Impact of COVID-19 on Incident Depression and Anxiety: A Population-Based Observational Study Using Statewide Claims...

Objectives: Evidence suggests that COVID-19 infection contributes to elevated risks of psychiatric disorders, including depression and anxiety, however, this association remains underexplored. This study aimed to examine the incidence of depression and anxiety in individuals with COVID-19 compared to those without any infection. Method: Using the Utah All Payers Claims Database (2019 to 2021), we examined adult patients with continuous insurance enrollment. Individuals with pre-existing depression or anxiety were excluded. COVID-19 infection in 2020 was identified using diagnostic and procedural codes. The Least Absolute Shrinkage and Selection Operator (LASSO) method was applied to select covariates, followed by entropy balancing to adjust for baseline differences. Weighted logistic regression models were used to estimate the association between COVID-19 infection and incident mental health diagnoses in 2021. Results: Among 356,985 adults included in the final analytic sample for depression analysis, 37.6 percent had a documented COVID-19 infection in 2020. Individuals with prior infection had significantly higher odds of receiving a depression diagnosis in 2021 compared to those without infection (OR = 1.48, p < 0.01). A similar pattern was observed for anxiety: among 371,491 adults, 38.1 percent had a COVID-19 infection, and infected individuals had 46 percent greater odds of receiving an anxiety diagnosis (OR = 1.46, p < 0.01), after adjusting for demographic and clinical characteristics. Conclusions: This study highlights the elevated risk of depression and anxiety among patients who had been infected with COVID-19, emphasizing the importance of addressing the mental health needs of individuals affected by the virus.