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. 2022 Feb 24;9(2):e33704.
doi: 10.2196/33704.

The Impact of Long COVID-19 on Mental Health: Observational 6-Month Follow-Up Study

Sarah Houben-Wilke  1 , Yvonne Mj Goërtz  1   2   3 , Jeannet M Delbressine  1 , Anouk W Vaes  1 , Roy Meys  1   2   3 , Felipe Vc Machado  1   2   3 , Maarten van Herck  1   2   3   4 , Chris Burtin  4 , Rein Posthuma  1   2   3 , Frits Me Franssen  1   2   3 , Herman Vijlbrief  5 , Yvonne Spies  5 , Alex J van 't Hul  6 , Martijn A Spruit  1   2   3 , Daisy Ja Janssen  1   7
Affiliations
Free PMC article

The Impact of Long COVID-19 on Mental Health: Observational 6-Month Follow-Up Study

Sarah Houben-Wilke et al. JMIR Ment Health. .
Free PMC article

Abstract

Background: The psychological impact of COVID-19 can be substantial. However, knowledge about long-term psychological outcomes in patients with COVID-19 is scarce.

Objective: In this longitudinal, observational study, we aimed to reveal symptoms of posttraumatic stress disorder (PTSD) and symptoms of anxiety and depression up to 6 months after the onset of COVID-19-related symptoms in patients with confirmed COVID-19 and persistent complaints. To demonstrate the impact in nonhospitalized patients, we further aimed to compare these outcomes between nonhospitalized and hospitalized patients.

Methods: Demographics, symptoms of PTSD (Trauma Screening Questionnaire [TSQ] ≥6 points) and symptoms of anxiety and depression (Hospital Anxiety and Depression Scale [HADS] ≥8 points) were assessed at 3 and 6 months after the onset of COVID-19-related symptoms in members of online long COVID-19 peer support groups.

Results: Data from 239 patients with confirmed COVID-19 (198/239, 82.8% female; median age: 50 [IQR 39-56] years) were analyzed. At the 3-month follow-up, 37.2% (89/239) of the patients had symptoms of PTSD, 35.6% (85/239) had symptoms of anxiety, and 46.9% (112/239) had symptoms of depression, which remained high at the 6-month follow-up (64/239, 26.8%, P=.001; 83/239, 34.7%, P=.90; 97/239, 40.6%, P=.08, respectively; versus the 3-month follow-up). TSQ scores and HADS anxiety and depression scores were strongly correlated at the 3- and 6-month follow-ups (r=0.63-0.71, P<.001). Symptoms of PTSD, anxiety, and depression were comparable between hospitalized (n=62) and nonhospitalized (n=177) patients.

Conclusions: A substantial percentage of patients with confirmed COVID-19 and persistent complaints reported symptoms of PTSD, anxiety, or depression 3 and 6 months after the onset of COVID-19-related symptoms. The prevalence rates of symptoms of PTSD, anxiety, and depression were comparable between hospitalized and nonhospitalized patients and merely improved over time. Health care professionals need to be aware of these psychological complications and intervene on time in post-COVID-19 patients with persistent complaints.

Trial registration: Netherlands Trial Register NTR8705; https://www.trialregister.nl/trial/8705.

Keywords: COVID-19; PASC; SARS-CoV-2; anxiety; corona; depression; post-traumatic stress disorder.

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Conflict of interest statement

Conflicts of Interest: FMEF reports grants and personal fees from AstraZeneca, personal fees from Boehringer Ingelheim, personal fees from Chiesi, personal fees from GlaxoSmithKline, grants and personal fees from Novartis, and personal fees from TEVA, outside the submitted work. DJAJ has received lecture fees from Chiesi and Boehringer Ingelheim within the previous three years, outside the submitted work. MAS reports grants from Lung Foundation Netherlands, grants from Stichting Astma Bestrijding, grants from Boehringer Ingelheim, grants from Chiesi, grants from TEVA, and grants from AstraZeneca, outside the submitted work. SHW, JMD, AWV, YMJG, RM, FVCM, MvH, CB, RP, HV, YS, and AvH have nothing to declare.

Figures

Figure 1
Figure 1
Percentage of patients reporting each item on the Trauma Screening Questionnaire (TSQ) at 3 and 6 months after the onset of COVID-19 symptoms (n=239). *P≤0.05 3 months versus 6 months.
Figure 2
Figure 2
Correlations between Trauma Screening Questionnaire (TSQ) scores and Hospital Anxiety and Depression Scale (HADS) scores at (A) 3 and (B) 6 months after the onset of COVID-19–related symptoms.
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