Prevalence and incidence of neuropsychiatric disorders in post hospitalized COVID-19 patients in South America: a systematic review and meta-analysis

Abstract

IntroductionThere are multiple reports of neuropsychiatric disorders (NDs) such as stress, depression, post-traumatic stress disorder (PTSD), or anxiety, in patients who have survived the acute phase of COVID-19, being even more frequent in people who were hospitalized with moderate or severe disease. South America (SA) was one of the most affected continents during this time due to its health, social, political and economic context. We aimed to determine the prevalence and incidence of NDs in patients following hospitalization for COVID-19 in SA.Materials and methodsWe searched in PubMed, Embase, Scopus, Web of Science, LILACS, SciELO, and Google Scholar databases up to October 2022. We performed proportion meta-analysis with a random-effect model and Freeman-Tukey Double Arcsine transformation using the STATA 16.1 program. Finally, we evaluated heterogeneity by subgroup analysis and certainty of evidence with the GRADE approach.ResultsWe included eight studies from four countries. We only pooled six studies with prevalence measures. The estimated prevalence of all NDs was 31.48% (two-studies, 95%CI: 25.82–37.43). Depression, anxiety, insomnia, PTSD, and memory alterations had a pooled prevalence of 16.23% (three-studies, 95%CI: 7.18–27.93, I2: 94.22), 18.72% (three-studies, 95%CI: 11.65–26.97, I2: 87.56), 43.07% (three-studies, 95%CI: 32.77–53.37, I2: 92.61), 31.78% (three-studies, 95%CI: 14.33–52.40, I2: 97.96), and 38.24% (two-studies, 95%CI: 35.5–40.97), respectively. The evidence included was deemed as moderate to high certainty.ConclusionWe suggest that NDs should be prioritized in research and care in South America with public policies that can support their identification and prompt management to improve the quality of life of patients. More studies are needed to adequately study the prevalence of NDs in South America, their associated factors, and evaluate the causes of heterogeneity.Systematic review registrationhttps://doi.org/10.6084/m9.figshare.21901041.v1.

Post-traumatic stress disorder in individuals who required hospitalization for COVID-19: A cross-sectional study

“…All the individuals evaluated in our study had the moderate and severe form of COVID-19 and required hospitalization in a hospital ward or in the ICU. The presence of PTSD after hospitalization for COVID-19 may be due to their experience in the context of hospitalization during the pandemic, in which they needed to be isolated in a hospital bed, they experienced the physical impacts of the disease, exposure to invasive procedures and had a constant fear of death 2 .…”

“…COVID-19 triggers inflammation in both the body and the brain, giving rise to psychiatric symptoms, particularly in individuals who have been discharged from the hospital after experiencing a significant level of emotional stress due to confinement within the hospital setting and the impact of the disease itself 2 . Social distancing and social isolation measures 3 have led patients being more prone to anxiety symptoms, depressive disorders and insomnia, resulting in the occurrence of post-traumatic stress disorder (PTSD) 2 .…”

“…COVID-19 triggers inflammation in both the body and the brain, giving rise to psychiatric symptoms, particularly in individuals who have been discharged from the hospital after experiencing a significant level of emotional stress due to confinement within the hospital setting and the impact of the disease itself 2 . Social distancing and social isolation measures 3 have led patients being more prone to anxiety symptoms, depressive disorders and insomnia, resulting in the occurrence of post-traumatic stress disorder (PTSD) 2 . PTSD is a persistent and intense experience of traumatic memories, psychological and physiological suffering, symbolizing aspects of the traumatic event, continuous symptoms of increased excitability and occupational impairment in several important areas of their life 4 .…”