Background: During the COVID-19 pandemic rates of depressive symptoms are markedly elevated, particularly among survivors of infection. Understanding whether such symptoms are distinct among those with prior SARS-CoV-2 infection, or simply a nonspecific reflection of elevated stress, could help target interventions. Method: We analyzed data from multiple waves of a 50-state survey that included questions about COVID-19 infection as well as the Patient Health Questionnaire examining depressive and anxious symptoms. We utilized multiple logistic regression to examine whether sociodemographic features associated with depression liability differed for those with or without prior COVID-19, and then whether depressive symptoms differed among those with or without prior COVID-19. Results: Among 91,791 respondents, in regression models, age, gender, race, education, and income all exhibited an interaction with prior COVID-19 in risk for moderate or greater depressive symptoms (p<0.0001 in all cases), indicating differential risk in the two subgroups. Among those with such symptoms, levels of motoric symptoms and suicidality were significantly greater among those with prior COVID-19 illness. Depression risk increased with greater interval following acute infection. Discussion: Our results suggest that major depressive symptoms observed among individuals with prior COVID-19 illness may not reflect typical depressive episodes, and merit more focused neurobiological investigation.

中文翻译：

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COVID后抑郁症和重度抑郁症的比较

背景：在COVID-19期间，抑郁症状的大流行率显着升高，尤其是在感染幸存者中。了解此类症状在先前患有SARS-CoV-2感染的患者中是否明显，或者仅仅是压力升高的非特异性反映，可以有助于采取干预措施。方法：我们分析了来自50个州的多次调查中的数据，这些数据包括有关COVID-19感染的问题以及检查抑郁和焦虑症状的《患者健康调查表》。我们利用多元logistic回归分析了与患有抑郁症的社会人口统计学特征在有或没有COVID-19的患者中是否存在差异，以及抑郁症状在有或没有COVID-19的患者中是否存在差异。结果：在91,791名受访者中，使用回归模型，年龄，性别，种族，教育程度和收入都与先前的COVID-19表现出相互作用，具有中度或重度抑郁症状的风险（在所有情况下，p <0.0001），表明这两个亚组的风险差异。在具有此类症状的患者中，先前患有COVID-19疾病的患者的运动症状和自杀水平显着更高。急性感染后抑郁风险随着间隔时间的延长而增加。讨论：我们的结果表明，在先前患有COVID-19疾病的个体中观察到的主要抑郁症状可能未反映典型的抑郁发作，值得进行更集中的神经生物学研究。在具有此类症状的患者中，先前患有COVID-19疾病的患者的运动症状和自杀水平显着更高。急性感染后抑郁风险随着间隔时间的延长而增加。讨论：我们的结果表明，在先前患有COVID-19疾病的个体中观察到的主要抑郁症状可能未反映典型的抑郁发作，值得进行更集中的神经生物学研究。在具有此类症状的患者中，先前患有COVID-19疾病的患者的运动症状和自杀水平显着更高。急性感染后抑郁风险随着间隔时间的延长而增加。讨论：我们的结果表明，在先前患有COVID-19疾病的个体中观察到的主要抑郁症状可能未反映典型的抑郁发作，值得进行更集中的神经生物学研究。