Association of COVID19-induced anosmia and ageusia with depression and suicidal ideation

Abstract

Background: Clinical reports from patients suffering from the novel coronavirus (COVID-19) reflect a high prevalence of sensory deprivation or loss pertaining to smell (dysosmia/anosmia) and/or taste (dysgeusia/ageusia). Given the importance of the senses to daily functioning and personal experience, the mental health consequences of these symptoms warrant further attention.

Methods: A cohort of Reddit users posting within the /r/covid19positive subforum (N = 15,821) was leveraged to analyze instantaneous risk of transition to a state of suicidal ideation or depression using Cox proportional-hazards models. Risk transition was defined by posts made in suicide- or depression-related forums, or mentions of relevant phrases with and without mention of anosmia/ageusia in /r/covid19positive. Self-diagnosis of COVID-19 was also modeled as a separate and simultaneous predictor of mental health risk.

Results: Mention of anosmia/ageusia was significantly associated with transition to a risk state. Users with a history of anosmia/ageusia-related posts and who self-identified as COVID-19 positive had 30% higher instantaneous risk relative to others. The highest increase in instantaneous risk of suicidal ideation or depression occurred more than 100 days after first posting in /r/covid19positive.

Limitations: Use of self-diagnosed disease as well as a broad array of anosmia/ageusia-related terminology may entail both information bias and overestimates of symptom incidence.

Conclusions: The specific effects of COVID-19 on the senses may have long-term implications for patient mental health well-being beyond the primary recovery period. Future work is needed to investigate the longitudinal mental health burden of residual COVID-19 symptom presentation.

Keywords: Ageusia; Anosmia; Coronavirus (COVID-19); Depression; Social network; Suicidal ideation.

Fig. 1

Cumulative hazard curve for transition to a suicidal ideation or depression risk state Note. The curve represents instantaneous risk of transition to a depression or suicidal ideation risk state between users who self-identified as having COVID-19 and mentioned anosmia or ageusia compared with those who self-identified as having COVID-19, but did not indicate these symptoms. Time is relative to the first posting in /r/covid19positive. (n = 5822).