What factors increase the risk of psychiatric symptoms in long-term COVID patients?

In a recent study published in pro swan Journal, researchers conducted a systematic type review to identify factors that increase the risk of psychiatric symptoms in patients with long coronavirus disease (COVID) or post-COVID-2019 (COVID-19) conditions (PCC) .

study: Risk factors for psychiatric symptoms in long-term COVID patients: a systematic review. Image Credit: Cryptographer/Shutterstock.com

Background

COVID-19 impacts the mental health of affected individuals primarily through anxiety, fear, and negative social behaviors, leading to distressing reactions and health-risk behaviors.

Psychiatric symptoms lasting weeks or months after recovery are frequently reported among PCC patients. However, the symptoms and associated risk factors for psychiatric PCC are unknown.

Studies show that anxiety, depression, post-traumatic stress disorder (PTSD), fatigue, sleep disturbance, and cognitive impairment are common during COVID-19 recovery.

Other symptoms such as somatization, sleep disturbance, phobias, hostility, and obsessive-compulsive disorder have been observed in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive patients. These symptoms have been reported to persist long after discharge.

About research

In the current systematic review, researchers analyzed data on psychiatric symptoms and associated risk factors in PCC patients.

We searched databases including EMBASE, PubMed, and SCOPUS on 24 October 2021 for English-language records published from January 2020 to October 2021, as well as available full-texts.

The study consisted of adults and older adults with a confirmed diagnosis of COVID-19, who had psychotic symptoms persisting beyond 4.0 weeks after acute SARS-CoV-2 infection, and who met the National Institutes of Health (NICE) PCC criteria. used.

In addition, the references listed in the identified records were searched, and citation searches were performed against the included records and previously published relevant reviews. The Newcastle-Ottawa scale (NOS) was used to assess the risk of bias of observational studies.

The team obtained risk factors and prevalence of psychiatric disorders. COVID-19 symptomsOnly records with study designs such as cohort type, case-control type, cross-section type and case series type were included.

Reviews and studies involving children and/or adolescents were excluded. One investigator searched the data and two investigators performed the title summarization and full-text screening.

Extracted data included author name, year of publication, country of publication, study design, sample population, age, sex ratio, time elapsed since diagnosis of acute COVID-19, prevalence of psychotic symptoms, assessment tools, statistical significant risk factors and their effect sizes (relative risk, odds ratio, hazard ratio, prevalence).

Results and discussion

In total, 2,218 records were retrieved initially, 1,022 duplicate records were removed, and 1,131 records were removed after title abstract screening.

In addition, 47 records that did not meet eligibility criteria were excluded and 5 additional records were included by citation search. As a result, 23 records were considered for the final analysis.

The majority of included studies used validated but self-documenting questionnaires. The mean NOS score of the included studies was 6.4, indicating moderate quality of evidence.

The most frequently recorded psychiatric symptoms included depression, anxiety, sleep disturbances, PTSD, cognitive impairment, and physical symptoms.

Female gender, history of psychiatric illness, family loss, self-perception of COVID-19 severity, and persistent symptoms increased the risk of psychiatric symptoms in PCC patients.

Anxiety was documented in 19 of the 23 records, with prevalence ranging from 7.0% to 48%. Depression he had on 17 records, and his prevalence ranged from 4.0% to 36%. PTSD he had on 7 records, with prevalence ranging from 13% to 43%. Insomnia and sleep disturbances were described in 13 records, with prevalence ranging from 4.0% to 50%.

In addition, the team found elevated neutrophil-lymphocyte ratio (NLR), interleukin-6 (IL-6), C-reactive protein (CRP) on admission, COVID-19-related hospitalization, and moderate-intensity SARS. – Discovered association with CoV. – 2 infections.

Follow-up time was associated with anxiety and PTSD, and obesity was associated with poor sleep quality in PCC patients. In addition, marital status, length of hospital/intensive care unit (ICU) stay, neurological complications, and days post-discharge were associated with cognitive impairment in PCC.

Female gender tends to internalize disorders of mental health and thus may increase the risk of psychiatric symptoms in patients with PCC. Additionally, women are accustomed to social interaction and support beyond the home to maintain their mental health.

The lack of social opportunities due to COVID-19-related lockdowns may therefore have a negative impact on women. In addition, women tend to be more hyperactive, have negative moods and cognitive impairment, which can lead to depression.

Obesity may contribute to sleep disturbances due to associated hyper-inflammation, immune dysfunction, and chronic comorbidities. PTSD has been reported during the pandemic because of the way people live.

Conclusion

Overall, the findings showed that psychiatric symptoms such as depression, anxiety, PTSD, and sleep disturbances were common among PCC patients, consistent with previous studies.

A woman’s gender and history of psychiatric illness increased her risk of developing most psychiatric PCC symptoms. The findings may help develop new strategies to improve the mental health of PCC patients.

Persistence of psychiatric symptoms after the acute phase of COVID-19 may increase the disease burden, requiring long-term monitoring, intensive screening, and early intervention for mental health disorders in patients with PCC.