Background

COVID-19 survivors may experience persistent neuropsychological disruptions such as lower satisfaction with life (SWLS), depression, and anxiety. While student-athletes are at low risk for severe COVID complications, the effect of COVID on mental health remains to be elucidated.

Objective

Compare patient-reported mental health outcomes for incoming collegiate athletes who did (COVID+) and did not (COVID-) have COVID-19.

Methods

79 COVID+ (79/178, 44.4%, 18.90±0.16 years) and 99 COVID- (99/178, 55.6%,18.95±0.16 years) completed SWLS, anxiety (HADS anxiety, STAI), depression (HADS depression). Unadjusted One-way ANOVAs were conducted across all patient-reported outcomes. ANCOVAs were conducted to determine the interaction of COVID history, sex, and race/ethnicity on outcomes. Post-hoc Bonferroni testing was performed to determine specific differences between groups. Chi-square analyses were used to compare the number of athletes who met the standard of clinical cut points for both groups.

Results

We observed a significant difference between groups for HADS depression (p=0.047), whereby athletes in the COVID+ group had significantly higher depression ratings (2.9±0.3). There was a significant group difference for SWLS (p=0.019), HADS anxiety (p=0.003), and STAI state anxiety (p=0.014) such that SWLS, HADS anxiety, and trait anxiety was higher for the COVID+ group in the adjusted model. Post-hoc testing revealed that COVID+ females had significantly worse HADS anxiety (p=0.011) and STAI trait anxiety (p=0.002). There were no significant differences in the percentage of responses below established diagnostic thresholds between groups.

Conclusions

Incoming collegiate student-athletes who reported prior COVID diagnosis reported significantly higher depression scores suggesting clinicians may need to be aware of the potential need to intervene with appropriate mental health identification and referral. However, it was encouraging that most participants, regardless of prior COVID diagnosis, had mental health scores that did not exceed established diagnostic threshold values.