The global prevalence of depression, anxiety, and sleep disorder among patients coping with Post COVID-19 syndrome (long COVID): a systematic review and meta-analysis

BMC Psychiatry, Journal Year: 2024, Volume and Issue: 24(1)

Published: Feb. 6, 2024

Post COVID-19 syndrome, also known as "Long COVID," is a complex and multifaceted condition that affects individuals who have recovered from SARS-CoV-2 infection. This systematic review meta-analysis aim to comprehensively assess the global prevalence of depression, anxiety, sleep disorder in coping with syndrome.

Language: Английский

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Clinical characteristics of Long COVID patients presenting to a dedicated academic post-COVID-19 clinic in Central Texas

Scientific Reports, Journal Year: 2023, Volume and Issue: 13(1)

Published: Dec. 11, 2023

Post-acute sequelae SARS-CoV-2 (PASC), also known as Long COVID, is a complex and widely recognized illness with estimates ranging from 5 to 30% of all COVID-19 cases. We performed retrospective chart review patients who presented dedicated Post-COVID-19 clinic between June 2021 May 2022. The median patient age was 44.5 years, 63.5% were female, at 10.4 months acute COVD-19 infection. 78% self-identified their race white, 21% identified Latino ethnicity. During the infection, 50% experienced moderate disease severity 10.5% hospitalized. top three co-morbid conditions prior infection included mental health conditions, hypertension asthma. Patients reported 18 new symptoms following illness, most common fatigue (89%), forgetfulness or "brain fog" difficulty concentrating (77%). MoCA (Montreal Cognitive Assessment) assessment demonstrated that 46% had mild cognitive dysfunction. PHQ-9 (Patient Health Questionnaire) testing revealed 42% severe depression, 38% anxiety on GAD-7 (Generalized Anxiety Disorder) assessment. Symptom burden similar across gender, age, initial severity. PASC presenting an academic numerous multisystem functional impairment, independent

Language: Английский

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Interplay between Comorbidities and Long COVID: Challenges and Multidisciplinary Approaches

Biomolecules, Journal Year: 2024, Volume and Issue: 14(7), P. 835 - 835

Published: July 11, 2024

Long COVID, a name often given to the persistent symptoms following acute SARS-CoV-2 infection, poses multifaceted challenge for health. This review explores intrinsic relationship between comorbidities and autoimmune responses in shaping trajectory of long COVID. Autoantibodies have emerged as significant players COVID-19 pathophysiology, with implications disease severity progression. Studies show immune dysregulation persisting months after marked by activated innate cells high cytokine levels. The presence autoantibodies against various autoantigens suggests their potential comorbid factors Additionally, formation complexes may lead severe progression, highlighting urgency early detection intervention. Furthermore, COVID is highly linked cardiovascular complications neurological symptoms, posing challenges diagnosis management. Multidisciplinary approaches, including vaccination, tailored rehabilitation, pharmacological interventions, are used mitigating COVID’s burden. However, numerous persist, from evolving diagnostic criteria addressing psychosocial impact predicting outcomes. Leveraging AI-based applications holds promise enhancing patient management improving our understanding As research continues unfold, unravelling complexities remains paramount effective intervention care.

Language: Английский

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Association of preexisting psychiatric disorders with post-COVID-19 prevalence: a cross-sectional study

Scientific Reports, Journal Year: 2023, Volume and Issue: 13(1)

Published: Jan. 7, 2023

Abstract Evidence demonstrating the association of preexisting psychiatric disorders with post-COVID-19 is limited. We aim to investigate using larger sample sizes and more extended postinfection periods than previous studies. A total 6015 (response rate = 77.5%) COVID-19 survivors were surveyed a self-administered questionnaire from July September 2021. Poisson regression analysis robust error variance was performed estimate prevalence ratios (PRs) or without disorders. Participants numbered 1067 (17.7%), 2149 (35.7%). Post-COVID-19 PR 1.09 (95% CI 1.02–1.18, p 0.013). The interaction between significant (p for < 0.001). subgroup showed that those might be at greater prolonged risk These findings suggested associated an increased risk, prolong even if time passes.

