Association between COVID-19 diagnosis and severe mental health symptoms in adolescents in southern Brazil.

A substantial proportion of high school adolescents in southern Brazil reported severe mental health symptoms.

• Of 462 participants, 16.6% reported severe symptoms of depression, 15.6% reported severe symptoms of anxiety, and 9.9% reported severe symptoms of stress.
• Outcomes were assessed using the 'Adolescent Anxiety, Depression, and Stress Scale' (DASS-21).
• The study was conducted with high school adolescents from the Instituto Federal do Rio Grande do Sul in Rio Grande, Brazil.
• The study design was cross-sectional.

A large proportion of adolescent participants reported a prior COVID-19 diagnosis.

• 41% of the 462 participants reported a diagnosis of COVID-19.
• COVID-19 diagnosis was obtained through self-report.
• Total sample size was 462 participants.

Adolescents with a self-reported COVID-19 diagnosis were significantly more likely to experience severe anxiety symptoms.

• In adjusted analysis, adolescents diagnosed with COVID-19 had a prevalence ratio (PR) of 2.12 for severe anxiety symptoms (95%CI 1.35–3.33).
• Poisson regression with robust variance adjustment was used for this analysis.
• This association was observed after adjustment for potential confounders.

Adolescents with a self-reported COVID-19 diagnosis were approximately three times more likely to develop severe symptoms of two of the three mental health disorders investigated simultaneously.

• The adjusted odds ratio (OR) for developing severe symptoms of two of the three disorders (depression, anxiety, or stress) was 2.98 (95%CI 1.35–6.56).
• Multinomial logistic regression was used to assess this association.
• This finding indicates a higher burden of comorbid severe mental health symptoms among COVID-19-diagnosed adolescents.

No statistically significant associations were found between COVID-19 diagnosis and severe depression or severe stress as individual outcomes in the adjusted analysis.

• Associations were specifically observed for severe anxiety and for the presence of multiple severe symptoms, but not reported individually for depression or stress in adjusted models.
• Descriptive and bivariate analyses were performed in addition to adjusted regression models.
• The authors highlight the need for further clinical and epidemiological research to better understand the impact of COVID-19 on adolescent mental health.