular (1.29), and constitutional PASC-AMs (1.23).
Secondary analysis indicated differing proportions of 50 individual clinical features among patients with various psychiatric diagnoses.
The study highlights a potential link between multiple organ system features following COVID-19 and the incidence of psychiatric conditions.
Findings suggest a need for further prospective studies to confirm these associations.

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Acute COVID-19 infection can be followed by diverse clinical manifestations referred to as Post Acute Sequelae of SARS-CoV2 Infection (PASC). Studies have shown an increased risk of being diagnosed with new-onset psychiatric disease 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 new-onset psychiatric disease following COVID-19. A retrospective electronic health record (EHR) cohort study of 2,391,006 individuals with acute COVID-19 was performed to evaluate whether non-psychiatric PASC-AMs are associated with new-onset psychiatric disease. Data were obtained from the National COVID Cohort Collaborative (N3C), which has EHR data from 76 clinical organizations. EHR codes were mapped to 151 non-psychiatric PASC-AMs recorded 28-120 days following SARS-CoV-2 diagnosis and before diagnosis of new-onset psychiatric disease. Association of newly diagnosed psychiatric disease with age, sex, race, pre-existing comorbidities, and PASC-AMs in seven categories was assessed by logistic regression. There were significant associations between a diagnosis of any psychiatric disease and five categories of PASC-AMs with odds ratios highest for neurological, cardiovascular, and constitutional PASC-AMs with odds ratios of 1.31, 1.29, and 1.23 respectively. Secondary analysis revealed that the proportions of 50 individual clinical features significantly differed between patients diagnosed with different psychiatric diseases. Our study provides evidence for association between non-psychiatric PASC-AMs and the incidence of newly diagnosed psychiatric disease. Significant associations were found for features related to multiple organ systems. This information could prove useful in understanding risk stratification for new-onset psychiatric disease following COVID-19. Prospective studies are needed to corroborate these findings.

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Association of post-COVID phenotypic manifestations with new-onset psychiatric disease

Abstract

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