People who have had Covid-19 face a greater risk of developing opioid use disorders and other mental health issues, according to new findings published Wednesday in the journal the BMJ. The large study compared the health records of 154,000 former Covid patients in the Veterans Health Administration system during the year after their infections to a similar population who did not get Covid and found a significant discrepancy in mental health outcomes.
During the months following their infection, the study showed people who’d had Covid were 34 percent more likely to develop opioid use disorders than those who had not. According to lead study author Dr. Ziyad Al-Aly, who is chief of research and development at the V.A. St. Louis Health Care System, this could be a result of Covid patients being prescribed painkillers for their illness. “What we’re seeing here in our data is that clearly, as a result of Covid, people may be coming back to the clinic and complaining of pain, and some of them are being prescribed opioids and some of them are manifesting with opioid use disorders,” he says. “That’s really alarming and definitely needs attention now to try to hopefully nip it in the bud and reduce the chance it cascades down to a much more serious problem down the road.”
People who’d had Covid were also 20 percent more likely to develop other substance use problems including alcoholism than people who’d never been infected, the study found. They were also 39 percent more likely to be diagnosed with depression, 35 percent more likely to be diagnosed with anxiety, 38 percent more likely to be diagnosed with stress and adjustment disorders, and 41 percent more likely to be diagnosed with sleep disorders.
According to Al-Aly, this is not a matter of Covid simply being stress-inducing, although that likely plays a part in people’s increased anxiety, depression, and related conditions. The study controlled for people who had experienced hardships and stressors of the pandemic as well as people who had endured other serious viral infections, like a flu that resulted in hospitalization. The impact of Covid was unique, suggesting the virus itself may be capable of affecting people’s mental health. Patients in the study were 80 percent more likely than non-patients to experience the telltale Covid brain fog, and confusion or forgetfulness that many people have reported noticing over the last two years. “Something specific about COVID 19 seems to be contributing to the effects that we are seeing here,” he says. “Two years into the pandemic, now we understand a little bit more about the biology of the virus itself and its ability to interact with brain tissue and brain vasculature and the changes that might induce in the brain. And it’s clear that it’s doing things.”
The mental health impacts were more intense for people who had more serious infections, but the trend persisted for all levels of infection, even asymptomatic. The vast majority of people in the study had not been hospitalized with Covid. Al-Aly says more research is needed to learn what Covid is doing to people’s brains — and how to prevent it. “On the biology side, we’d like to drive a deeper understanding of how the virus is affecting mood centers in the brain, and is there anything we can do to try to mitigate that from the get go?” he says. “And then on the clinical side, [we need a] better understanding of the even longer term effect. We did this for one year, but I think we would want to know what happens to these people a year and a half, two years out. Hopefully we won’t see increased suicides or an even bigger number of opioid use disorders, but I think that definitely needs careful watching and careful analysis and research.”