Mental disorders can either be caused by, or be risk factors for, COVID-19 infection. Acute COVID-19 infections can affect the neurological system directly or through the body’s inflammatory response, leading to anxiety, depression, or cognitive symptoms. Psychosocial factors including social isolation, fears about getting sick, and and job loss can also lead to depression and anxiety. Gaps in mental health care related to the pandemic can exacerbate existing mental health conditions.
Serious mental illnesses (SMI) are risk factors for for COVID-19 infection, severity, and mortality. Risk factors including smoking, medical comorbidity, and poverty place these individuals at elevated risk for infection and adverse outcomes from COVID-19. Individuals with SMI who are homeless or living in residential settings such as nursing homes or state hospitals may be at particularly high risk for becoming infected. Taken together, the bidirectional relationship between mental illness and COVID-19 outcomes highlights the urgency of ensuring high quality mental health care and COVID-19 mitigation strategies in this population.