Publication date: Jan 21, 2025
Survivorship after coronavirus disease 2019 (COVID-19) critical illness may be associated with important long-term sequelae, but little is known regarding mental health outcomes. What is the association between COVID-19 critical illness and new post-discharge mental health diagnoses. AND METHODS: We conducted a population-based cohort study in Ontario, Canada (January 1, 2020-March 31, 2022). We included consecutive adult survivors (age ≥ 18 years) of COVID-19 critical illness, and compared them with consecutive adult survivors of critical illness from non-COVID-19 pneumonia. The primary outcome was a new mental health diagnosis (a composite of mood, anxiety, or related disorders; schizophrenia/psychotic disorders; and other mental health disorders) following hospital discharge. We compared patients using overlap propensity score-weighted, cause-specific proportional hazard models. We included 6,098 survivors of COVID-19 critical illness, and 2,568 adult survivors of critical illness from non-COVID-19 pneumonia at 102 centres. Incidence of new mental health diagnosis among survivors of COVID-19 critical illness was 25. 3 per 100-person years (95% confidence interval [CI] 24. 0-26. 6), and 25. 9 per 100-person years (95% CI: 24. 0-27. 8) among non-COVID-19 pneumonia. Following propensity weighting, COVID-19 critical illness was not associated with increased risk of new mental health diagnosis overall (hazard ratio [HR] 1. 08 [95% CI: 0. 96-1. 23]), but was associated with increased risk in the category of new mood, anxiety, or related disorders (HR 1. 21 [95% CI: 1. 05-1. 40]). No difference was seen in psychotic disorders, other mental health diagnoses, social problems, or deliberate self-harm. As compared to survival after critical illness from non-COVID-19 pneumonia, survival after COVID-19 critical illness was not associated with increased risk of the composite outcome of new mental health diagnosis, but was associated with elevated risk for new mood, anxiety, or related disorders.
| Concepts | Keywords |
|---|---|
| Canada | Chronic Critical Illness |
| Coronavirus | COVID-19 |
| Schizophrenia | Intensive Care |
| Therapy | Mental Health |
| Post-Intensive Care Syndrome | |
| Self-Harm | |
| Suicide |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | Morbidity |
| disease | MESH | COVID-19 |
| disease | MESH | Critical Illness |
| disease | MESH | sequelae |
| disease | MESH | pneumonia |
| disease | MESH | anxiety |
| disease | MESH | schizophrenia |
| disease | MESH | psychotic disorders |
| disease | MESH | social problems |
| disease | MESH | Post-Intensive Care Syndrome |
| disease | MESH | Suicide |