Risk of psychological sequelae among coronavirus disease‐2019 survivors: A nationwide cohort study in South Korea

Abstract

Background We sought to investigate the risk of psychological diseases among coronavirus disease-2019 (COVID-19) survivors in South Korea. Methods The National Health Insurance Service (NHIS) COVID-19 cohort database, comprising COVID-19 patients and a control population from January 1, 2020 to June 4, 2020, was used in this study. COVID-19 patients were defined as individuals who were confirmed as COVID-19 positive, regardless of disease severity, and COVID-19 survivors were defined as individuals who recovered from COVID-19. The control population was extracted using stratification methods according to the age, sex, and residence of COVID-19 patients. Individuals previously diagnosed with any psychological disease were excluded from the analysis. The primary endpoint was a new diagnosis of psychological disease. Multivariable logistic modeling was used for statistical analyses. Results A total of 99,742 individuals (5879 [5.9%] COVID-19 survivors and 93,863 [94.1%] controls) were included in the final analysis. The incidence of newly diagnosed psychological disease, depression, psychosis, alcohol abuse, and drug abuse was 1438 (1.4%), 1268 (1.3%), 44 (0.0%), 173 (0.2%), and 2 (0.0%), respectively. In the multivariable model after adjusting for confounders, the COVID-19 survivors had a 2.98-fold higher probability of developing the psychological disease compared with the control group. Specifically, the odds of depression and psychosis in the COVID-19 survivors were 3.34-fold and 2.49-fold higher than that in the control group, respectively. Conclusion COVID-19 survivors had a higher risk of experiencing psychological disease than the control population in South Korea. Particularly, COVID-19 may increase the risk of developing depression and psychosis.