Depression, Anxiety, and Acute Stress Disorder Among Patients Hospitalized With COVID-19: A Prospective Cohort Study

Parker, Catherine; Shalev, Daniel; Hsu, Ian C.; Shenoy, Akhil; Cheung, Samson; Nash, Sara; Wiener, Ilona; Fedoronko, David A.; Allen, Nicole E.; Shapiro, Peter A.

doi:10.1016/j.psym.2020.10.001

Cited by 61 publications

(56 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Most of the published studies thus far evaluating anxiety and other neuropsychiatric disorders in patients with COVID-19 are cross-sectional, and few of the newer studies are prospective (Parker et al 2020). In future, it is important to conduct more prospective studies with follow up of the patients after clearance of COVID-19 symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Very useful will be application of anxiety peripheral blood biomarkers (Vismara et al 2020). It is notable that some patients with COVID-19 display a correlation between anxiety and inflammatory markers Parker et al 2020). It is possible for anxiety to be comorbid with, or often specifically precede delirium, which is a complication of acute COVID-19 infection (Han et al 2020;Iqbal et al 2020;Parker et al 2020).…”

Section: Presentation Of Anxiety In Covid-19 Patientsmentioning

confidence: 99%

“…It is notable that some patients with COVID-19 display a correlation between anxiety and inflammatory markers Parker et al 2020). It is possible for anxiety to be comorbid with, or often specifically precede delirium, which is a complication of acute COVID-19 infection (Han et al 2020;Iqbal et al 2020;Parker et al 2020). While physicians and psychiatrists should have this in mind as a differential diagnosis of anxiety in COVID-19 infection, delirium is not the focus of this review.…”

Section: Presentation Of Anxiety In Covid-19 Patientsmentioning

confidence: 99%

“…In individuals infected with SARS-CoV-2, de novo neuropsychiatric symptoms are observed in a very high fraction of the population (Theoharides and Conti 2020;Varatharaj, Thomas et al 2020). At present, few published studies examine the neuropsychiatric effects, including anxiety, of COVID-19 on patients with prior mental illness in comparison with patients without prior mental illness (Sergeant et al 2020) (Parker et al 2020). One prospective study reports that more patients with previous psychiatric diagnosis screened positive for mood symptoms using HADS than those without psychiatric diagnosis, but the differences were not statistically significant (Parker et al 2020).…”

Section: Presentation Of Anxiety In Covid-19 Patientsmentioning

confidence: 99%

“…At present, few published studies examine the neuropsychiatric effects, including anxiety, of COVID-19 on patients with prior mental illness in comparison with patients without prior mental illness (Sergeant et al 2020) (Parker et al 2020). One prospective study reports that more patients with previous psychiatric diagnosis screened positive for mood symptoms using HADS than those without psychiatric diagnosis, but the differences were not statistically significant (Parker et al 2020). This is an area of further investigation as more becomes known about the COVID-19 infection and its course.…”

Section: Presentation Of Anxiety In Covid-19 Patientsmentioning

confidence: 99%

See 4 more Smart Citations

Presentation and management of anxiety in individuals with acute symptomatic or asymptomatic COVID-19 infection, and in the post-COVID-19 recovery phase

Uzunova

Pallanti

Hollander

2021

International Journal of Psychiatry in Clinical Practice

View full text Add to dashboard Cite

COVID-19 is associated with neuropsychiatric complications, the most frequent one being anxiety. Multiple biological and psychosocial factors contribute to anxiety in COVID-19. Among the biological factors, stress, genetics, gender, immune system, resilience, anosmia, hypogeusia, and central nervous system infection with SARS-CoV-2 are key. Anxiety is a complication of COVID-19 that may exacerbate the infection course, and the infection may exacerbate anxiety. We present the mechanisms of anxiety in symptomatic or asymptomatic COVID-19. We discuss the presentation of anxiety in patients without or with prior psychiatric illness, and with co-morbidities. Timely diagnosis and management of anxiety in COVID-19 patients is important. Given the frequent complication of COVID-19 with Acute Respiratory Distress Syndrome and Intensive Care Unit stay, anxiety may be a long-term complication. We review the diagnostic tools for anxiety in COVID-19, and summarise pharmacologic and non-pharmacologic treatments. We provide recommendations for diagnosis, treatment, prevention and follow up of anxiety in COVID-19. KEY POINTS Patients with COVID-19 (symptomatic or asymptomatic) exhibit a high frequency of neuropsychiatric complications with highest percentage attributed to anxiety. Multiple biological and psychosocial risk factors for anxiety exist in COVID-19-ill individuals. Biological risk factors include stress, resilience, genetics, gender, age, immune system, direct infection of the central nervous system (CNS) with SARS-CoV-2, comorbid psychiatric and general medical illnesses, ARDS and ICU stay. Anosmia and hypogeusia are COVID-19-specific anxiety risk factors. Knowledge of the anxiety risk factors is essential to focus on timely interventions, because anxiety may be a complication of and exacerbate the COVID-19 course. An inverse correlation exists between resilience and anxiety because of COVID-19, and therefore efforts should be made to increase resilience in COVID-19 patients. In COVID-19, important anxiety mechanism is neuroinflammation resulting from activation of the immune system and an ensuing cytokine storm. The general approach to management of anxiety in COVID-19 should be compassionate, similar to that during trauma or disaster, with efforts focussed on instilling a sense of hope and resilience. In selecting pharmacological treatment of anxiety, the stress response and immune system effects should be key. Medications with cardio-respiratory adverse effects should be avoided in patients with respiratory problems. Anxiety is a disorder that will require for long-term follow up at least one month after COVID-19.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Presentation Of Anxiety In Covid-19 Patientsmentioning

