Researchers confirm link between testing positive for COVID-19 and fatigue and sleep problems

Those who tested positive for COVID-19 (confirmed by a PCR test) had an increased risk of mental illness, fatigue and sleep problems, finds a new study which analysed the electronic primary care health care records* of 226,521 people from across the UK between February 2020 and December 2020.

The research**, published in The Journal of the American Medical Association Network Open (JAMA Network Open) today, was funded by the National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre (NIHR GM PSTRC). The Centre is a partnership between The University of Manchester and The Northern Care Alliance NHS Foundation Trust.

The study found there was an almost six-fold increase in the likelihood of reporting fatigue to a GP following a positive PCR test and a threefold increase in the risk of sleep problems compared to those without a positive test, for people who haven’t previously visited their GP for any of these reasons in the past.

There was also an 83% increase in mental illness following a positive PCR test. However, there was also a 71% increase in the risk of mental illness for people who received a negative PCR test compared to the general population. Researchers believe this throws some doubt about whether COVID-19 is directly causing mental illness, because it is clear that those who get a test are more likely to have risk factors for mental illness, for example pandemic-related anxieties.

Dr Matthias Pierce, researcher at The University of Manchester who led the work, said: “When we began this research project we wanted to investigate whether we could find any evidence in primary health care records that COVID-19 was linked to an increased risk of mental health illness, sleep and fatigue problems.

“While fatigue is clearly a consequence of COVID-19 the risk of experiencing sleep problems is also very high. However, we are sceptical regarding the extent that COVID-19 is directly causing people to become mentally ill, or whether those with a predisposition to mental illness are more likely to get tested.”

Professor Roger Webb, from The University of Manchester, who co-leads the Mental Health research programme at the NIHR GM PSTRC, said: “Our findings align with those generated by investigations conducted in other countries in revealing elevated risks of mental illness, self-harm, fatigue, and disrupted sleep patterns among people testing positive for infection during the pandemic. Establishing the mechanisms that have caused these outcomes to occur is the next major challenge for researchers in our field.”

Professor Carolyn Chew-Graham, a co-author on the paper, Professor of General Practice Research at Keele University and a General Practitioner, said “It is vital that general practitioners recognise the long-term impact of COVID-19 infection on their patient population. Offering follow-up to people who test positive for COVID-19 infection may help identify persisting symptoms, and sign-post people to the Your COVID Recovery website. The increased risk of developing mental health problems in people who tested negative may be due to health anxiety in these patients, and primary care has a role in identifying and supporting such patients.”

* Clinical Practice Research Datalink (CPRD-Aurum) dataset: a large UK primary care registry covering 19 million patients. It contains information on clinical events recorded by healthcare professionals, including diagnosis, symptoms and therapies.

** Is infection with COVID-19 causing an increased risk of psychological distress, psychotropic prescribing or sleep and fatigue problems? A study of patients in English primary care