OBJECTIVES : The COVID-19 pandemic lockdown during the spring of 2020 is assumed to have impacted the mental health of US adults. Outcomes researchers currently lack the understanding of how to adapt ongoing research or modify analysis plans in light of COVID-19. The objective of this study is to assess the impact of the COVID-19 pandemic lockdown on established anxiety and depression measures.

METHODS : Cases from a cross-sectional, nationally-representative web-based survey of US adults conducted 24 April through 13 May 2020 reporting COVID-19 symptoms and test results were matched with cases from a 2018-19 study using a similar sampling frame. Mental and physical health were assessed by adjusting anxiety and depression scores and logistic regression model coefficients mapped to GAD-7 and PHQ-9 scores. Participant demographics, comorbid conditions and a PROMIS measure of Global Mental Health were also collected. Chi-square tests were used to assess categorical variables and ANOVAs for continuous variables.

RESULTS : Of the 5,203 participants surveyed during the COVID-19 pandemic, 4,959 (95.3%) were matched with a case from a 2018-19 study using a similar sampling frame. Participants surveyed during the lockdown compared to those surveyed prior to the pandemic reported: >50% higher mean anxiety scores (6.99 vs. 4.66, p<0.001) and more moderate to severe anxiety (62.73% vs. 40.61%, p<0.001) relative to no or mild anxiety; >45% higher mean depression scores (7.70 vs. 5.30, p<0.001) and more moderate to severe depression (62.42% vs. 40.06%, p<0.001) relative to no or mild depression; and a lower mean PROMIS mental health score (48.71 vs. 50.32, p<0.001). Those with a positive COVID-19 test had the highest rates of anxiety and depression.

CONCLUSIONS : This study quantifies the increase in anxiety and depression in US adults during the Spring of 2020. The results may help others interpret or place data collected during the COVID-19 pandemic in context.