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COVID-19 and Mental Illnesses in Vaccinated and Unvaccinated People
Venexia M. Walker,
Praveetha Patalay,
Jose Ignacio Cuitun Coronado,
Rachel Denholm,
Harriet Forbes,
Jean Stafford,
Bettina Moltrecht,
Tom Palmer,
Alex Walker,
Ellen J. Thompson,
Kurt Taylor,
Genevieve Cezard,
Elsie M. F. Horne,
Yinghui Wei,
Marwa Al Arab,
Rochelle Knight,
Louis Fisher,
Jon Massey,
Simon Davy,
Amir Mehrkar,
Seb Bacon,
Ben Goldacre,
Angela Wood,
Nishi Chaturvedi,
John Macleod,
Ann John,
Jonathan A. C. Sterne,
(Longitudinal Health and Wellbeing COVID-19 National Core Study),
Agnieszka Lemanska,
Alex Kwong ,
Alexia Sampri,
Alicja Rapala,
Alisia Carnemolla,
Alun Hughes,
Amelia Green,
Amos Folarin,
Amy Roberts ,
Ana Goncalves Soares,
Andrew Steptoe,
Andrew Wong,
Andy Boyd,
Andy Gibson,
Anika Knueppel ,
Anoop Shah,
Archie Campbell,
Arun Kanagaratnam,
Arun Karthikeyan Suseeladevi ,
Bang Zheng ,
Betty Raman,
Bo Hou,
Bozena Wielgoszewska,
Brain Mackenna ,
Callum Stewart,
Chao Fang,
Charis Bridger-Staatz,
Charlotte Booth ,
Chelsea Beckford,
Chloe Park,
Claire Steves,
Colm Andrews,
Daniel McCartney ,
Daniel Kopasker ,
Diane Foster,
Dominik Piehlmaier,
Dylan Williams,
Edward Parker,
Elena Rafeti ,
Elena Lukaschuk ,
Elizabeth Tunnicliffe ,
Ellena Badrick,
Emily Herrett,
Emma L Turner,
Eoin McElroy,
Fatima Almaghrabi ,
Felix Greaves,
Fintan McArdle,
Fiona Glen,
Francisco Perez-Reche,
Gareth Griffith,
George Ploubidis,
Gillian Santorelli,
Giorgio Di Gessa,
Hannah Woodward,
Helen Curtis ,
Annie Herbert,
Ian Douglas,
Jacqui Oakley,
James M Wild,
Jane Maddock,
JD Carpentieri,
Jess Morley,
Jingmin Zhu,
John Tazare,
John Wright,
John Kellas,
Jonathan Kennedy,
Kate Northstone,
Kate Tilling,
Kate Mansfield,
Katharine M Evans,
Kathryn Mansfield ,
Kathryn Willan,
Kevin Wang,
Kirsteen C Campbell,
Kishan Patel,
Laura Fox,
Laura Sheard,
Laura C Saunders,
Laurie Tomlinson,
Lee Hamill Howes,
Liam Smeeth ,
Lidia Nigrelli,
Linda Nab,
Lisa Hopcroft ,
Lizzie Huntley,
Louise Jones,
Lucy Finnigan ,
Lucy Teece,
Mark Green ,
Matthew Crane,
Maxim Freydin,
Michael Parker,
Michael Green,
Milla Kibble,
Nathan Cheetham,
Nicholas Timpson,
Olivia Hamilton,
Paola Zaninotto,
Paz Garcia,
Peter Jezzard,
Rebecca Whitehorn,
Rebecca Rhead,
Renin Toms,
Richard Thomas,
Richard Silverwood,
Richard Dobson,
Robert Willans,
Robin Flaig ,
Rosie McEachan,
Ruth Mitchell,
Ruth Bowyer,
Ruth Costello,
Sam Parsons,
Samantha Berman,
Samantha Ip,
Sarah Baz,
Scott Walker,
Shah Syed Ahmar,
Richard Shaw,
Sheikh Aziz,
Sinead Langan,
Sinead Brophy ,
Spiros Denaxas,
Stefan Neubauer ,
Stefan Piechnik ,
Stela McLachlan,
Stephen Smith ,
Steve Sharp,
Teri North ,
Theocharis Kromydas ,
Thomas Cowling,
Tiffany Yang,
Tom Bolton ,
Vanessa Ferreira ,
Vittal Katikireddi ,
Viyaasan Mahalingasivam,
Wels Jacques,
William Hulme,
Yatharth Ranjan,
Zeena-Britt Sanders ,
Ann John 
JAMA Psychiatry, Volume: 81, Issue: 11, Pages: 1071 - 1080
Swansea University Author:
Ann John
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DOI (Published version): 10.1001/jamapsychiatry.2024.2339
Abstract
Importance: Associations have been found between COVID-19 and subsequent mental illness in both hospital- and population-based studies. However, evidence regarding which mental illnesses are associated with COVID-19 by vaccination status in these populations is limited. Objective: To determine which...
