Depression and its associated factors among COVID-19 survivors in a middle income country

Introduction: COVID-19 survivors who have mental health issues are more likely to have a lower quality of life, reduced work productivity, social troubles, and other health issues. However, information on the mental health of COVID-19 survivors is scarce. Therefore, we aimed to determine the COVID-19 survivors' mental health status in the form of depression and its associated factors. Methods: This was a cross-sectional study conducted in Malaysia, from July to September 2021, during a nationwide lockdown. Data was collected using an online questionnaire shared on social and news media. Socio-demographic variables, comorbidities, self-perception of health, information on the persons acute condition during COVID-19 infection, symptoms and duration of symptoms post-COVID, and state of depression were gathered. The Patient Health Questionnaire 9 was used to assess depression. Factors associated with mild to severe depression were analysed using both univariable and multivariable logistic regression analyses. Results: A total of 732 COVID-19 survivors responded to the survey. The respondents were mainly females and of younger age (in their 20s and 30s). Two-thirds perceived themselves to be in good health. One in five reported to have experienced Long COVID. Slightly less than half (47.3%) of the respondents had mild to severe depression (total PHQ-9 score of 5 -27). In the multivariable analysis, being female (aOR: 1.68; 95% CI: 1.08,2.62), of younger age (20s - aOR: 3.26; 95% CI: 1.47, 7.25; 30s - aOR: 2.08; 95% CI: 1.05, 4.15; and 40s - aOR: 2.43; 95% CI: 1.20, 4.90; compared to those in the 50s and above), being overweight/obese (aOR: 1.83; 95% CI: 1.18, 2.83), having Long COVID (aOR: 2.45; 95% CI: 1.45, 4.16) and perceiving to have poorer health (aOR: 4.54; 95% CI: 2.89, 7.13) were associated with mild to severe depression. Conclusion: Females, younger age groups, being overweight/obese, having Long COVID and perceiving to be in poor health were factors associated with higher odds for mild to severe depression.