Post-COVID-19 mental health and its associated factors at 3-months after discharge: A case-control study

Prevalence of depression, anxiety, stress, and suicide tendency among individual with long-COVID and determinants: A systematic review and meta-analysis

BACKGROUND

While mental health alterations during active COVID-19 infection have been documented, the prevalence of long-term mental health consequences remains unclear. This study aimed to determine the prevalence of mental health symptoms-depression, anxiety, stress, and suicidal tendencies-and to identify their trends and associated risk factors in individuals with long-COVID.

METHODS

We conducted a systematic literature search of databases including PubMed, EMBASE, Scopus, CINAHL, Cochrane Library, Web of Science, and PsycINFO up to August 2024, targeting observational studies published in English. Study quality was assessed using structured standard tools. The primary outcome was the pooled prevalence of depression, anxiety, stress, and suicidal tendencies in individuals with long-COVID. Secondary outcomes included trends in these mental health problems over time and identification of associated determinants.

RESULTS

A total of 94 eligible studies were included in the analysis. The pooled prevalence estimates, regardless of follow up times duration, were as follows: depression, 25% (95%CI:22-28%; PI:1-59%); anxiety (adjusted via trim and fill method), 23%(95%CI:21-25%;PI:2-35%); composite outcomes of depression and/or anxiety, 25% (95%CI:23-27%;PI:2-51%); stress, 26%(95%CI:13-39%;PI:1-69%); and suicidality, 19%(95%CI:15-22%;PI:13-25%). The results of meta-regression analyses revealed a statistically significant trend showing a gradual decrease in the prevalence of the composite outcome of anxiety and/or depression over time (RD = -0.004,P = 0.022). Meta-regression results indicated that being female and younger age were significantly associated with a higher prevalence of mental health symptoms. Study design and study setting did not contribute to heterogeneity.

CONCLUSION

One-fourth of individual with long-COVID experience mental health symptoms, including depression, anxiety, and stress, which remain prevalent even two years post-infection despite a slight decreasing trend. Factors such as female gender and younger age were linked to higher rates of anxiety and depression. These findings indicate the need for ongoing mental health screening and early interventions to mitigate long-term psychological distress in long-COVID patients.

Prevalence of Depressive Symptoms in a Predominantly Hispanic/Latinx South Texas Community in the Aftermath of the COVID-19 Pandemic

OBJECTIVE

COVID-19 has a lasting impact on mental health, particularly within the Hispanic/Latinx communities. This paper empirically investigates the post-COVID-19 presence and severities of depression, one of the most common mental health disorders, among adults in a predominantly U.S.-born Hispanic/Latinx community in South Texas composed primarily of Mexican Americans.

METHODS

Multiple statistic regression models were applied to data from 515 adults in Nueces County who completed all questions in a survey from convenience sampling between June 2022 and May 2023. Depression was assessed using both standard PHQ-2 and PHQ-9 measurements.

RESULTS

Of the 515 participants, 377 (64.5%) were Hispanic, and 441 (85.6%) had a high school education or higher, reflecting the county's demographics. About half of the participants (47%) reported mild/moderate to severe depression. The regression model estimation results reveal that female participants, those not in full-time employment, and individuals with disabilities were more likely to feel depressed after COVID-19. Middle-aged adults demonstrated greater resilience to depression compared to other age groups. Notably, non-Hispanic participants in the study reported higher levels of depression compared to their Hispanic counterparts. Additionally, COVID-19-related experiences, such as testing positive for the virus, being hospitalized, or having a history of depression before COVID-19, were associated with higher levels of reported depression.

CONCLUSIONS

COVID-19 has significantly impacted the mental health of this predominantly U.S.-born Hispanic/Latinx community. These findings can assist healthcare providers and policymakers in developing targeted strategies to tailor interventions aimed at enhancing mental health well-being, reducing disparities, and fostering overall improvement within the Hispanic/Latinx community.

Comparable Psychotropic Prescription Rates After Hospital Discharge Between Patients with COVID-19 and Those With Non-COVID-19-Related Respiratory Infection

INTRODUCTION

Whether psychiatric symptoms after recovery from coronavirus disease 2019 (COVID-19) are specific to this illness remains unclear.

METHODS

In this retrospective study, the Diagnosis Procedure Combination data and outpatient clinic data were used for patients who received inpatient treatment in Saiseikai-affiliated hospitals for COVID-19 or other respiratory tract infections (non-COVID) from 2020 to 2022. The primary outcome was new prescriptions of psychotropic drugs after discharge (i. e., prescriptions of psychotropics to patients who had not received them before or during their hospitalization). Values of interest were compared between groups using the chi-square test or Fisher's exact test. A COX proportional-hazards model was used to examine factors associated with psychotropic prescriptions after discharge in age- and sex-matched COVID-19 and non-COVID patients.

