Severe Post-COVID-19 Condition after Mild Infection: Physical and Mental Health Eight Months Post Infection: A Cross-Sectional Study

Abstract

Severe acute COVID-19 infections requiring intensive care treatment are reported risk factors for the development of post-COVID-19 conditions. However, there are also individuals suffering from post-COVID-19 symptoms after mild infections. Therefore, we aimed to describe and compare the health status of patients who were initially not hospitalized and patients after critical illness due to COVID-19. The outcome measures included health-related quality of life (EQ-5D-5L, visual analogue scale (VAS)); mental health (hospital anxiety and depression scale (HADS)); general disability (WHODAS-12); and fatigue (Fatigue-Severity-Scale-7). Individuals were recruited at Schoen Clinic Bad Aibling, Germany. A total of 52 non-hospitalized individuals (47 ± 15 years, 64% female, median 214 days post-infection) and 75 hospitalized individuals (61 ± 12 years, 29% female, 235 days post-infection) were analyzed. The non-hospitalized individuals had more fatigue (87%) and anxiety (69%) and a decreased health-related quality of life (VAS 47 ± 20) compared to the hospitalized persons (fatigue 45%, anxiety 43%, VAS 57 ± 21; p < 0.010). Severe disability was observed in one third of each group. A decreased quality of life and disability were more pronounced in the females of both groups. After adjusting for confounding, hospitalization did not predict the burden of symptoms. This indicates that persons with post-COVID-19 conditions require follow-up services and treatments, independent of the severity of the acute infection.

Prevalences and Interrelationships of Post COVID-19 Fatigue, Sleep Disturbances, and Depression in Healthy Young and Middle-Aged Adults

“…Young and middle-aged adults with post-COVID-19 conditions represent a significant socioeconomic burden due to their impaired ability to return to work [16][17][18][19][33][34][35][36]. According to the U.S. Census Bureau, of the estimated 16 million working-age adults affected by this condition, 2 to 4 million had not yet returned to their workplaces, resulting in an annual economic loss of approximately $170 billion [20].…”

“…According to the U.S. Census Bureau, of the estimated 16 million working-age adults affected by this condition, 2 to 4 million had not yet returned to their workplaces, resulting in an annual economic loss of approximately $170 billion [20]. Even for those who return to work, persistent symptoms such as brain fog, fatigue, and sleep disorders can reduce work efficiency and concentration [16][17][18][19][33][34][35][36]. Our study demonstrates that these symptoms may further exacerbate the situation by contributing to anxiety and depression.…”

“…Post-COVID-19 conditions is distinguished by its prolonged duration and diverse array of symptoms compared to other respiratory illnesses, such as influenza infection, despite exhibiting a similar prevalence of symptoms compared to other respiratory virus infections [3][4][5][6]. Fatigue and neuropsychiatric manifestations, such as sleep disturbances, anxiety, and depression, are the most frequently reported symptoms [7][8][9][10]; these symptoms significantly impair patient quality of life and ability to return to work [11][12][13][14][15][16]. Working individuals are particularly susceptible to long-term effects [17][18][19].…”