| Published in: | JAMA Psychiatry |
|---|---|
| ISSN: | 2168-622X 2168-6238 |
| Published: |
American Medical Association (AMA)
2024
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| Online Access: |
Check full text
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa67602 |
| Abstract: |
Importance: Associations have been found between COVID-19 and subsequent mental illness in both hospital- and population-based studies. However, evidence regarding which mental illnesses are associated with COVID-19 by vaccination status in these populations is limited. Objective: To determine which mental illnesses are associated with diagnosed COVID-19 by vaccination status in both hospitalized patients and the general population. Design, Setting, and Participants: This study was conducted in 3 cohorts, 1 before vaccine availability followed during the wild-type/Alpha variant eras (January 2020-June 2021) and 2 (vaccinated and unvaccinated) during the Delta variant era (June-December 2021). With National Health Service England approval, OpenSAFELY-TPP was used to access linked data from 24 million people registered with general practices in England using TPP SystmOne. People registered with a GP in England for at least 6 months and alive with known age between 18 and 110 years, sex, deprivation index information, and region at baseline were included. People were excluded if they had COVID-19 before baseline. Data were analyzed from July 2022 to June 2024. Exposure: Confirmed COVID-19 diagnosis recorded in primary care secondary care, testing data, or the death registry. Main Outcomes and Measures: Adjusted hazard ratios (aHRs) comparing the incidence of mental illnesses after diagnosis of COVID-19 with the incidence before or without COVID-19 for depression, serious mental illness, general anxiety, posttraumatic stress disorder, eating disorders, addiction, self-harm, and suicide. Results: The largest cohort, the pre–vaccine availability cohort, included 18 648 606 people (9 363 710 [50.2%] female and 9 284 896 [49.8%] male) with a median (IQR) age of 49 (34-64) years. The vaccinated cohort included 14 035 286 individuals (7 308 556 [52.1%] female and 6 726 730 [47.9%] male) with a median (IQR) age of 53 (38-67) years. The unvaccinated cohort included 3 242 215 individuals (1 363 401 [42.1%] female and 1 878 814 [57.9%] male) with a median (IQR) age of 35 (27-46) years. Incidence of most outcomes was elevated during weeks 1 through 4 after COVID-19 diagnosis, compared with before or without COVID-19, in each cohort. Incidence of mental illnesses was lower in the vaccinated cohort compared with the pre–vaccine availability and unvaccinated cohorts: aHRs for depression and serious mental illness during weeks 1 through 4 after COVID-19 were 1.93 (95% CI, 1.88-1.98) and 1.49 (95% CI, 1.41-1.57) in the pre–vaccine availability cohort and 1.79 (95% CI, 1.68-1.90) and 1.45 (95% CI, 1.27-1.65) in the unvaccinated cohort compared with 1.16 (95% CI, 1.12-1.20) and 0.91 (95% CI, 0.85-0.98) in the vaccinated cohort. Elevation in incidence was higher and persisted longer after hospitalization for COVID-19. Conclusions and Relevance: In this study, incidence of mental illnesses was elevated for up to a year following severe COVID-19 in unvaccinated people. These findings suggest that vaccination may mitigate the adverse effects of COVID-19 on mental health. |
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| College: |
Faculty of Medicine, Health and Life Sciences |
| Funders: |
This work was supported by the COVID-19 Longitudinal Health and Wellbeing National Core Study, which is funded by the Medical Research Council (MRC) (MC_PC_20059) and the National Institute for Health and Care Research (NIHR) (COV-LT-0009). Dr V. Walker is also supported by the Medical Research Council (MRC) Integrative Epidemiology Unit at the University of Bristol (MC_UU_00032/03). Dr Wei was supported by a UK Research and Innovation (UKRI) MRC (MC/W021358/1) and received funding from UKRI Engineering and Physical Sciences Research Council impact acceleration account (EP/X525789/1). Dr Mehrkar received funding from the Bennett Foundation, Wellcome Trust, NIHR Oxford Biomedical Research Centre, NIHR Applied
Research Collaboration Oxford and Thames Valley, and the Mohn-Westlake Foundation. The
OpenSAFELY Platform is supported by grants from the Wellcome Trust (222097/Z/20/Z) and the MRC (MR/V015737/1, MC_PC_20059, and MR/W016729/1). In addition, development of OpenSAFELY has
been funded by the Longitudinal Health and Wellbeing strand of the National Core Studies programme (MC_PC_20030: MC_PC_20059), the NIHR-funded CONVALESCENCE programme (COV-LT-0009), the NIHR (NIHR135559 and COV-LT2-0073), and the Data and Connectivity National Core Study funded by UK Research and Innovation (MC_PC_20058) and Health Data Research UK (HDRUK2021.000). |
| Issue: |
11 |
| Start Page: |
1071 |
| End Page: |
1080 |