Post-infection depression, anxiety and PTSD: a retrospective cohort study with mild COVID-19 patients

Abstract

Background: It remains unclear whether COVID-19 is associated with psychiatric symptoms during or after the acute illness phase. Being affected by the disease exposes the individual to an uncertain prognosis and a state of quarantine. These factors can predispose individuals to the development of mental symptoms during or after the acute phase of the disease. There is a need for prospective studies assessing mental health symptoms in COVID-19 patients in the post-infection period. Methods: In this retrospective cohort study, nasopharyngeal swabs for COVID-19 tests were collected at patients homes under the supervision of trained healthcare personnel. Patients who tested positive for COVID-19 and were classified as mild cases (N=895) at treatment intake were further assessed for the presence of mental health disorders (on average, 56.6 days after the intake). We investigated the association between the number of COVID-19 symptoms at intake and depression, anxiety and PTSD, adjusting for previous mental health status, time between baseline and outcome, and other confounders. Multivariate logistic regression and generalized linear models were employed for categorical and continuous outcomes, respectively. Findings: Depression, anxiety and PTSD were reported by 26.2% (N=235), 22.4% (N=201), and 17.3% (N=155) of the sample. Reporting an increased number of COVID-related symptoms was associated with depression (aOR=1.059;95%CI=1.002-1.119), anxiety (aOR=1.072;95%CI=1.012-1.134), and PTSD (aOR=1.092;95%CI=1.024-1.166). Sensitivity analyses supported findings for both continuous and categorical measures. Interpretation: Exposure to an increased number of COVID-19 symptoms may predispose individuals to depression, anxiety and PTSD after the acute phase of the disease. These patients should be monitored for the development of mental health disorders after COVID-19 treatment discharge. Early interventions, such as brief interventions of psychoeducation on coping strategies, could benefit these individuals.

The Association between Future Anxiety, Health Literacy and the Perception of the COVID-19 Pandemic: A Cross-Sectional Study

“…Increased anxiety, apart from fear, symptoms of depression, and lower quality of sleep, was the most frequently reported mental consequence of the COVID-19 pandemic in the general population [75][76][77]. Similar findings were confirmed for health care professionals [78] and patients who had suffered from the symptoms of COVID-19 infection [79]. A better understanding of the determinants of anxiety during COVID-19 pandemic is of the utmost importance as symptoms of anxiety and depression may result in people being less likely to adhere to the recommended preventative measures [80].…”

Correlates of psychotic like experiences (PLEs) during Pandemic: An online study investigating a possible link between the SARS-CoV-2 infection and PLEs among adolescents

“…Our findings also showed that the number of SARS-CoV-2 symptoms during the acute infection period was associated with PLEs-frequency, PLEs-related stress, and depression and anxiety levels. Consistent with this finding, an increased number of SARS-CoV-2 symptoms at baseline, which may show illness severity, was found to be related to increased prevalence of depression, anxiety, and post-traumatic stress disorder ( Ismael et al, 2020 ).…”

Treatment, Persistent Symptoms, and Depression in People Infected with COVID-19 in Bangladesh

“…Another study also suggested that lower family income (OR = 2.99, 95% CI = 1.11–8.05), persistent symptoms (OR = 2.63; 95% CI = 1.34–5.17), and poor social support (OR = 3.13; 95% CI = 1.34–7.30) were significantly associated with depression [ 65 ]. Negative emotions linked to COVID-19 may underlie associations with depression [ 66 ]. Our findings agree with data showing frequent depression, panic, and general anxiety disorder in Bangladesh during the COVID-19 pandemic [ 67 , 68 ].…”