Fallout from the COVID-19 pandemic – should we prepare for a tsunami of post viral depression?

Abstract

The current Covid-19 pandemic is not just a medical and social tragedy, but within the threat of the outbreak looms the potential for a significant and persistent negative mental health impact, based on previous experience with other pandemics such as SARS in 2003 and the earlier H1N1 outbreak of 1918. This piece will highlight the links between depression and viral illnesses and explore important overlaps with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, potentially implicating inflammatory mechanisms in those exposed to a range of viral agents. While containment of psychological distress currently focuses on social anxiety and quarantine measures, a second wave of psychological morbidity due to viral illness may be imminent.

How mental health care should change as a consequence of the COVID-19 pandemic

“… 36 In a study by Helms and colleagues, 37 15 (33%) of 45 patients who had recovered from COVID-19 after admission to intensive-care units (ICUs) had dysexecutive syndrome after ICU discharge. Emerging reports 38 , 39 suggest the possibility of a post-viral syndrome that resembles depression. The possibility that SARS-CoV-2 is neurotropic emphasises the need for evaluation of potential short-term and long-term effects on the nervous system.…”

The lasting misery of coronavirus long-haulers

“…If COVID-19 is such a trigger, a wave of psychological effects "may be imminent", write a group of researchers led by Declan Lyons, a psychiatrist at St Patrick's Mental Health Services in Dublin 13 . In many countries, the pandemic shows no sign of waning, and health systems are already at capacity responding to acute cases.…”

Mobilizing an institutional supportive response for healthcare workers and other staff in the context of COVID-19: The Yale experience

“…People with psychiatric disorders may experience COVID-19 related stress more intensely [ 30 ], increasing their risk for illness exacerbation. Also, COVID-19 infection may trigger a persisting pro-inflammatory state that contributes to persisting depression-like symptoms [ 31 , 32 ].…”