Post-traumatic symptoms after COVID-19 may (or may not) reflect disease severity

Badenoch, James; Cross, Benjamin; Hafeez, Danish; Song, Jia; Butler, Matthew; Nicholson, Timothy; Rooney, Alasdair G

doi:10.1017/s003329172000481x

Cited by 5 publications

(6 citation statements)

References 10 publications

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“…Some reports suggest that COVID-19 infection is contemporaneous with de novo psychiatric disorders such as psychosis and catatonia (5,14,15), although in many cases causality cannot be ascribed with confidence (10,16). Others have also suggested high rates of post-traumatic stress symptoms, and higher odds of anxiety and depressive symptoms in COVID-19 inpatients in comparison to controls, although this has not been consistently replicated (49)(50)(51). In many cases in the literature, where psychiatric manifestations are noted, they are new diagnoses, although this data has also not always been replicated (5,52,53).…”

Section: Characterizing the Sars-cov-2 Positive Cohortmentioning

confidence: 99%

Reduced Activity in an Inpatient Liaison Psychiatry Service During the First Wave of the COVID-19 Pandemic: Comparison With 2019 Data and Characterization of the SARS-CoV-2 Positive Cohort

et al. 2021

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Background: The COVID-19 pandemic led to changes in the way that healthcare was accessed and delivered in the United Kingdom (UK), particularly during the peak of the first lockdown period (the “first wave”) beginning in March 2020. In some patients, COVID-19 is associated with acute neuropsychiatric manifestations, and there is suggestion that there may also be longer term neuropsychiatric complications. Despite this, at the time of writing there are only emerging data on the direct effects of the COVID-19 pandemic on psychiatric care.Methods: In this retrospective study we analyzed referrals to an inpatient liaison psychiatry department of a large acute teaching hospital during the first wave of covid-19 in the UK and compared this data to the same period in 2019.Results: We saw a 40% reduction in the number of referrals in 2020, with an increase in the proportion of referrals for both psychosis or mania and delirium. Almost one third (28%) of referred patients tested positive for COVID-19 at some point during their admission, with 40% of these presenting with delirium as a consequence of their COVID-19 illness. Save delirium, we did not find evidence for high prevalence of new-onset acute mental illness in COVID-19 positive patients.Conclusion: Our data indicate decreased clinical activity in our inpatient psychiatry liaison department during the first wave of the COVID-19 pandemic, although a relative increase in relative increase in referrals for psychosis or mania, suggesting less of a relative decrease in more severe cases of mental illness. The reasons for this are likely multifactorial, including structural changes in the NHS and patient reluctance to present to emergency departments (ED) due to infection fears and Government advice. Our data also supports the literature suggesting the high relative prevalence of delirium in COVID-19, and we support integration of psychiatry liaison teams in acute general hospital wards to optimize delirium management. Finally, consideration should be given to adequate staffing of community and crisis mental health teams to safely manage the mental health of people reluctant to visit EDs.

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Section: Characterizing the Sars-cov-2 Positive Cohortmentioning

confidence: 99%

Reduced Activity in an Inpatient Liaison Psychiatry Service During the First Wave of the COVID-19 Pandemic: Comparison With 2019 Data and Characterization of the SARS-CoV-2 Positive Cohort

et al. 2021

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“…According to a previous meta-analysis, 17-44% of critical illness survivors, particularly those who required hospitalization and/or admission to an ICU, reported clinically significant PTSD symptoms ( 52 ). Due to the fact that the severity of the medical condition seems to be a predicting factor for the development of PTSD symptomatology, the early identification of vulnerable and high-risk patients seems a perquisite for timely effective interventions ( 53 ).…”

Section: Post-traumatic Stress Disorder and Covid-19 Survivorsmentioning

confidence: 99%

“…To summarize, the severity of the medical condition has the potential to determine the future risk of patients to develop PTSD. Research into COVID-19-related PTSD symptomatology and its determinants is of paramount importance in identifying possible modifiable risk factors and vulnerable patients, as well as in evidence-informed decision-making interventions ( 53 ). Moreover, effective professional mental health services should be designed to support the psychological wellbeing of inpatients with COVID-19, and particularly those who required hospitalization and/or ICU care.…”

Section: Post-traumatic Stress Disorder and Covid-19 Survivorsmentioning

confidence: 99%

COVID‑19 and post‑traumatic stress disorder: The perfect ‘storm’ for mental health (Review)

et al. 2021

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Since its outbreak, in December, 2019, in the Chinese city of Wuhan, coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has evolved into an ongoing global pandemic. Due to the novel antigenic properties of this virus, the world population could not develop immunity effectively and this led to the subsequent spread of COVID-19. This caused an unprecedented emergency situation with significant negative effects on health and well-being both on an individual and societal level. Apart from health, economic and social consequences, the impact of this pandemic on mental health is increasingly being reported in the scientific literature. The present review aimed to provide a comprehensive discussion of the possible neurological and neuropsychiatric manifestations of SARS-CoV-2, together with the related underlying molecular pathways. In addition, the present review focused on populations which are at a higher risk of developing psychiatric disturbances due to the COVID-19 pandemic and discussed possible routes of clinical management and therapeutics to minimize the burden associated with psychiatric disorders. Moreover, research findings exploring the prevalence of COVID-19-related post-traumatic stress disorder (PTSD) symptoms across vulnerable groups, including children, adolescents and COVID-19 survivors are presented, with particular emphasis on those with severe disease who required hospitalization and/or intensive care unit admission. Based on the available literature, the identification of potential determinants associated with PTSD across the different populations is underlined. Lessons learnt from the pandemics across the globe together with the ongoing research on COVID-19 and its impact on mental health, highlight the utmost importance for evidence-based, proactive and targeted interventions in high-risk groups aiming to mitigate the risks and manage vulnerabilities.

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“…To demonstrate the impact of COVID-19 on mental health, especially in nonhospitalized patients, we aimed to compare these outcomes between nonhospitalized and hospitalized patients. As the number of reports demonstrating a substantial burden of psychological trauma in patients with less severe COVID-19 is increasing [18], we hypothesized in advance that the long-term impact of COVID-19 on mental health, even in nonhospitalized patients, is substantial.…”

Section: Introductionmentioning

confidence: 99%

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

Houben-Wilke¹,

Goërtz²,

Delbressine³

et al. 2022

JMIR Ment Health

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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.

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Post-traumatic symptoms after COVID-19 may (or may not) reflect disease severity

Cited by 5 publications

References 10 publications

Reduced Activity in an Inpatient Liaison Psychiatry Service During the First Wave of the COVID-19 Pandemic: Comparison With 2019 Data and Characterization of the SARS-CoV-2 Positive Cohort

Reduced Activity in an Inpatient Liaison Psychiatry Service During the First Wave of the COVID-19 Pandemic: Comparison With 2019 Data and Characterization of the SARS-CoV-2 Positive Cohort

COVID‑19 and post‑traumatic stress disorder: The perfect ‘storm’ for mental health (Review)

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

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