Abstract P546: Depressive Symptoms and Perceived Stress Are Associated With Post-Acute Sequelae of Sars-CoV-2 Infection

Abstract

Introduction: Post-acute sequelae of SARS-CoV-2 infection (PASC), a constellation of disabling symptoms, persisting after COVID-19, is an emerging health issue affecting substantial number of persons globally and in the US. Cardiac PASC refers to the wide range of cardiovascular-specific PASC symptoms. The psychological impact of PASC, cardiac PASC is poorly characterized. Objective: To examine whether PASC and cardiac PASC symptoms are associated with depressive symptoms and high levels of perceived stress. Methods: We conducted cross-sectional analyses among persons with history of COVID-19. Exposures were self-reported PASC and cardiac PASC symptoms. Outcomes were depressive symptoms and perceived stress measured using Patient Health Questionnaire (PHQ8) and Perceived Stress Scale (PSS4), respectively. Scores on PHQ8 ranged from 0-24, and clinical cutoff for depressive symptoms was ≥10. Scores on PHQ8 were dichotomized as minimal-mild (<10) and moderate-severe (≥10). Scores on PSS4 ranged from 0 to 16 with higher scores suggesting greater perceived stress. PSS4 scores were dichotomized as low/moderate (<6) and high (≥6) stress. We performed logistic regression analyses, adjusting for age, sex, race and comorbidities. Results: Of 197 participants, mean age was 47.3 (±15.9) years, 74% were female, 77% were White. About 48% (95/197) reported PASC, 46% (90/197 participants) reported cardiac PASC. The odds for moderate-severe depressive symptoms (adjusted Odds Ratio [aOR]: 5.03, 95%CI: 2.43-10.41, Table ) and high perceived stress (aOR: 4.19, 95%CI: 2.17-9.08) were higher compared to those who did not report PASC. Similarly, the odds for moderate-severe depression (aOR: 2.42, 95%CI: 1.25-4.70) and high perceived stress (aOR: 2.68, 95%CI: 1.43-5.02) was higher compared to those who did not report cardiac PASC. Conclusion: PASC and cardiac PASC are associated with clinical depressive symptoms and high perceived stress. Psychological and mental health interventions should be integrated into PASC care models.