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Association of psychiatric disorders with clinical diagnosis of long COVID in US veterans

Published online by Cambridge University Press:  05 February 2024

Kristen Nishimi Open the ORCID record for Kristen Nishimi [Opens in a new window] ,
Thomas C. Neylan ,
Daniel Bertenthal ,
Karen H. Seal  and
Aoife O'Donovan
Kristen Nishimi*
Affiliation:
Mental Health Service, San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
Thomas C. Neylan
Affiliation:
Mental Health Service, San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA Department of Neurology, University of California San Francisco, San Francisco, CA, USA
Daniel Bertenthal
Affiliation:
Mental Health Service, San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
Karen H. Seal
Affiliation:
Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA Integrative Health Service, San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA Department of Medicine, University of California San Francisco, San Francisco, CA, USA
Aoife O'Donovan*
Affiliation:
Mental Health Service, San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
*
Corresponding author: Kristen Nishimi; Email: kristen.nishimi@ucsf.edu; Aoife O'Donovan; Email: aoife.odonovan@ucsf.edu
Corresponding author: Kristen Nishimi; Email: kristen.nishimi@ucsf.edu; Aoife O'Donovan; Email: aoife.odonovan@ucsf.edu
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Abstract

Background

Psychiatric disorders may be a risk factor for long COVID, broadly defined as COVID-19 conditions continuing three months post-acute infection. In US Veterans with high psychiatric burden, we examined associations between psychiatric disorders and clinical diagnosis of long COVID.

Methods

We conducted a retrospective cohort study using health records from VA patients with a positive SARS-CoV-2 test from February 2020 to February 2023. Generalized linear models estimated associations between any psychiatric disorder and likelihood of subsequent diagnosis with long COVID (i.e. two or more long COVID clinical codes). Models were adjusted for socio-demographic, medical, and behavioral factors. Secondary models examined individual psychiatric disorders and age-stratified associations.

Results

Among 660 217 VA patients with positive SARS-CoV-2 tests, 56.3% had at least one psychiatric disorder diagnosis and 1.4% were diagnosed with long COVID. Individuals with any psychiatric disorder had higher risk for long COVID diagnosis in models adjusted for socio-demographic factors, vaccination status, smoking, and medical comorbidities (relative risk, RR = 1.28, 95% CI 1.21–1.35), with the strongest associations in younger individuals. Considering specific disorders, depressive, anxiety, and stress-related disorders were associated with increased risk for long COVID diagnoses (RRs = 1.36–1.48), but associations were in the opposite direction for substance use and psychotic disorders (RRs = 0.78–0.88).

Conclusions

Psychiatric disorder diagnoses were associated with increased long COVID diagnosis risk in VA patients, with the strongest associations observed in younger individuals. Improved surveillance, treatment, and prevention for COVID-19 and its long-term sequelae should be considered for individuals with psychiatric conditions.

Keywords

long COVIDpost-COVID-19 conditionspsychiatric disordersveterans
Type
Original Article
Information
Psychological Medicine , First View , pp. 1 - 9
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Copyright
Copyright © The Author(s), 2024. Published by Cambridge University Press

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