Psychiatric symptoms in Long-COVID patients: a systematic review

Abstract

ObjectivePeople who have been infected by COVID-19 showing persistent symptoms after 4 weeks from recovery are thought to suffer from Long-COVID syndrome (LC). There is uncertainty on the clinical manifestations of LC. We undertook a systematic review to summarize the available evidence about the main psychiatric manifestations of LC.MethodPubMed (Medline), Scopus, CINHAL, PsycINFO, and EMBASE were searched until May 2022. Studies reporting estimation of emerging psychiatric symptoms and/or psychiatric diagnoses among adult people with LC were included. Pooled prevalence for each psychiatric condition was calculated in absence of control groups to compare with.ResultsThirty-three reports were included in the final selection, corresponding to 282,711 participants with LC. After 4 weeks from COVID-19 infection recovery, participants reported the following psychiatric symptoms: depression, anxiety, post-traumatic symptoms (PTS), cognitive and sleeping disturbances (i.e., insomnia or hypersomnia). The most common psychiatric manifestation resulted to be sleep disturbances, followed by depression, PTS, anxiety, and cognitive impairment (i.e., attention and memory deficits). However, some estimates were affected by important outlier effect played by one study. If study weight was not considered, the most reported condition was anxiety.ConclusionsLC may have non-specific psychiatric manifestations. More research is needed to better define LC and to differentiate it from other post-infectious or post-hospitalization syndromes.Systematic review registrationPROSPERO (CRD42022299408).

Is Recovery Just the Beginning? Persistent Symptoms and Health and Performance Deterioration in Post-COVID-19, non-hospitalised University Students - A Cross-Sectional Study

“…The minimal or absent impact of merely contracting the infection on physical and mental health and cognitive performance, which contrasts with results of many already published studies, e.g. (Altuna, Sánchez-Saudinós, Lleó, & 2021; Delgado-Alonso et al, 2022; Flegr & Latifi, 2023; Havervall et al, 2021; Lamontagne et al, 2021; Lu et al, 2020; Marchi et al, 2023; Mazza et al, 2020; O’Mahoney et al, 2023; Zhao et al, 2020) could be related to the fact that all students included in our study were younger than 31 years old (95% were 20-24 years old). As is often the case with such a young population, most students experienced a relatively mild form of COVID-19; only about 20% described it as “severe flu,” and none of the study participants was hospitalized due to COVID-19.…”

Long-term reduced functional capacity and quality of life in hospitalized COVID-19 patients

“…Mental and physical aspects of HRQoL were significantly reduced in COVID-19 patients 6 months after discharge. A reduced mental aspect of HRQoL is consistent with the findings of sleep disturbances, depression, anxiety, and cognitive impairment as reported in a systematic review ( 28 ). Of note, the comparison of HRQoL scores was adjusted by age and sex according to national normative data, which strengthens the evidence for this impairment when compared to the general population.…”

Modifiable in‐hospital factors for 12‐month global cognition, post‐traumatic stress disorder symptoms, and depression symptoms in adults hospitalized with COVID‐19

“…Our findings align with a metaanalysis of 33 studies that reported a 19% prevalence of PTSD and 21% prevalence of depression after the COVID-19 illness. 10 We also examined which individual cognitive domains were particularly affected after COVID-19 to fully characterize the oftreported "brain fog." We observed prominent impairments in executive function and immediate and delayed memory-domains previously reported to be affected by critical illness and acute respiratory distress syndrome.…”

“…9 Another meta-analysis reported that 19% developed post-traumatic stress disorder (PTSD) and 21% developed depression. 10 To our knowledge, few studies have evaluated modifiable risk factors during hospitalization, such as delirium, medications, and the effect of in-person and virtual visitation with friends and family on the severity of Long-COVID symptoms. Identifying in-hospital modifiable risk factors could assist with the development of strategies to prevent or lessen the contribution of neuropsychological dysfunction to Long-COVID.…”

“… 9 Another meta‐analysis reported that 19% developed post‐traumatic stress disorder (PTSD) and 21% developed depression. 10 …”