Dimensional structure of one-year post-COVID-19 neuropsychiatric and somatic sequelae and association with role impairment

Abstract

This study examined the latent structure of the broad range of complex neuropsychiatric morbidities occurring 1 year after COVID-19 infection. As part of the CU-COVID19 study, 248 (response rate=39.3%) of 631 adults hospitalized for COVID-19 infection in Hong Kong completed an online survey between March-2021 and January-2022. Disorder prevalence was compared against a random non-infected household sample (n=1834). 248 surveys were received on average 321 days post-infection (Mean age: 48.9, 54% female, moderate/severe/critical infection: 58.2%). 32.4% were screened to have at least one mental disorder, 78.7% of whom had concurrent fatigue/subjective cognitive impairment (SCI). Only PTSD (19.1%) was significantly more common than control (14%, p=0.047). Latent profile analysis classified individuals into P1 (12·4%)-no current neuropsychiatric morbidities, P2 (23.1%)-SCI/fatigue, P3 (45.2%)-anxiety/PTSD, P4 (19.3%)-depression. SCI and fatigue pervaded in all profiles (P2-4) with neuropsychiatric morbidities one-year post-infection. PTSD, anxiety and depressive symptoms were most important in differentiating P2-4. Past mental health and P4 independently predicted functional impairment. Neuropsychiatric morbidity was associated with past mental health, reduced resilience, financial problems, but not COVID-19 severity. Their confluence with depressive and anxiety symptoms predicted impairment and are associated with psychological and environmental factors.

Chronic post-COVID neuropsychiatric symptoms persisting beyond one year from infection: a case-control study and network analysis

“…While other studies have shown similar results, the limitations in the designs of such studies, namely in terms of the potential for reverse causality, have made it difficult to draw such conclusions straightforwardly from their results. A study from Hong Kong, for example, reported financial worry as one of the predictors of post-COVID mental health trajectory [ 27 ]. Because they only measured the subjects’ evaluation of their financial situation post-COVID, however, there is difficulty determining the direction of causality given that a self-reported concern about financial status can be secondary to and a result of poor mental and physical health.…”

“…Contrary to our hypothesis, the severity of the index infection did not predict whether there would be a high or low load of chronic neuropsychiatric symptoms post-COVID. Available evidence on the ability of infection severity to predict PACS has not been consistent [ 27 , 29 – 32 ]. There is convergent evidence, however, that persistent PACS can occur in individuals with mild infections.…”