Self-Reported Symptoms of Depression Increase After Recovery From an Acute COVID-19 Infection

sad woman alone with surgical mask
With depressive symptoms rising after an acute COVID-19 infection, study researchers looked at whether these symptoms are a consequence of stress associated with COVID or, do they reflect more specific sequelae associated with the pathophysiology of the illness.

The magnitude of major depressive symptoms differed significantly on the basis of previous infection with COVID-19. These findings, from a survey, were published in JAMA Network Open.

Every month between May 2020 and February 2021, 12 waves of internet-based surveys were conducted through the vendor PureSpectrum by researchers at Harvard Medical School. Adult participants (N=61,472) were assessed for sociodemographic characteristics, COVID-19 illness, and symptoms of depression.

Respondents were aged mean 42.34 (standard deviation [SD], 16.36) years, 67.0% were women, 10.5% were Black, 7.3% were Hispanic, 5.8% were Asian, 24.2% lived in urban locations, 40.1% completed some college, and median annual income was $49,000 (interquartile range [IQR], $22,500-$85,000).

Clinical diagnoses of COVID-19 were reported by 6.5% of respondents and 31.2% said they had moderate or increased symptoms of depression.

Among individuals who had a COVID-19 diagnosis, symptoms of depression associated with gender (z, -9.58; P <.001), income (z, −9.75; P <.001), Black vs White ethnicity (z, 3.02; P =.003), and urban vs rural location (z, 2.89; P =.004).

Those who had COVID-19 scored significantly higher on patient health questionnaire-9 (PHQ-9) questions about suicidality (mean, 2.50 vs 1.99 points; t, -24.83; P <.001) and motor symptoms (mean, 2.58 vs 2.11 points; t, -23.74; P <.001).

The investigators observed a temporal pattern of depressive symptoms, in which for every additional month since acute COVID-19 illness, symptoms of depression increased (odds ratio [OR], 1.07; 95% CI, 1.05-1.09). This association was increased after correcting for the time of the survey, location, and sociodemographic characteristics (adjusted OR [aOR], 1.09; 95% CI, 1.07-1.11).

This study may have been limited with relying on the PHQ-9 assessment which only includes a subset of depressive symptoms.

The results of this study may suggest that after acute COVID-19 infection, some patients may experience increased symptoms of depression. It remains unclear whether these trends are caused by long-term sequalae of the disease or from increased stress and isolation associated with the global pandemic. Additional studies are needed to validate these findings.

Disclosure: An author declared affiliations with industry. Please refer to the original article for a full list of disclosures.


Perlis RH, Santillana M, Ognyanova K, et al. Factors associated with self-reported symptoms of depression among adults with and without a previous COVID-19 diagnosis. JAMA Netw Open. Published online June 11, 2021. doi:10.1001/jamanetworkopen.2021.16612