Observational studyBMC psychiatry2026
COVID-19 and risk of first-time major depressive disorder in patients without history of psychiatric disorders.
Observational study in BMC psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
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Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSeveral studies have shown that patients who survived hospitalization with COVID-19 are at higher risk of psychiatric illness including major depressive disorder (MDD) compared to COVID− controls. However, few prior studies excluded patients with prior psychiatric illness from their analyses, and therefore the post-COVID risk of new-onset MDD among those without psychiatric vulnerabilities remains unclear.
methodsThis observational study analyzed patients with at least one COVID-19 test, no history of prior psychiatric diagnosis, and at least one follow-up visit 30 days post-COVID-19 test from February 2020 to August 2024. Risk of new-onset MDD was assessed using Fine-Gray subdistribution hazards models, accounting for all-cause mortality as a competing risk. Demographic variables, pre-existing comorbidities, insurance, Zone Improvement Plan (ZIP) code-linked median household income, and the presence of unmet social needs were adjusted for using multivariate regression and inverse probability weighting (IPW). The possibility of unmeasured residual confounding was investigated using an array approach, to assess the extent of confounder variable prevalence imbalance and effect size necessary to fully explain the observed effect estimate.
results8,836 COVID+ hospitalized, 22,253 COVID + non-hospitalized, and 82,482 COVID− patients were included in the analysis. Compared to COVID− patients, COVID + non-hospitalized patients were at similar risk of new-onset MDD, while COVID+ hospitalized patients were at higher risk (multivariate adjusted hazard ratio [HR] = 1.15 [1.05, 1.27], IPW-adjusted HR = 1.17 [1.03, 1.33]). This association was robust to sensitivity analyses addressing potential residual confounding. Risk of new-onset MDD was particularly highest among females, younger patients, Hispanics, those with type-2 diabetes, asthma, tobacco use, those on Medicare, Medicaid, those living in low-income ZIP codes, and those with unmet social needs.
conclusionAmong patients with no prior history of psychiatric illness, hospitalization for COVID-19 is an independent risk factor for new-onset clinician-diagnosed MDD. Addressing clinical risk factors for MDD and social determinants of health will be essential to mitigating the long-term mental health consequences.
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