Language: Английский

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Prevalence and factors associated with depression and anxiety among COVID-19 survivors in Dhaka city

Frontiers in Psychiatry, Journal Year: 2024, Volume and Issue: 15

Published: Jan. 23, 2024

Background Coronavirus disease 2019 (COVID-19) is a global public health concern. Evidence shows that depression and anxiety are common among patients with COVID-19 after recovery. About one-third of the total cases in Bangladesh have been reported Dhaka city. Therefore, study aimed to evaluate prevalence survivors city as well identify factors associated these mental conditions. Methods A cross-sectional was carried out 384 aged 18 years or older. Data collection done through face-to-face telephone interviews using semi-structured questionnaire. Patient Health Questionnaire (PHQ-9) Generalized Anxiety Disorder (GAD-7) scales were used assess anxiety, respectively. Binary logistic regression analysis performed predictors recovered from COVID-19. Results The overall 26.0% 23.2%, respectively survivors. respondents who ≥60 2.62 3.02 times more likely report depressive symptoms, than those 39 years. Hospitalised had 2.18 higher chance developing their non-hospitalised counterparts. comorbidities at 3.35 2.97 risk compared without comorbidities. Similarly, already passed period 15 days 3 months recovery showed 3.06 1.85 odds above 6 Conclusion high living findings suggest need for appropriate interventions reduce complications

Language: Английский

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Long-Term Psychiatric Outcomes of Autoimmune Encephalitis

Journal of Neuropsychiatry, Journal Year: 2025, Volume and Issue: unknown

Published: April 7, 2025

The authors aimed to characterize the long-term psychiatric outcomes and their predictors among survivors of autoimmune encephalitis (AE). In this retrospective cohort study, patients diagnosed as having AE between 2008 2023 at two academic medical centers (in New York City Toronto) completed Mini International Neuropsychiatric Interview 7.0.2 (MINI) Profile Mood States (POMS-2) assess outcomes. Clinical characteristics were assessed for potential Bivariate analyses univariate logistic regressions conducted relationship primary outcome. Overall, 42 participants (female, N=26, 62%; median age=37.5 years, interquartile range [IQR]=32.8 years) a 4 years (IQR=6 after an diagnosis. subtypes included anti-N-methyl-d-aspartate (33%), anti-leucine-rich-glioma-inactivated 1 (24%), anti-glutamic acid decarboxylase 65 (14%), antibody-negative (29%). total, 71% who MINI met criteria DSM-5 diagnosis, 56% mood disorder. Thirteen (31%) reported above-average total disturbance on POMS-2. Mann-Whitney U tests revealed that disorder self-reported significantly higher levels confusion bewilderment (z=-2.04, p=0.04) depression dejection (z=-2.24, p=0.03) lower vigor activity (z=-2.62, p=0.01). have high prevalence comorbid conditions, with most being significant proportion endorsing ongoing disturbance. Patients history may benefit from closer follow-up.

Language: Английский

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Multi‐disciplinary collaborative consensus guidance statement on the assessment and treatment of mental health symptoms in patients with post‐acute sequelae of SARS‐CoV‐2 infection (PASC)

