New Studies Further Define Mental and Physical Problems for Months After Acute COVID-19

In two new studies, investigators examined health outcomes in patients who have recovered from COVID-19. In one study, researchers evaluated 150,000 patients in the U.S. Veterans Affairs (VA) healthcare system and who survived at least 30 days after diagnosis of COVID-19 in 2020. Follow-up started 30 days after diagnosis with COVID-19 and averaged ≈1 year. Compared with patients in large non–COVID-19 control groups, patients recovering from COVID-19 were at significantly elevated risk for all 28 prespecified mental health disorders (e.g., anxiety disorders, depressive disorders, stress and adjustment disorders, opioid and nonopioid substance abuse disorders, neurocognitive decline, sleep disorders). Risks for all diagnoses were elevated significantly in those who were not hospitalized for acute COVID-19 and were even higher in those who were hospitalized. Patients recovering from COVID-19 also had significantly greater risks than those recovering from seasonal influenza and those who had non–COVID-19-related hospitalizations.

In another study, researchers used a U.S. Medicare Advantage insurance database to identify 88,000 older patients (age, ≥65) with COVID-19; 27% were hospitalized. One third of these patients sought medical attention for problems that either emerged during the postacute period (later than 20 days after diagnosis of COVID-19) or began during the acute period and continued into the postacute period. Compared with propensity-matched controls, the proportion of patients with late sequelae was 11% higher in the COVID-19 group overall and was 24% higher in the subgroup of hospitalized patients. Risk differences were greatest for respiratory failure (7.6%) and hypertension (4.4%); hazard ratios were highest for respiratory failure, thrombotic conditions, and encephalopathy. Hospitalized patients also had 9% higher risk for late sequalae than did controls who had non–COVID-19 viral lower respiratory tract infections.