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SO071

Severe COVID-19 infection and the subsequent risk of mental illness in patients and their family members

SEVERE COVID-19 INFECTION AND SUBSEQUENT MENTAL ILLNESS RISK AMONG PATIENTS AND THEIR FAMILY MEMBERS

Patients hospitalized for severe COVID-19 and their family members, particularly female spouses, have an increased subsequent risk of mental illness, and this association is stronger than that observed with severe influenza.

The aim of the study was to examine the association between severe COVID-19 infection and the subsequent risk of mental illness in patients and their family members. Swedish national registers were used to identify individuals hospitalized for COVID-19 between 2020 and 2022 (including intensive care admissions), who were compared with individuals without a hospital diagnosis of severe COVID-19, matched 1:10 by age and sex; a severe influenza cohort from 2017–2019 was used as a comparison group, and both patients and cohorts of parents, children, siblings, and spouses were followed. The patient cohort included 30,883 exposed and 308,830 matched unexposed individuals (mean age, 62.8 years; 68.0% male); outcomes were diagnoses of depression, anxiety, and stress-related disorders; prescriptions for antidepressants, anxiolytics, or hypnotics; suicide attempts; and death by suicide. Severe COVID-19 was associated with an increased risk of any mental illness (hazard ratio [HR] in men, 2.87; 95% CI, 2.70–3.04; HR in women, 2.50; 95% CI, 2.30–2.73); HRs for a clinical psychiatric diagnosis were 4.21 (3.39–5.22) in men and 3.11 (2.35–4.12) in women, for anxiety disorders 5.54 (4.13–7.43) and 4.92 (3.36–7.20), and for hypnotic prescriptions 5.48 (5.11–5.87) and 4.21 (3.76–4.71), respectively. Risk was also elevated among family members; the most pronounced increase was observed among spouses (HR in men, 1.61; 1.40–1.86; HR in women, 1.70; 1.56–1.85), while HRs were 1.19 (1.10–1.28) and 1.12 (1.04–1.19) in children, and 1.14 (1.03–1.26) and 1.10 (1.00–1.22) in siblings; among parents, the association was not significant in men (1.13; 0.97–1.30). The risk of mental illness was higher following severe COVID-19 than following severe influenza (HR in men, 1.62; 1.38–1.89; HR in women, 2.00; 1.61–2.50), a sibling comparison analysis yielded similar results (HR for any mental illness, 2.68; 2.34–3.06), and the association persisted after accounting for the competing risk of death (sHR, 2.61; 2.50–2.72). In conclusion, integrated mental health care focusing on both patients and their families is needed following severe infections.

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