Depression and Anxiety worsened during COVID pandemic, putting patients at higher heart disease risk

  • The COVID-19 pandemic has not only affected the physical health of millions of Americans, but it’s also taken a toll on the country’s mental health

By Intermountain Healthcare, November 13, 2021

A new study by researchers at Intermountain Healthcare in Salt Lake City finds that depression remained common during the pandemic and worsened for some patients leading to increased visits to the emergency department for treatment of anxiety and chest pain.

Researchers found that nearly 40 percent of patients studied reported new or continuing symptoms of depression during the first year of the pandemic. They say the study of 4,633 patients is further evidence of the pandemic’s negative impact on people’s mental health and physical well-being has been significant.

Findings from the study were presented at the American Heart Association’s virtual 2021 Scientific Session on Saturday, November 13, 2021.

A patient is treated at an Intermountain Healthcare emergency room. Credit: Intermountain Healthcare

“These findings are significant. In looking at the first year of the pandemic, we are already seeing the mental health effects on our patients,” said Heidi T. May, PhD, cardiovascular epidemiologist at the Intermountain Healthcare Heart Institute and principal investigator of the study.

“We already know that depression raises a person’s risk for developing cardiovascular disease and other chronic health problems, so this is very concerning and highlights the importance of screening patients and providing mental health resources that they need,” Dr. May added.

For the study, researchers examined 4,633 Intermountain Healthcare patients who completed a depression screening that is a standard part of primary care at Intermountain Healthcare, before and during the COVID-19 pandemic. For the purposes of this study, “before” was between March 1, 2019, to February 29, 2020, and “during” was between March 1, 2020, and April 20, 2021.

Patients were separated into two groups: those with no depression/no longer depressed, and those who remained depressed/became depressed. Using electronic health records, patients were then assessed for follow-up emergency department visits for anxiety and chest pain.

Researchers found that among depressed patients, depression screening scores were higher during the pandemic than before it. Depression was also associated with increased emergency department visits for anxiety.

They found that the odds of visiting an emergency room for anxiety was 2.8 greater for people with depression than those without, and 1.8 greater for anxiety with chest pains compared to non-depressed patients.

Dr. May said it is important to identify people with depression because “we know that it’s a strong risk factor for cardiovascular disease; and if people are becoming more depressed because of the pandemic, in a few years, we could see a higher incidence of cardiovascular disease.”

“Clinicians should be acutely aware of their patients’ mental health so that it can be addressed and treated immediately to improve the overall quality of their lives, and hopefully avoid the development of subsequent health problems in the future. This is vital because the pandemic is still not over,” she added.

Longer follow-up is needed to determine potential long-term effects from the pandemic may be on mental health, Dr. May said.

Other members of the Intermountain research team are: Tami L. Bair; Viet Le; Joseph B. Muhlestein, MD; Stacey Knight; Jeffrey L. Anderson, MD; Kirk U. Knowlton, MD, and Benjamin D. Horne.

Meeting: American Heart Association Scientific Sessions 2021

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