PM&R, Journal Year: 2023, Volume and Issue: 15(12), P. 1588 - 1604

Published: Nov. 8, 2023

Post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC), also called Long COVID (coronavirus disease), is the experience new or worsened signs, symptoms, conditions that develop after resolution phase a COVID-19 infection. Although some people with recover well, others have persisting symptoms.1 PASC can manifest as wide-ranging constellation disabling sequelae, including mental health conditions.2 Anxiety and depression been reported second third most common symptoms PASC, respectively.3 Furthermore, in narrative review summarizing neuropsychiatric dimensions anxiety, post-traumatic stress disorder (PTSD), were among both ongoing symptomatic PASC. Pooled prevalence each was: anxiety 19.1% (95% confidence interval [CI], 13.3%–26.8%), PTSD 15.7% CI, 9.9%–24.1%), 12.9% 7.5%–21.5%).4 Despite high often impact PASC-related emerging data persist for months years,5 limited guidance currently exists regarding assessment treatment patients Addressing setting involves several unique complexities, addressing stigma may interfere appropriate diagnosis(es) treatment, insufficient availability professionals, differentiating physical diagnoses. Many described being questioned about their way feels dismissive and/or mistakenly attributed to an underlying condition.6 effects pandemic on individuals society exacerbate direct from SARS-CoV-2 infection, increasingly evidence supports be component caused by SARS- CoV-2 pre-existing exacerbated yet are not, themselves, overall cause PASC.7-9 Another challenge disorders national global shortage professionals.10 This further intensified because clinicians who not specialists express discomfort perception training discuss patients. Nevertheless, report they want broach topic acknowledge interplay between health.11-13 Finally, studies found due condition, but mimic disorder. These include fatigue, dysautonomia, disordered sleep, cognitive dysfunction,14, 15 which patient's ability fully participate first-line recommendations. The goal this consensus statement present practical treat Specifically, addresses initial depression, (including panic), PTSD. People worsening suicidal ideation, psychosis, obsessive compulsive (OCD), pandemic-related grief survivor's remorse8, 16-18; however, specific focus these outside scope statement. recommendations applicable all experiencing regardless time course. Of note, reflects current base related expert panel care professionals regularly should preclude clinical judgment must applied context patient, adjustments patient preferences, comorbidities, other factors. American Academy Physical Medicine Rehabilitation (AAPM&R) Multi-Disciplinary Collaborative (PASC Collaborative) was convened address pressing need members experts across variety disciplines specialties PM&R, neurology, neuropsychiatry, neuropsychology, rehabilitation psychology, primary care. following iterative, modified Delphi process achieve presented series statements symptoms. A full description methodology has published previously.19 informed established centers managing range symptoms.20-26 Whenever possible, existing specifically incorporated into statement, body somewhat evolving. As needed, guided applying general, well-established, approaches considerations intentional equity disparities critical factor contributing widespread outcomes, considered addressed. Collaborative's broaden understanding practices, only guide management, identify gaps opportunities future research. According original definition U.S. Centers Disease Control Prevention (CDC), "Long (PASC) broadly defined continue 4 weeks more infection; multisystemic; relapsing–remitting pattern progression over time, possibility life-threatening events even years CDC uses 4-week timeframe describing post-COVID emphasize importance evaluation supportive during 12 COVID-19.27 Based feedback our process, we advocate improving access beneficial interventions facilitating early evaluation, diagnosis, management experienced For purposes recommend if within 1 month symptom onset. Emotional mood fluctuations part normal everyday life, persistent, distressing disturbances emotional regulation, behavior, cognition indicative Diagnostic Statistical Manual Mental Disorders, Fifth Edition (DSM-5) depressive characterized primarily persistent sadness, emptiness, irritability, loss pleasure interest activities (anhedonia). They associated secondary poor concentration, psychomotor agitation retardation, fatigue energy, sleep difficulty (insomnia hypersomnia), feelings low self-worth excessive guilt, hopelessness future, changes appetite weight, thoughts dying suicide. fear, worry, apprehension, dread out proportion perceived threat. intrusive memories, dreams, dissociative reactions (flashbacks), prolonged psychological distress, physiological occur exposure actual threatened traumatic event.28 resulted 28% increase cases major (MDD) 26% worldwide 2020.29, 30 It estimated 137 additional disability-adjusted life (DALYs) per 100,000 MDD 116 DALYs disorders, incidence higher than influenza infections.15, 31, 32 Both women underrepresented race ethnic minority groups type(s) sequelae.33, 34 Women autoimmune diseases men, risk factors developing PASC35 conditions. at increased women, older adults, potentially Black/African socioeconomic strata.36, 37 In addition effect health, cumulative burden chronic (allostatic load) grown stressors concerns such fear death, short- long-term financial uncertainty, quarantine-associated social isolation, familial stress, guilt.38 surrounding disruptions system diminished services, frequent dismissal patients' community, particularly those without formal laboratory infection.39 Moreover, worse outcomes illness, hospitalization, PASC.39-44 pathophysiology still under investigation, it surmised cytokine storm created virus affect initiating central inflammatory response, reducing serotonin production attenuates downstream monoamine neurotransmission, increasing brain glutamate upregulation N-methyl-d-aspartate (NMDA) receptors.7, 8 aggregate, produce damaging neuronal excitotoxicity subsequent synaptic pruning loss. compounded cytokine-mediated reduction trophic induction new-onset re-exacerbation conditions.8, 9 role cytokines similar pro-inflammatory That is, appropriately generated response peripheral when cross brain, normal, evolutionarily conserved, protective illness allowing cope fever, lethargy, malaise.45 However, activation immune sustained beyond duration (e.g., disease, systemic cancer, PASC), resulting signaling lead exacerbation development vulnerable individuals.46 addition, biologic directly viral reservoirs, microvascular blood clots endothelial dysfunction, altered gut microbiome, autoimmunity.47-50 encountering stigmatization, disbelief, assumptions whole state,51 despite contrary.50 led fractured