RESULTS

Of 31,993 chart records, 19,613 were excluded due to a positive history with psychiatric disorders (n=2,445), prescriptions of psychotropics (n=744), and no follow-ups (n=16,424). Thus, 3,648 COVID-19 and 8,732 non-COVID patients were included (mean [range] duration of follow-up, days: 146.9 [1-727] and 239.2 [1-729], respectively). Two hundred and four (5.6%) of the 3,648 patients with COVID-19 received psychotropic prescriptions after discharge. No statistically significant differences were observed in the prescription rates of any psychotropic category between the COVID-19 and non-COVID groups. An increase in severity during hospitalization was significantly associated with more frequent psychotropic prescriptions (hazard ratio 1.83, p<0.001).

DISCUSSION

The development of psychiatric symptoms should be closely observed, especially in patients who experienced increased severity during hospitalization, regardless of whether they suffered from COVID-19.

Prevalence and factors associated with depression and anxiety among patients recovered from COVID-19: a cross-sectional study in a tertiary care hospital in Nepal

Introduction

COVID-19 has immensely affected the mental health of all people with prominent effects among the COVID-19 survivors who underwent hospitalisation. The evidence of the long-term mental health implications among the recovered COVID-19 patients remains unknown in Nepal. The study aimed to determine the prevalence of depression and anxiety and the associated factors among COVID-19 recovered patients.

Methods

An analytical cross-sectional study was conducted from May to August 2021 among 269 COVID-19 recovered patients admitted to Dhulikhel Hospital during the first wave (July 2020 to January 2021), and second wave (April 2021 to July 2021) of the COVID-19 pandemic. Anxiety and depression of the participants were assessed using the Hospital Anxiety and Depression Scale. Multivariate logistic regression analysis was performed to determine the factors associated with anxiety and depression.

Results

The prevalence of anxiety and depression were 38.66% (95% CI 32.99 to 44.65), and 30.48% (95% CI 25.24 to 36.28), respectively. Participants who received COVID-19 related information from the radio reported higher levels of anxiety and depression symptoms. Similarly, stigma, and being a health worker were significantly associated with a higher level of anxiety and depression symptoms, respectively. However, social support and long recovery duration were protective factors against anxiety and depression symptoms. Participants receiving a higher level of social support and having a recovery duration of 3-6 months, 7 months and more reported lower odds of anxiety and depression symptoms, respectively.

Conclusions

The greater prevalence of anxiety and depression symptoms among recovered COVID-19 patients highlights the need to design and implement appropriate mental health interventions. This could be done through psychosocial support and counselling services in health facilities, mental health service in emergency situation and post-discharge rehabilitation programmes.

Prevalence of symptoms of anxiety and depression one year after intensive care unit admission for COVID-19

BACKGROUND

To the best of our knowledge, the long term prevalence of symptoms of anxiety and depression in ICU admitted individuals after COVID-19 in Sweden during the first wave of the pandemic has not been investigated. Furthermore, no studies have exclusively investigated the risk factors for experiencing symptoms of anxiety and depression in this population.

AIM

The aim of this study was to determine the prevalence of symptoms of anxiety and depression at one year after ICU admission for COVID-19. An additional aim was to identify any early predictors that are associated with symptoms of anxiety and depression, at one year following ICU admission for COVID-19.

METHODS

This multicenter cohort study had a cross-sectional and a longitudinal design. The primary outcomes and dependent variables, symptoms of anxiety and depression, were assessed using the Hospital Anxiety and Depression Scale (HADS). The independent variables were related to demographic factors, comorbidities, and complications during COVID-19-related ICU admission. Logistic regression analyses were performed to identify any predictors of symptoms of anxiety and depression.

RESULTS

Out of 182 eligible individuals, 105 participated in the study. Symptoms of anxiety was found in 40 (38.1%) and depression in 37 (35.2%) of the participants. Using univariable logistic regression analyses, female sex was identified as a predictor of depression as defined by HADS at one year following ICU admission for COVID-19 (odds ratio 2.53, 95% confidence intervals 1.01-6.34, p-value 0.048).

CONCLUSIONS

The high prevalence of symptoms of anxiety and depression in ICU admitted individuals one year after COVID-19 is a public health issue of concern. Our findings imply that individuals who recovered after an ICU stay for COVID-19 may benefit from long-term follow-ups and continuous mental health support for more than a year following the ICU admission. For women specifically, this is true.

