Mental health risk factors for psychological disorders after COVID-19 infection: A systematic review and meta-analysis

The coronavirus disease 2019 (COVID-19) global pandemic was a time of uncertainty and rapid change that has had demonstrable effects on the mental health of those who experienced it. For individuals who contracted the illness, some types of risk factors for adverse mental health post-COVID have been examined (e.g., demographics), but how pre-COVID psychiatric risk factors may have contributed to worsened outcomes has not been systematically evaluated. This systematic review and meta-analysis examines mental health risk factors (e.g., general psychiatric history, trauma history) for depression, anxiety, posttraumatic stress disorder (PTSD), and adjustment disorder in individuals after resolution of acute COVID-19 infection. We searched three databases (PubMed, PsycInfo, Scopus) and included 27 studies (15 cohort, 12 cross-sectional). Studies were dually extracted and assessed for quality. We conducted meta-analyses by study design and outcome for the risk factor of a general psychiatric history. Medium-to-large effect sizes were found for psychiatric history on post-COVID infection depression, anxiety, and PTSD. No studies examined adjustment disorder as an outcome. Studies of mental health risk factors that could not be incorporated into the meta-analyses (e.g., history of trauma) showed small-to-large effect sizes on post-COVID mental health. These results consistently show that mental health factors predict worse psychological health after acute COVID-19 infection. More robust study designs would improve this body of research.