text: Comparison of post COVID depression and major depressive disorder During the COVID 19 pandemic rates of depressive symptoms are markedly elevated particularly among survivors of infection Understanding whether such symptoms are distinct among those with prior SARS CoV 2 infection or simply a nonspecific reflection of elevated stress could help target interventions We analyzed data from multiple waves of a 50 state survey that included questions about COVID 19 infection as well as the Patient Health Questionnaire examining depressive and anxious symptoms We utilized multiple logistic regression to examine whether sociodemographic features associated with depression liability differed for those with or without prior COVID 19 and then whether depressive symptoms differed among those with or without prior COVID 19 Among 91 791 respondents in regression models age gender race education and income all exhibited an interaction with prior COVID 19 in risk for moderate or greater depressive symptoms p 0 0001 in all cases indicating differential risk in the two subgroups Among those with such symptoms levels of motoric symptoms and suicidality were significantly greater among those with prior COVID 19 illness Depression risk increased with greater interval following acute infection Our results suggest that major depressive symptoms observed among individuals with prior COVID 19 illness may not reflect typical depressive episodes and merit more focused neurobiological investigation 