Longer-Term Mental Health Consequences of COVID-19 Infection: Moderation by Race and Socioeconomic Status

Abstract

While evidence suggests that the mental health consequences of coronavirus disease 2019 (COVID-19) can persist for several months following infection, little is known about the longer-term mental health consequences and whether certain sociodemographic groups may be particularly impacted. The study objectives were to characterize the longer-term mental health consequences of COVID-19 infection and examine whether such consequences are more pronounced in Black people and people with lower socioeconomic status. 277 Black and White adults (age ≥ 30 years) with a history of COVID-19 (cases; tested positive ≥ 6 months prior to participation) or no history of COVID-19 infection (controls) completed a 45-minute online questionnaire battery. Unadjusted t-tests revealed that cases had greater depressive (d = 0.24), anxiety (d = 0.34), PTSD (d = 0.32), and insomnia (d = 0.31) symptoms than controls. These differences remained significant for symptoms of anxiety, PTSD, and insomnia after adjusting for age, sex, race, education, income, and smoking status. No case-control differences were detected for perceived stress and general psychopathology. Cases had more than double the odds of clinically significant symptoms of anxiety (OR = 2.22) and PTSD (OR = 2.40). Case-control status was more strongly and positively associated with depressive, anxiety, PTSD, perceived stress, and general psychopathology symptoms at lower education levels. Race and income were not moderators of the relationships. The mental health consequences of COVID-19 may be significant, widespread, and persist for at least 6 months after infection, and people with lower education levels may face a greater burden of these consequences.