Impact of Sequelae Resulting From the COVID-19 Pandemic on Mental Health: a Cross-sectional Study in Japan and Sweden

Background: Due to the coronavirus disease 2019 (COVID-19) pandemic, people have undermined their mental health. It has been reported that sequelae resulting from COVID-19 occur at a certain rate. However, information on the mental health of people with sequelae is limited. Thus, this study investigated the relationship between sequelae resulting from COVID-19 and mental health. Methods: : Design of the present study was an International and collaborative cross-sectional study in Japan and Sweden from March 18 to June 15, 2021. The analyzed data included 763 adults who participated in online surveys in Japan and Sweden and submitted complete data. In addition to demographic data including terms related to COVID-19, psychiatric symptoms such as depression, anxiety, and post-traumatic stress were measured by using the fear of COVID-19 scale (FCV-19S), Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 item (GAD-7), and Impact of Event Scale-Revised (IES-R). Results: : of the 135 COVID-19 survivors among the 763 total participants, 40.7% had COVID-19-related sequelae. First, the results of the Bonferroni-corrected Mann Whitney U test showed that the group infected SARS-CoV-2 with sequelae scored significantly higher than those without sequelae and the non-infected group on all clinical symptom scales (P ≤ .001). Next, there was a significant difference that incidence rates of clinical-significant psychiatric symptoms among each group from the results of the Chi-squared test (P ≤ .001). Finally, the results of the multivariate logistic model revealed that the risk of having more severe clinical symptoms were 2.48–4.64 times higher among participants with sequelae. Conclusion: The results showed that approximately half had sequelae after COVID-19 and that the sequelae of COVID-19 may lead to the onset of mental disorders. Trial registration: The ethics committee of Chiba University approved this cross-sectional study (approval number: 4129). However, as no medical intervention was conducted, a clinical trial registration was not necessary.