Increased risk of depression and anxiety in patients with chronic back pain following COVID-19 infection based on a nationwide population-based study

Using a nationwide database from the Korean National Health Insurance Service database, this retrospective cross-sectional study investigated how COVID-19 affects the onset of depression and anxiety in individuals with pre-existing back pain. Patients were enrolled between 2019 and 2020 using the International Classification of Diseases, Tenth Revision code. Ultimately, 28,593 and 24,777 eligible patients were classified into depression and anxiety groups, respectively. Further group subdivisions were made according to back pain and no back pain, established through a 1:3 ratio. The Cox proportional-hazards regression model was used to explore the risk of depression or anxiety developing in patients with back pain, adjusting for basic characteristics. Compared with individuals without back pain, those with back pain had higher crude hazard ratios (HRs) for depression (HR 1.877, 95% confidence interval [CI] 1.165-3.025, P = 0.01) and anxiety (HR 3.256, 95% CI 1.809-5.859, P < 0.001). Moreover, the back pain group had relatively high adjusted HRs for depression (HR 1.768, 95% CI 1.092-2.862, P = 0.02) and anxiety (HR 3.493, 95% CI 1.916-6.365, P < 0.001). COVID-19 is associated with a relatively high risk of developing depression and anxiety in patients with back pain than in those without.