TRIAL REGISTRATION

The study was registered at researchweb.org on 28 May 2020 (Project number: 274477).

Efficacy of online psychoeducation and relaxation training program (OnPR) on mental health problems in COVID-19 patients: A randomized controlled trial

Purpose

Prior studies found that the prevalence of anxiety, depression, stress and insomnia were relatively high in COVID-19 patients. This study aimed to explore the efficacy of OnPR on mental health outcomes in patients with asymptomatic or mildly symptomatic COVID-19.

Patients and methods

We employed a randomized controlled trial following the CONSORT guidelines. The Thai Clinical Trials Registry identification number of this study is TCTR20220729003. We used a block of 4 randomizations generated by a computer program. The intervention group (n = 38) received the OnPR program, and the control group (n = 36) received care as usual. OnPR was an online psychological intervention comprising psychoeducation, sleep hygiene education and relaxation techniques. OnPR was provided by qualified therapists trained with a standard protocol. The primary outcomes were depression, anxiety, and stress, which were determined by the Depression Anxiety and Stress Scale-21 (DASS-21). Sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI). Outcomes were compared between groups at pre-intervention and post-intervention at 1, 4, and 12 weeks using paired t-test or Wilcoxon signed-rank test. In addition, a linear mixed model was employed to demonstrate the effect changes of OnPR over time. All analyses were two-tailed, with a significance level of 0.05.

Results

Of 74 Thai participants, 89.2 % were female, and 11.8 % were male. The average age was 31 years. Participants' baseline characteristics were not statistically significant between the intervention and control groups except for depression and stress scores from DASS-21. OnPR resulted in significantly better improvement in depression, anxiety, stress, and sleep quality. The mean differences between groups of DASS-21 scores in depression, anxiety and stress at 7-day follow-up were -4.69, -3.29, and -5.50 respectively. The differences continue to be significant at 4-week and 12-week follow-ups. The mean difference between groups of PSQI at 7-day follow-up is -0.91.

Conclusion

OnPR improved mental health outcomes, and the effect on depression, anxiety and stress lasted for at least a 12-week follow-up period. In addition, it could enhance sleep quality after the intervention.

Symptom Burden among Older COVID-19 Survivors Two Years after Hospital Discharge

To study the long-term symptom burden among older COVID-19 survivors 2 years after hospital discharge and identify associated risk factors. The current cohort study included COVID-19 survivors aged 60 years and above, who were discharged between February 12 and April 10, 2020, from two designated hospitals in Wuhan, China. All patients were contacted via telephone and completed a standardized questionnaire assessing self-reported symptoms, the Checklist Individual Strength (CIS)-fatigue subscale, and two subscales of the Hospital Anxiety and Depression Scale (HADS). Of the 1,212 patients surveyed, the median (IQR) age was 68.0 (64.0-72.0), and 586 (48.3%) were male. At the two-year follow-up, 259 patients (21.4%) still reported at least one symptom. The most frequently self-reported symptoms were fatigue, anxiety, and dyspnea. Fatigue or myalgia, which was the most common symptom cluster (11.8%; 143/1212), often co-occurred with anxiety and chest symptoms. A total of 89 patients (7.7%) had CIS-fatigue scores ≥ 27, with older age (odds ratio [OR], 1.08; 95% CI: 1.05-1.11, P < 0.001) and oxygen therapy (OR, 2.19; 95% CI: 1.06-4.50, P= 0.03) being risk factors. A total of 43 patients (3.8%) had HADS-Anxiety scores ≥ 8, and 130 patients (11.5%) had HADS-Depression scores ≥ 8. For the 59 patients (5.2%) who had HADS total scores ≥ 16, older age, serious illness during hospitalization and coexisting cerebrovascular diseases were risk factors. Cooccurring fatigue, anxiety, and chest symptoms, as well as depression, were mainly responsible for long-term symptom burden among older COVID-19 survivors 2 years after discharge.

Los beneficios de la telepsicología para la relación docencia-servicio en el contexto de pandemia: Una reseña crítica

Revisión crítica del artículo: Colón Llamas, T., Escobar Altare, A., Bermúdez Jaimes, M. E., López Sánchez, M. C., Castellanos Urrego, S. G., & Ramírez Castro, M. F. (2022). Telepsicología en un centro de atención psicológica universitario durante el COVID-19: Experiencias de consultantes y estudiantes. Universitas Psychologica, 21, 1-18. https://doi.org/10.11144/Javeriana.upsy21.tcap