confidence: 99%

Section: Presentation Of Anxiety In Covid-19 Patientsmentioning

confidence: 99%

Section: Presentation Of Anxiety In Covid-19 Patientsmentioning

confidence: 99%

Section: Presentation Of Anxiety In Covid-19 Patientsmentioning

confidence: 99%

See 3 more Smart Citations

Presentation and management of anxiety in individuals with acute symptomatic or asymptomatic COVID-19 infection, and in the post-COVID-19 recovery phase

Uzunova

Pallanti

Hollander

2021

International Journal of Psychiatry in Clinical Practice

View full text Add to dashboard Cite

show abstract

Four-Month Clinical Status of a Cohort of Patients After Hospitalization for COVID-19

Morin

Savale

Pham

et al. 2021

JAMA

485

344

View full text Add to dashboard Cite

The Writing Committee for the COMEBAC Study Group IMPORTANCE Little is known about long-term sequelae of COVID-19.OBJECTIVE To describe the consequences at 4 months in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTSIn a prospective uncontrolled cohort study, survivors of COVID-19 who had been hospitalized in a university hospital in France between March 1 and May 29, 2020, underwent a telephone assessment 4 months after discharge, between July 15 and September 18, 2020. Patients with relevant symptoms and all patients hospitalized in an intensive care unit (ICU) were invited for further assessment at an ambulatory care visit. EXPOSURES Survival of hospitalization for COVID-19.MAIN OUTCOMES AND MEASURES Respiratory, cognitive, and functional symptoms were assessed by telephone with the Q3PC cognitive screening questionnaire and a checklist of symptoms. At the ambulatory care visit, patients underwent pulmonary function tests, lung computed tomographic scan, psychometric and cognitive tests (including the 36-Item Short-Form Health Survey and 20-item Multidimensional Fatigue Inventory), and, for patients who had been hospitalized in the ICU or reported ongoing symptoms, echocardiography. RESULTS Among 834 eligible patients, 478 were evaluated by telephone (mean age, 61 years [SD, 16 years]; 201 men, 277 women). During the telephone interview, 244 patients (51%) declared at least 1 symptom that did not exist before COVID-19: fatigue in 31%, cognitive symptoms in 21%, and new-onset dyspnea in 16%. There was further evaluation in 177 patients (37%), including 97 of 142 former ICU patients. The median 20-item Multidimensional Fatigue Inventory score (n = 130) was 4.5 (interquartile range, 3.0-5.0) for reduced motivation and 3.7 (interquartile range, 3.0-4.5) for mental fatigue (possible range, 1 [best] to 5 [worst]). The median 36-Item Short-Form Health Survey score (n = 145) was 25 (interquartile range, 25.0-75.0) for the subscale "role limited owing to physical problems" (possible range, 0 [best] to 100 [worst]). Computed tomographic lung-scan abnormalities were found in 108 of 171 patients (63%), mainly subtle ground-glass opacities. Fibrotic lesions were observed in 33 of 171 patients (19%), involving less than 25% of parenchyma in all but 1 patient. Fibrotic lesions were observed in 19 of 49 survivors (39%) with acute respiratory distress syndrome. Among 94 former ICU patients, anxiety, depression, and posttraumatic symptoms were observed in 23%, 18%, and 7%, respectively. The left ventricular ejection fraction was less than 50% in 8 of 83 ICU patients (10%). New-onset chronic kidney disease was observed in 2 ICU patients. Serology was positive in 172 of 177 outpatients (97%).CONCLUSIONS AND RELEVANCE Four months after hospitalization for COVID-19, a cohort of patients frequently reported symptoms not previously present, and lung-scan abnormalities were common among those who were tested. These findings are limited by the absence of a control group and of pre-COVID assessments in this cohort. ...

show abstract

Psychological Effects and Neuropsychiatric Sequelae in COVID‐19 Patients

Sakka¹,

Kalniunas²,

Vitkauskaite³

et al. 2022

Coronavirus Disease 2019 (COVID‐19)

View full text Add to dashboard Cite

Depression, Anxiety, and Acute Stress Disorder Among Patients Hospitalized With COVID-19: A Prospective Cohort Study

Cited by 61 publications

References 25 publications

Presentation and management of anxiety in individuals with acute symptomatic or asymptomatic COVID-19 infection, and in the post-COVID-19 recovery phase

Presentation and management of anxiety in individuals with acute symptomatic or asymptomatic COVID-19 infection, and in the post-COVID-19 recovery phase

Four-Month Clinical Status of a Cohort of Patients After Hospitalization for COVID-19

Psychological Effects and Neuropsychiatric Sequelae in COVID‐19 Patients

Contact Info

Product

Resources

About