Self-Reported Mental Health Measures of Incoming Collegiate Student-Athletes With a History of COVID-19

Background: People with a history of COVID-19 may expe-rience persistent neuropsychological disruptions such as lower satisfaction with life, depression, and anxiety. Although student -athletes are at low risk for severe COVID-19 complications, the effect of COVID-19 on mental health has not been elucidated.Objective: To compare patient-reported mental health out-comes for incoming collegiate athletes with (COVID+) or without (COVID-) a history of COVID-19.Design: Case-control study.Setting: Laboratory.Patients or Other Participants: A total of 178 student -athletes, consisting of 79 in the COVID+ group (44.3%; age = 18.90 +/- 0.16 years) and 99 in the COVID-group (55.6%; age = 18.95 +/- 0.16 years).Main Outcome Measure(s): Participants completed the Satisfaction With Life Scale (SWLS), the Hospital Anxiety and Depression Scale (HADS), and the State-Trait Anxiety Inventory (STAI). Unadjusted 1-way analyses of variance were conducted across all patient-reported outcomes. Analyses of covariance were calculated to determine the interaction of COVID-19 group, sex, and race and ethnicity on outcomes. Post hoc Bonferroni testing was performed to identify specific differences between groups. A v2 analysis was computed to compare the number of athletes in each group who met the standard clinical cut points.Results: We observed a between-groups difference for HADS depression (P = .047), whereby athletes in the COVID+ group had higher ratings (2.86 +/- 0.26). We found group differences for the SWLS (P = .02), HADS anxiety (P = .003), and STAI state anxiety (P = .01) such that all scores were higher for the COVID+ group in the adjusted model. Post hoc testing revealed that female student-athletes in the COVID+ group had worse HADS anxiety (P = .01) and STAI trait anxiety (P = .002) scores than individuals in all other groups. We did not demonstrate differences between groups in the percentage of responses below established diag-nostic thresholds. Conclusions: Incoming collegiate student-athletes who reported a previous COVID-19 diagnosis displayed higher depres-sion scores, suggesting that clinicians may need to provide appro-priate identification and referral for mental health conditions. However, we were encouraged that most participants, regard-less of a history of COVID-19 diagnosis, had mental health scores that did not exceed established diagnostic threshold values.