{"doi":"10.1101/2021.07.25.21261094","title":"The adverse impact of consecutive COVID-19 waves on mental health","abstract":"Summary Background Although several studies documented the impact of COVID-19 on mental health, the long-term effects of COVID-19 on mental health remain unclear. Aims To examine longitudinal changes in mental health prior to and during the consecutive COVID-19 waves in a well-established probability sample. Method An online survey was completed by the participants of the COVID-19 add-on study at 4 timepoints (N 1 =1823, N 2 =788, N 3 =532, N 4 =383): pre-COVID period (2014/2015), 1 st COVID-19 wave (April-May, 2020), 2 nd COVID-19 wave (August-October, 2020) and 3 rd COVID-19 wave (March-April, 2021). Data were collected via a set of validated instruments and analysed using latent growth models. Results During the pandemic, we observed a significant increase in stress levels (slope=1.127, P<0.001) and depressive symptoms (slope=1.177, P<0.001). The rate of increase in stress levels (cov=2.167, P=0.002), but not in depressive symptoms (cov=0.558, P=0.10), was associated with the pre-pandemic mental health status of the participants. Further analysis revealed two opposing clusters of factors that influenced mental health: loneliness and COVID-19 showed a negative effect on emotionality, while higher resilience acted protectively. A greater increase in stress was observed in women and younger participants. Conclusions The surge in stress levels and depressive symptoms persisted across all three consecutive COVID-19 waves. This surge is attributable to the effect of several risk factors including the status of mental health prior to the COVID-19 pandemic. Our findings have implications for strategies promoting resilience and addressing loneliness to mitigate the mental health impact of COVID-19 pandemic.","journal":"medRxiv","year":2021,"id":221297,"datarank":0.10397207708399181,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"self_citation_contribution":0.10397207708399181,"citation_network_contribution":0.0,"self_endowment_contribution":0.10397207708399181,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8765,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":821306,"name":"Juan P. González‐Rivas","orcid":"0000-0001-7676-7900","position":1,"is_corresponding":false},{"id":821307,"name":"Šárka Kunzová","orcid":"0000-0003-1868-5856","position":2,"is_corresponding":false},{"id":821308,"name":"Mária Skladaná","orcid":"0000-0001-5008-3279","position":3,"is_corresponding":false},{"id":821309,"name":"Anna Pospíšilová","orcid":"0000-0001-6803-3130","position":4,"is_corresponding":false},{"id":821310,"name":"Anna Bartošková Polcrová","orcid":"0000-0002-3358-8475","position":5,"is_corresponding":false},{"id":461079,"name":"Maria Vassilaki","orcid":"0000-0001-8328-136X","position":6,"is_corresponding":false},{"id":393524,"name":"José R. Medina‐Inojosa","orcid":"0000-0001-8705-0462","position":7,"is_corresponding":false},{"id":393528,"name":"Francisco López-Jiménez","orcid":"0000-0001-5788-9734","position":8,"is_corresponding":false},{"id":461080,"name":"Yonas E. Geda","orcid":"0000-0003-1187-7230","position":9,"is_corresponding":false},{"id":393527,"name":"Gorazd B. Stokin","orcid":"0000-0001-8430-8755","position":10,"is_corresponding":false},{"id":821305,"name":"Jan Novotný","orcid":"0000-0001-5074-8971","position":0,"is_corresponding":true}],"reference_count":88,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-18T23:53:55.215284Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}