Journal of the American Academy of Child and Adolescent Psychiatry · 2024
Post-COVID-19 Mental Health Distress in 13 Million Youth: A Retrospective Cohort Study of Electronic Health Records.
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Zhang-James Yanli, Clay John W S, Aber Rachel B, Gamble Hilary M, Faraone Stephen V
Аннотация
OBJECTIVE: To investigate the impact of the SARS-CoV-2 infection on the rates of mental disorders in youth.
METHOD: The study involved 7,519,465 children and 5,338,496 adolescents from the TriNetX Research Network, all without prior mental disorder histories. Among them, 290,145 children and 223,667 adolescents had SARS-CoV-2-positive tests or confirmed COVID-19 diagnoses. Kaplan-Meier survival analysis was used to evaluate the probability of developing new mental disorders (any codes in International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) F01-F99 category and suicidal behaviors) within 2 years post infection, compared to the propensity score-matched youth who were never infected.
RESULTS: Within 2 years post SARS-CoV-2 infection, children had a probability of 0.15 in acquiring new psychiatric diagnoses, compared to 0.026 for matched non-infected children; adolescents had a 0.19 probability against 0.05 for their non-infected counterparts. The hazard ratio (HR) was 6.0 (95% CI = 5.8-6.3) for children and 4.2 for adolescents (95% CI = 4.1-4.4), with children vs adolescents HR of 1.4 (95% CI = 1.36-1.51). Elevated HRs were observed for almost all subcategories of mental disorders and suicidal behaviors, with variations based on sex, severity of SARS-CoV-2 infection, and viral variants. COVID-19 was similar to other respiratory infections and was associated with a similarly increased rate of mental disorders in adolescents, but had a significantly higher effect on children (HR = 1.57, 95% CI =1.53-1.61).
CONCLUSION: This study revealed significant mental health distress following SARS-CoV-2 infection in youth, which was more pronounced in children than in adolescents. These findings underscore the urgent need to support at-risk youth, particularly those who contracted SARS-CoV-2 at younger ages and had more severe infections.
PLAIN LANGUAGE SUMMARY: The authors of this study conducted analyses using electronic medical records from the TriNetX Research Network to investigate the impact of SARS-CoV-2 infection on the rates of mental health disorders in youth. Within 2 years after SARS-CoV-2 infection, children and adolescents were 6.0 and 4.2 times more likely to acquire a new psychiatric diagnosis, respectively. While the risk of being diagnosed with a mental health disorder following SARS-CoV-2 infection in adolescents was comparable to other respiratory infections, it had a more pronounced effect on children.
METHOD: The study involved 7,519,465 children and 5,338,496 adolescents from the TriNetX Research Network, all without prior mental disorder histories. Among them, 290,145 children and 223,667 adolescents had SARS-CoV-2-positive tests or confirmed COVID-19 diagnoses. Kaplan-Meier survival analysis was used to evaluate the probability of developing new mental disorders (any codes in International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) F01-F99 category and suicidal behaviors) within 2 years post infection, compared to the propensity score-matched youth who were never infected.
RESULTS: Within 2 years post SARS-CoV-2 infection, children had a probability of 0.15 in acquiring new psychiatric diagnoses, compared to 0.026 for matched non-infected children; adolescents had a 0.19 probability against 0.05 for their non-infected counterparts. The hazard ratio (HR) was 6.0 (95% CI = 5.8-6.3) for children and 4.2 for adolescents (95% CI = 4.1-4.4), with children vs adolescents HR of 1.4 (95% CI = 1.36-1.51). Elevated HRs were observed for almost all subcategories of mental disorders and suicidal behaviors, with variations based on sex, severity of SARS-CoV-2 infection, and viral variants. COVID-19 was similar to other respiratory infections and was associated with a similarly increased rate of mental disorders in adolescents, but had a significantly higher effect on children (HR = 1.57, 95% CI =1.53-1.61).
CONCLUSION: This study revealed significant mental health distress following SARS-CoV-2 infection in youth, which was more pronounced in children than in adolescents. These findings underscore the urgent need to support at-risk youth, particularly those who contracted SARS-CoV-2 at younger ages and had more severe infections.
PLAIN LANGUAGE SUMMARY: The authors of this study conducted analyses using electronic medical records from the TriNetX Research Network to investigate the impact of SARS-CoV-2 infection on the rates of mental health disorders in youth. Within 2 years after SARS-CoV-2 infection, children and adolescents were 6.0 and 4.2 times more likely to acquire a new psychiatric diagnosis, respectively. While the risk of being diagnosed with a mental health disorder following SARS-CoV-2 infection in adolescents was comparable to other respiratory infections, it had a more pronounced effect on children.