relationships patients, inherently degree able offer We encourage model approach based best practices myalgic encephalomyelitis/chronic (ME/CFS). take supportive, open, nonjudgmental stance; consider multifaceted biological aspects complex medical health–related treatments truly requires types interventions.52 especially challenging underreport clinician will attribute health. phenomenon contribute trend likely receiving significantly below-optimal level care.53 Therefore, helpful reassure let them know although one well-documented manifestations potential severe.53 Intentional effective challenging. Some delay accurate diagnosis dismissed purely psychosomatic manifestations.6 light context, suggest introduce validating PASC.50 by, mimic, worsen, coexisting why essential.2, 54 example, generalized post-exertional malaise another, result impairments function.55 developed fatigue.20, 22 Clinicians great driver(s) functional impairment treatment. When thorough facilitated collateral information close friends family members. Collateral history impaired memory, awareness how functioning long function impaired, otherwise would independently reporting sleep-related snoring, dozing off daytime, nighttime awakenings, etc.).22, 26 Loved ones important course severity observed mood, coping abilities, energy level, appetite, daily function, participation usual (Table 1). Patients screened signs using validated tools instruments, appropriate. Note: suicide screening screen positive plan place prior screening. questionnaires efficient implements questionnaires, understand whether questionnaire assesses somatic instance, Patient Health Questionnaire (PHQ-9) concentrating, disorders.56 autonomic dysfunction,20-26 so PHQ-9 overpredict presence multiple PASC.57 contrast, Patient-Reported Outcomes Measurement Information System (PROMIS) Depression scale does inquire reduce confounding comorbidities (such PASC) health.58 Other measures used PHQ-2 (for screening), Generalized Disorder 7 (GAD-7) Hospital Scale (HADS) screening). Regardless tool(s) used, follow-up interview clarify settings versus select school/work, home, contexts), plans. Common PCL-5 (PTSD Checklist DSM-5) IES (Impact Events Scale). confirmation require referral specialist extensive testing. Suspicion raised survivors intensive unit (ICU),59 had confirmed frontline workers, quarantined. flashback-like reactions; efforts avoid trauma-related thoughts, feelings, places, people; negative mood; hyperarousal, difficulties, irritability.60-63 delivering tool responses. given encounter before any provided, answering questions thoughtfully honestly when: (1) team member describes relevance purpose introduced them, (2) acknowledges responses explains results recommendations.11 assessing ideation depressed lack familiarity immediate next steps expresses active ideation. Psychological Association provides continuing education intervening (https://www.apa.org/monitor/2022/06/continuing-education-intervene-suicide), Columbia University, through Lighthouse Project, disseminates Protocol—also known Columbia-Suicide Severity Rating (C-SSRS) https://cssrs.columbia.edu/. establish what endorse consultation in-clinic worker psychologist interdisciplinary setting, contacting crisis worker, hotline (988 National Alliance Illness [NAMI] hotline), center detailed inquiry necessary intervention maintain safety patient. If left unsupervised. assure acknowledging distress providing care, transfer hospital emergency department psychiatric hospital. Urgent equally situations managed equal immediacy. selecting tools, administration approaches, informants, essential chronological/mental age, educational history, environments. reading (in language administered), read aloud rather self-administered. cases, sensitive acceptability bias tool. manage neurodevelopmental judicious measurements informants. Assessment sensorimotor proxy inventories focused largely behaviors subjective experiences, informants characterize onset, changes). extent possible comprehension self caregiver, teacher, etc.) assessments diagnostic evaluation. Literature intellectual disabilities suggested mixed agreement self- caregiver-report health-related factors, better correlation activity engagement, support.64 identity race, ethnicity sexual orientation gender identity, make conscious effort own implicit (unconscious) biases. aware cultural differences exist expressed certain cultures hesitant concern acceptability.65 appropriate, tests reviewed obtained evaluate masquerade tachycardia palpitations cardiovascular dysfunction.23, 24 having condition presents as, contributes to, conditions, lower strata.66 There considerable overlap neurologic commonly Commonly overlapping pain, apathy, changes, changes. Major categories disease neurodegenerative Parkinson Huntington's Alzheimer's vascular inflammatory/infectious/autoimmune trauma, metabolic/endocrine disturbances, nutritional deficiencies, structural disorders. Post-intensive (PICS) coexist movement PICS PASC.67 Factors (or coexisting) opposed isolated include: features atypical disorder, unusual age paroxysmal recent substance abuse/intoxication leading encephalopathy, prescription medicine overuse, resistant respond unusually conventional treatment.66 DSM-5 considers careful assess Because wellness bidirectionally person's engage tasks, vice versa. explore baseline self-care instrumental living bathing, dressing, grooming, ambulating use adaptive equipment, cooking, cleaning, shopping, attending household chores, paying needs/bills). limit attend work, school, social, activities, limitations can, turn, coping, satisfaction life.68 Decreased engagement added strain, feeling feel pressured worsens malaise. Understanding patient-specific prerequisite patient-centered interrelated impairments, skills, premorbid triggers Reported include, foods, menstrual cycles,69 conditions,70 prescribed over-the-counter medications, alcohol drug misuse,71 psychosocial uninsured underinsured, unemployed underemployed, socially isolated, support assist transportation, translation, needs), personal safety, food insecurity, stable housing.72-74 prevalent PASC.72,73 itself, as: distancing, childcare, media coverage infection.75 varies widely Symptoms COVID-19.76, 77 Available suggests general principles treating generally mirror do (see Table 2).78, 79 Patients' constellations, impairment, quality impacted approach. impacting life/function practice clinician, (examples therapist, counselor, neuropsychologist, psychologist, psychiatrist) expertise psychological/psychiatric (and worsen) note provided recognizes typically cluster systems, might co-existing always suggesting test rehabilitation. plan, encouraged unknowns prognosis, well benefits risks screens aforementioned interview, adequate comfort psychopharmacologic provide in-office means offering intervention. referrals psychiatrist,

