Changes in mental health following COVID-19 infection: results of a prospective cohort study in mongolia
- VernacularTitle:Ковид-19-ийн дараах сэтгэцийн эрүүл мэндийн өөрчлөлт: проспектив когорт судалгааны үр дүн
- Author:
Enkhtuvshin R
1
;
Mongoljin A
2
;
Munkh.E
2
;
Uranchimeg M
3
;
Yerkyebulan A
3
;
Munkh-Uchral D
3
;
Enkhnaran T
4
;
Nasantsengel L
1
;
Khishigsuren Z
1
Author Information
1. Department of Mental Health, School of Medicine, MNUMS
2. National center for mental health
3. Department of Epidemiology and Biostatistics, School of Public Health, MNUMS
4. Department of clinical neuroscience, Brain and Mind Research Institute, MNUMS
- Publication Type:Journal Article
- Keywords:
depression, anxiety, insomnia, PTSD, post-COVID-19
- From:
Mongolian Journal of Health Sciences
2025;90(6):39-44
- CountryMongolia
- Language:Mongolian
-
Abstract:
Background:COVID-19, first identified in Wuhan, China, in December 2019, was declared a global pandemic by the
WHO on March 11, 2020, leading to over 770 million infections and 7 million deaths worldwide. In Mongolia, the first
case emerged on March 10, 2020, followed by more than 1 million infections and over 2,100 deaths by 2023. The virus
affects the central nervous system, manifesting as depression, anxiety, insomnia, and PTSD through biological pathways
(e.g., ACE-2 receptor invasion, cytokine storm) combined with psychological stressors (e.g., fear, isolation). Global
studies (WHO Mental Health Atlas 2022; Ettman et al., JAMA 2020; Huang et al., Lancet Psychiatry 2021; Xie et al.,
BMJ 2022) indicate a 25–40% rise in depression and anxiety during the pandemic’s first year, with 30–60% of infected
individuals experiencing persistent symptoms 6–12 months post-infection. In Mongolia, cross-sectional surveys (National
Center for Mental Health 2021: 28.7% moderate-to-severe depression, 22.4% high anxiety) have been conducted, but
long-term prospective data remain scarce. This study evaluates longitudinal changes in depression, anxiety, insomnia, and
PTSD among COVID-19 patients over 12 months, compared to a control group.
Aim:To conduct long-term follow-up and comparative assessment of depression, anxiety, insomnia, and post-traumatic
stress disorder (PTSD) among individuals who have had COVID-19
Materials and Methods:In this prospective cohort study, 459 adults (326 COVID-19 cases, 133 controls) were recruited
from MNUMS-affiliated hospitals, Central Hospital, and the National Center for Maternal and Child Health between 2021
and 2023. Participants without baseline mental disorders underwent follow-up assessments at 14 days, 3 months, and 12
months using validated scales: PHQ-9 (depression), GAD-7 (anxiety), ISI (insomnia), and PCL-5 (PTSD). Incident cases
were identified through baseline exclusion. Data were analyzed via χ² tests, t-tests, relative risk (RR) calculations, and
multivariable logistic regression (p < 0.05).
Results:Baseline demographics were comparable between groups (mean age 46.3 ± 13.8 years; 58.4% female). At 12
months, the COVID-19 group exhibited higher rates of depression (37.3% vs. 16.9%; RR = 2.22, 95% CI: 1.28–3.83, p =
0.003) and anxiety (28.0% vs. 11.2%; RR = 2.49, 95% CI: 1.25–4.96, p = 0.006). Insomnia was lower in the COVID-19
group (33.3% vs. 49.4%; RR = 0.67, p = 0.037), while PTSD rates remained low (<3%, p > 0.05). Adjusted odds ratios
confirmed COVID-19 as an independent predictor of depression (aOR = 2.18) and anxiety (aOR = 2.41). Females and
individuals aged 40–59 years were at elevated risk.
Conclusions:1. In the cohort of individuals who had contracted COVID-19, levels of depression after 12 months were 2.2 times
higher, levels of anxiety were 2.5 times higher, and levels of insomnia were 0.67 times lower compared to the control
group.
2. Post-traumatic stress disorder was observed in 3.1% of participants 14 days post-exposure, but was not detected
after 12 months; this resolution is posited to be associated with the adaptive capacity of the population.
3. COVID-19 constitutes a long-term independent risk factor for the onset of depression and anxiety.
- Full text:2025121013381733074Ковид-19 -ийн дараах сэтгэцийн эрүүл мэндийн өөрчлөлт-Проспектив когорт судалгааны үр дүн.pdf
