By Kathleen Berger, Executive Producer for Science and Technology

From the start of the pandemic, COVID-19 infections had mysterious twists and turns.

“They were healthy before they got COVID-19, telling us that weeks after the initial infection they were still having lingering problems in the form of brain fog or fatigue and all sorts of different symptoms,” said senior author Ziyad Al-Aly, MD, chief of research and development at the VA St. Louis Health Care System and a clinical epidemiologist at Washington University.

During this time, people experienced varying degrees of uncertainty, isolation and mental health challenges. Al-Aly paid close attention.

“To their credit, this patient community, they called themselves long haulers and started to refer to the syndrome or the entity as long Covid,” said Al-Aly.

When people felt helpless, Al-Aly became committed to finding answers.

“We committed right there and then to try to understand, to do our best to try to understand what’s going on,” he said.

Al-Aly and his colleagues conducted extensive studies on long COVID. He’s focused on a wide variety of symptoms affecting different parts of the body, and mental health is one of the top concerns on that list.

“We knew that that all of us during this pandemic experienced some sort of stress, right? But what we didn’t know – do people with COVID-19 have it worse? So we did this study to evaluate the risk of mental health problems and people with COVID-19 versus control groups who did not get COVID-19.”

For the study, the research team analyzed the de-identified medical records of more than 13 million veterans in the vast database maintained by the U.S. Department of Veterans Affairs. The dataset covered the months of March of 2020 through January 2021, before widely available vaccinations. But in a later study conducted by Al-Aly, he found that vaccination against the virus that causes COVID-19 reduced the risk of getting long COVID by 15% compared to unvaccinated people. So, long COVID is still a problem for the vaccinated too.

The study about the increasing mental health risk from having a COVID-19 infection involved more than 150,000 people with COVID-19 from the U.S. Department of Veterans Affairs database compared to control groups.

“Compared to the control groups that are together more than 10 million people. And what we found out is people with COVID-19 have increased risks of mental health disorders including anxiety, depression, stress and adjustment disorders, sleep problems,” Al-Aly said. “Some of them were needing to be initiated on sleep medications, antidepressants, etc.”

Researchers discovered increasing chances of suicidal thoughts and substance use disorders. The study found that mental health disorders occurred within one year after recovery from COVID-19 infections, even when people had asymptomatic infections or only mild symptoms.

“People who got COVID-19 that survived the first 30 days, we found a year later they manifested with higher risk of mental health problems than people who did not have COVID-19 “

Overall, the study found that people who had COVID-19 were 60% more likely to suffer from mental health problems than those who were not infected.

“It’s very, very clear that people with COVID-19 have increased risk of variety of neurologic problems and neuropsychiatric problems that could be explained by the virus itself, through inducing some potential structural changes in the brain or other neurological alterations that might then lead to the higher risk of neurologic consequences and psychiatric consequences.”

The study does not include data involving the virus’s delta and omicron variants, which began spreading rapidly in the latter half of 2021, but Al-Aly is tackling studies about long COVID after infections from variants currently.