Bidhendi-Yarandi Razieh, Biglarian Akbar, Karlstad Jannike Lie, Moe Cathrine Fredriksen, Bakhshi Enayatollah, Khodaei-Ardakani Mohammad-Reza, Behboudi-Gandevani Samira
Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Department of Biostatistics and Epidemiology, School of Social Health, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
PLoS One. 2025 Jan 28;20(1):e0312351. doi: 10.1371/journal.pone.0312351. eCollection 2025.
While mental health alterations during active COVID-19 infection have been documented, the prevalence of long-term mental health consequences remains unclear. This study aimed to determine the prevalence of mental health symptoms-depression, anxiety, stress, and suicidal tendencies-and to identify their trends and associated risk factors in individuals with long-COVID.
We conducted a systematic literature search of databases including PubMed, EMBASE, Scopus, CINAHL, Cochrane Library, Web of Science, and PsycINFO up to August 2024, targeting observational studies published in English. Study quality was assessed using structured standard tools. The primary outcome was the pooled prevalence of depression, anxiety, stress, and suicidal tendencies in individuals with long-COVID. Secondary outcomes included trends in these mental health problems over time and identification of associated determinants.
A total of 94 eligible studies were included in the analysis. The pooled prevalence estimates, regardless of follow up times duration, were as follows: depression, 25% (95%CI:22-28%; PI:1-59%); anxiety (adjusted via trim and fill method), 23%(95%CI:21-25%;PI:2-35%); composite outcomes of depression and/or anxiety, 25% (95%CI:23-27%;PI:2-51%); stress, 26%(95%CI:13-39%;PI:1-69%); and suicidality, 19%(95%CI:15-22%;PI:13-25%). The results of meta-regression analyses revealed a statistically significant trend showing a gradual decrease in the prevalence of the composite outcome of anxiety and/or depression over time (RD = -0.004,P = 0.022). Meta-regression results indicated that being female and younger age were significantly associated with a higher prevalence of mental health symptoms. Study design and study setting did not contribute to heterogeneity.
One-fourth of individual with long-COVID experience mental health symptoms, including depression, anxiety, and stress, which remain prevalent even two years post-infection despite a slight decreasing trend. Factors such as female gender and younger age were linked to higher rates of anxiety and depression. These findings indicate the need for ongoing mental health screening and early interventions to mitigate long-term psychological distress in long-COVID patients.
虽然已有文献记载了新冠病毒活跃感染期间的心理健康变化，但长期心理健康后果的患病率仍不清楚。本研究旨在确定心理健康症状（抑郁、焦虑、压力和自杀倾向）的患病率，并确定其在新冠后患者中的趋势及相关风险因素。
我们对包括PubMed、EMBASE、Scopus、CINAHL、Cochrane图书馆、科学网和PsycINFO在内的数据库进行了系统的文献检索，检索截至2024年8月发表的英文观察性研究。使用结构化标准工具评估研究质量。主要结局是新冠后患者中抑郁、焦虑、压力和自杀倾向的合并患病率。次要结局包括这些心理健康问题随时间的趋势以及相关决定因素的识别。
共有94项符合条件的研究纳入分析。无论随访时间长短，合并患病率估计如下：抑郁，25%（95%CI：22-28%；PI：1-59%）；焦虑（通过修剪和填充法调整），23%（95%CI：21-25%；PI：2-35%）；抑郁和/或焦虑的综合结局，25%（95%CI：23-27%；PI：2-51%）；压力，26%（CI：13-39%；PI：1-69%）；自杀倾向，19%（95%CI：15-22%；PI：13-25%）。Meta回归分析结果显示，焦虑和/或抑郁综合结局的患病率随时间呈逐渐下降的统计学显著趋势（RD = -0.004，P = 0.022）。Meta回归结果表明，女性和较年轻年龄与心理健康症状的较高患病率显著相关。研究设计和研究环境对异质性无影响。
四分之一的新冠后患者经历心理健康症状，包括抑郁、焦虑和压力，尽管呈轻微下降趋势，但在感染后两年仍很普遍。女性性别和较年轻年龄等因素与焦虑和抑郁的较高发生率有关。这些发现表明需要持续进行心理健康筛查和早期干预，以减轻新冠后患者的长期心理困扰。
