Trajectories of post-traumatic stress symptoms, anxiety, and depression in hospitalized COVID-19 patients: A one-month follow-up

Abstract

Objectives Little is known about the mental health outcomes of hospitalized COVID-19 patients. The aims of the study were: (1) to examine the trajectories of anxiety, depression, and pandemic-related stress factors (PRSF) of COVID-19 hospitalized patients one-month following hospitalization; (2) to assess the presence of post-traumatic stress symptoms (PTSS) a month after hospitalization; (3) to identify baseline risk and protective factors that would predict PTSS one month after hospitalization. Methods We contacted hospitalized COVID-19 patients ( n = 64) by phone, at three time-points: during the first days after admission to the hospital (T1); after ~two weeks from the beginning of hospitalization (T2), and one month after hospitalization (T3). At all time-points we assessed the levels of anxiety and depression symptoms, as well as PRSF. At T3, PTSS were assessed. Results The levels of depressive and anxiety symptoms decreased one-month following hospitalization. Moreover, higher levels of anxiety (standardized β = 1.15, 95% CI = 0.81–1.49, p < 0.001) and depression (β = 0.97, 95% CI = 0.63–1.31 p < 0.001) symptoms during the first week of hospitalization, feeling socially disconnected (β = 0.59, 95% CI = 0.37–0.81 p < 0.001) and experiencing a longer hospitalization period (β = 0.25, 95% CI = 0.03–0.47 p = 0.026) predicted higher PTSS scores a month post-hospitalization. Conclusions We identified early hospitalization risk factors for the development of PTSS one month after hospitalization that should be targeted to reduce the risk for PTSS.

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

“…Depression is significantly higher than controls until 30 days after recovery whereafter the symptoms improve and no significant differences between cases and controls were found. Matalon et al (2021) reported that depression and anxiety had normalised at the one month follow-up, but were predictors of longer lasting PTSD. Mazza et al (2021) found persistent depressive symptomatology at 3 month follow-up, whereas anxiety had improved at this timepoint.…”

“…The most frequently reported psychiatric deficits were depression and/or anxiety. In total, this was examined in 47 studies ( Al-Aly et al, 2021 , Alemanno et al, 2021 , Boari et al, 2021 , Chen et al, 2020 , Chevinsky et al, 2021 , Daher et al, 2020 , Darley et al, 2021 , Daugherty et al, 2021 , De Lorenzo et al, 2020 , Frontera et al, 2021 , Gennaro et al, 2021 , González et al, 2021 , Halpin et al, 2021 , Huang et al, 2021a , Iqbal et al, 2021 , Lorenzo et al, 2021 , Matalon et al, 2021 , Mattioli et al, 2021 , Mazza et al, 2020 , Mazza et al, 2021 , Méndez et al, 2021 , Monti et al, 2021 , Morin et al, 2021 , Negrini et al, 2021 , Noviello et al, 2021 , Ortelli et al, 2021 , Poyraz et al, 2021 , Romero-Duarte et al, 2021 , Sykes et al, 2021 , Tanriverdi et al, 2021 , Taquet et al, 2021a , Taquet et al, 2021b , Tomasoni et al, 2021 , Townsend et al, 2021 , van den Borst et al, 2020 , Venturelli et al, 2021 , Wang et al, 2020b , Wang et al, 2020c , Whiteside et al, 2021 , Wong et al, 2020 , Wu et al, 2020 , Xiong et al, 2021 , Yuan et al, 2020 , Zhou et al, 2020 , D'Cruz et al, 2021 , de Graaf et al, 2021 , Weerahandi et al, 2021 ). The results range from no indication of depression or anxiety ( Daher et al, 2020 , Zhou et al, 2020 ) to >30% at follow-up ( De Lorenzo et al, 2020 , Frontera et al, 2021 , Iqbal et al, 2...…”

“…GMV was negatively correlated with LDH. Global MD of WM was found to correlate with memory loss Matalon et al, 2021 (Israel) To examine anxiety, depression and stress in COVID-19 patients 1 months after hospitalization Prospective cohort study PROMIS 64 35 (55%) 47 1 month Adult hospitalized COVID-19 survivors Cognitive or language barriers Depressive and anxiety symptoms decreased from acute disease to follow up, but was a predictor of PTSS Mattioli et al, 2021 (Italy) To investigate neurological and cognitive impairments 4 months after COVID-19 Cohort study MMSE 120 30 (25%) 48 4 months Health care workers with COVID-19 Not reported No cognitive impairment was found. Anxiety, stress and depression was higher than in the matched comparison group Mazza et al, 2020 (Italy) To investigate the psychopathological impact of COVID-19 in survivors at one month follow up Cohort study Unstructured clinical interview + IES-R, PCL-5, ZSDS, BDI-13, STAI-Y, MOS-SS, WHIIRS, and OCI 402 264 (65.7%) 57.8 31 days after discharge or 28 days after visit to ED Patients surviving COVID-19 which had either been hospitalised at or evaluated at the ED at San Raffaele Hospital in Milan.…”

COVID-19-associated PTSD in the elderly—lessons learned for the next global pandemic

“…Only a few studies have been performed to evaluate post-traumatic stress symptoms in the general population, though [ 5 ]. A study that had addressed the prevalence of PTSD among COVID recovered patients found that nearly 20% of these patients had symptoms of post-traumatic stress 1 month following hospitalization [ 7 ]. However, this study does not have a good representation of older adults above 65 years, who are the most vulnerable and the hardest-hit age group [ 7 , 8 ].…”

“…A study that had addressed the prevalence of PTSD among COVID recovered patients found that nearly 20% of these patients had symptoms of post-traumatic stress 1 month following hospitalization [ 7 ]. However, this study does not have a good representation of older adults above 65 years, who are the most vulnerable and the hardest-hit age group [ 7 , 8 ]. Current literature on PTSD primarily focuses on stressors like physical assault, sexual violence, war, accident, kidnapping, and being threatened with a weapon, as the causative triggers of PTSD [ 9 ].…”