Persistent Somatic Symptom Burden and Sleep Disturbance in Patients with COVID-19 During Hospitalization and After Discharge: A Prospective Cohort Study

Abstract

Background The present study was designed to reveal the trajectory of self-reported somatic symptom burden and sleep quality over time in patients with COVID-19 and to identify prognostic factors for greater somatic symptom burden and sleep disturbance. Material/Methods Seventy-four patients with COVID-19 were prospectively followed for longitudinal assessment of somatic symptom burden and sleep quality. We used the 8-item Somatic Symptom Scale (SSS-8) and the modified Medical Research Council (mMRC) scale for somatic symptom burden and the Pittsburgh Sleep Quality Index for sleep quality investigation. Univariate and multivariate analyses were performed to identify independent factors associated with somatic symptom burden and sleep quality. Results Although the degree of physical discomfort and sleep quality issues tended to decline during self-quarantine, patients still experienced these problems to a certain degree. Univariate and multivariate analyses showed that SSS-8 scores at admission (relative risk [RR] 1.234, 95% CI 1.075–1.417, P =0.003) and mMRC scores at discharge (RR 2.420, 95% CI 1.251–4.682, P =0.009) were 2 independent prognostic indicators of somatic symptom burden. In addition, muscle pain as a chief complaint (RR 4.682, 95% CI 1.247–17.580, P <0.022) and history of use of hypnotic drugs (RR 0.148, 95% CI 0.029–0.749, P <0.019) were 2 independent indicators of patient sleep quality during hospitalization. Conclusions To the best of our knowledge, the present study was the first dynamic assessment of the somatic symptom burden and sleep quality in patients with COVID-19 during hospitalization and quarantine after discharge. Patients with high somatic symptom burden at admission, especially muscle pain as the chief complaint, are prone to having a higher physical burden and more sleep disturbance at discharge.

Psychiatric and neuropsychiatric sequelae of COVID-19 – A systematic review

“…Fatigue following recovery from acute COVID-19 was reported in 32 studies ( Al-Aly et al, 2021 , Albu et al, 2021 , Augustin et al, 2021 , Boari et al, 2021 , Chevinsky et al, 2021 , D'Cruz et al, 2021 , Daher et al, 2020 , Darley et al, 2021 , Daugherty et al, 2021 , Frontera et al, 2021 , Gautam et al, 2021 , Graham et al, 2021 , Halpin et al, 2021 , Huang et al, 2021a , Huang et al, 2021b , Iqbal et al, 2021 , Liang et al, 2020 , Morin et al, 2021 , Noviello et al, 2021 , Petersen et al, 2020 , Qu et al, 2021 , Romero-Duarte et al, 2021 , Sami et al, 2020 , Shang et al, 2021 , Sudre et al, 2021 , Sun et al, 2021 , Sykes et al, 2021 , Tenforde et al, 2020 , Townsend et al, 2020 , Townsend et al, 2021 , van den Borst et al, 2020 , Xiong et al, 2021 ). The results ranged from no fatigue at 1 month follow-up ( Huang et al, 2021b ) to 87% suffering from fatigue with 12 studies reporting >45% of their populations to be affected ( Albu et al, 2021 , Boari et al, 2021 , D'Cruz et al, 2021 , Daher et al, 2020 , Gautam et al, 2021 , Graham et al, 2021 , Halpin et al, 2021 , Huang et al, 2021a , Iqbal et al, 2021 , Liang et al, 2020 , Townsend et al, 2020 , van den Borst et al, 2020 ).…”

“… Sami et al (2020) found sleep disturbances to be independent of severity of acute COVID-19. Augustin et al, 2021 , Huang et al, 2021b , Sudre et al, 2021 , Taquet et al, 2021a on the contrary found that severity of acute COVID-19 was a predictor for sleep disturbances at follow-up. Mazza et al, 2021 , Lorenzo et al, 2021 , Sykes et al, 2021 reported that insomnia had improved after 3 months.…”

“…Sleep disturbances following COVID-19 was reported in 24 studies ( Al-Aly et al, 2021 , Boari et al, 2021 , D'Cruz et al, 2021 , De Lorenzo et al, 2020 , Frontera et al, 2021 , Gautam et al, 2021 , Gennaro et al, 2021 , Graham et al, 2021 , Huang et al, 2021a , Huang et al, 2021b , Iqbal et al, 2021 , Lorenzo et al, 2021 , Mazza et al, 2020 , Mazza et al, 2021 , Negrini et al, 2021 , Noviello et al, 2021 , Romero-Duarte et al, 2021 , Sami et al, 2020 , Shang et al, 2021 , Sykes et al, 2021 , Tanriverdi et al, 2021 , Taquet et al, 2021a , Taquet et al, 2021b , Wong et al, 2020 ). The results range from Noviello et al (2021) reporting no differences between COVID-19 survivors and controls at a 5 months follow-up to Graham et al (2021) , showing that 85% of the patients experienced sleep disturbances at 4–6 months follow-up.…”

“…Anxiety or depression in 23%. Anxiety/depression was highest in patients recovering from severe COVID-19 Huang et al, 2021b (China) To examine somatic symptom burden and sleep quality over time in COVID-19 survivors Cohort study PSQI 74 44 (60%) 52 1 month Adult COVID-19 survivors Incomplete medical records Fatigue had improved by follow up, but sleep disturbances were still present. Severity of acute COVID-19 was a predictor of sequelae Iqbal et al, 2021 (Pakistan) To assess the prevalence and characteristics of COVID 19 sequelae Cross sectional study Self-designed questionnaire 158 71 (45%) 40 20–90 days since recovery Adult recovered COVID-19 patients Psychiatric history 83% suffered from fatigue, 56% from sleep disturbances, 53% anxiety, 42% depression.…”

Strategies to aid self‐isolation and quarantine for individuals with severe and persistent mental illness during the COVID‐19 pandemic: A systematic review

“…To that end, the literature has extensively reviewed the psychological impact of isolation and quarantine ( 9 , 10 , 11 , 12 , 13 ). However, the effects of quarantine and self‐isolation on individuals with severe and persistent mental illnesses (SPMIs)—such as psychotic, mood, and substance use disorders (SUDs)—are unclear ( 14 ).…”