Characteristics of studied included.

BackgroundWhile mental health alterations during active COVID-19 infection have been documented, the prevalence of long-term mental health consequences remains unclear. This study aimed to determine the prevalence of mental health symptoms—depression, anxiety, stress, and suicidal tendencies—and to identify their trends and associated risk factors in individuals with long-COVID.MethodsWe conducted a systematic literature search of databases including PubMed, EMBASE, Scopus, CINAHL, Cochrane Library, Web of Science, and PsycINFO up to August 2024, targeting observational studies published in English. Study quality was assessed using structured standard tools. The primary outcome was the pooled prevalence of depression, anxiety, stress, and suicidal tendencies in individuals with long-COVID. Secondary outcomes included trends in these mental health problems over time and identification of associated determinants.ResultsA total of 94 eligible studies were included in the analysis. The pooled prevalence estimates, regardless of follow up times duration, were as follows: depression, 25% (95%CI:22–28%; PI:1–59%); anxiety (adjusted via trim and fill method), 23%(95%CI:21–25%;PI:2–35%); composite outcomes of depression and/or anxiety, 25% (95%CI:23–27%;PI:2–51%); stress, 26%(95%CI:13–39%;PI:1–69%); and suicidality, 19%(95%CI:15–22%;PI:13–25%). The results of meta-regression analyses revealed a statistically significant trend showing a gradual decrease in the prevalence of the composite outcome of anxiety and/or depression over time (RD = -0.004,P = 0.022). Meta-regression results indicated that being female and younger age were significantly associated with a higher prevalence of mental health symptoms. Study design and study setting did not contribute to heterogeneity.ConclusionOne-fourth of individual with long-COVID experience mental health symptoms, including depression, anxiety, and stress, which remain prevalent even two years post-infection despite a slight decreasing trend. Factors such as female gender and younger age were linked to higher rates of anxiety and depression. These findings indicate the need for ongoing mental health screening and early interventions to mitigate long-term psychological distress in long-COVID patients.

背景 尽管现有研究已证实活动性新冠病毒感染期间会出现精神健康改变，但长期精神健康后遗症的患病率仍不明确。本研究旨在明确长新冠（long-COVID）患者出现抑郁、焦虑、压力应激及自杀倾向等精神健康症状的患病率，并探究其变化趋势与相关危险因素。
方法 本研究于2024年8月前，针对PubMed、EMBASE、Scopus、CINAHL、Cochrane Library、Web of Science及PsycINFO等数据库开展系统性文献检索，纳入以英语发表的观察性研究。采用标准化结构化工具对研究质量进行评估。主要结局指标为长新冠患者抑郁、焦虑、压力应激及自杀倾向的合并患病率（pooled prevalence）；次要结局指标包括上述精神健康问题随时间的变化趋势，以及相关影响因素的识别。
结果 本研究最终纳入94项符合纳入标准的研究进行合并分析。无论随访时长如何，各项精神健康症状的合并患病率估算结果如下：抑郁为25%（95%置信区间：22%~28%；预测区间（PI）：1%~59%）；经剪补法（trim and fill）校正后的焦虑患病率为23%（95%置信区间：21%~25%；PI：2%~35%）；抑郁或/和焦虑的复合结局患病率为25%（95%置信区间：23%~27%；PI：2%~51%）；压力应激为26%（95%置信区间：13%~39%；PI：1%~69%）；自杀倾向为19%（95%置信区间：15%~22%；PI：13%~25%）。Meta回归分析（meta-regression）结果显示，抑郁和/或焦虑的复合结局患病率随时间呈具有统计学意义的下降趋势（率差（RD）=-0.004，P=0.022）。此外，Meta回归分析结果表明，女性性别与低龄人群的精神健康症状患病率显著更高；研究设计与研究场景未对研究异质性产生影响。
结论 约四分之一的长新冠患者存在抑郁、焦虑、压力应激等精神健康症状，尽管该类症状的患病率呈轻微下降趋势，但在感染后两年仍维持较高流行水平。女性性别与低龄与焦虑、抑郁的高发生率相关。本研究结果提示，需持续开展精神健康筛查并实施早期干预，以缓解长新冠患者的长期心理困扰。