Language: Английский

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Are the Comorbidities Constitute an Intrinsic Factor for Long COVID?

Published: May 2, 2024

Long COVID, a name often given to the persistent symptoms following acute SARS-CoV-2 infection, poses multifaceted challenge for health. This review explores intrinsic relationship between comorbidities and autoimmune responses in shaping trajectory of long COVID. Autoantibodies have emerged as significant players COVID-19 pathophysiology, with implications disease severity progression. Studies show immune dysregulation persisting months after marked by activated innate cells high cytokine levels. The presence autoantibodies against various autoantigens suggests their potential comorbid factors Additionally, formation complexes may lead severe progression, highlighting urgency early detection intervention. Furthermore, COVID is highly linked cardiovascular complications neurological symptoms, posing challenges diagnosis management. Multidisciplinary approaches, including vaccination, tailored rehabilitation, pharmacological interventions, are used mitigating COVID&#039;s burden. However, numerous persist, from evolving diagnostic criteria addressing psychosocial impact predicting outcomes. Leveraging AI-based applications holds promise enhancing patient management improving our understanding As research continues unfold, unravelling complexities remains paramount effective intervention care.

Language: Английский

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3 Months Follow Up of the Post-COVID Syndrome after Admission in a Specialised Post-COVID Centre – A Prospective Study Focusing Mental Health with Patient Reported Outcome Measures (PROMs)

Published: July 24, 2024

Background and objective: The impairments duration of PASC (Post-acute sequelae COVID-19) symptoms in mental health have up to date not been comprehensively examined. Our objective is provide longitudinal data on the Post-COVID patients identify risk protective factors associated with a severe or prolonged course. Methods: Mental 265 outpatient centre University-Hospital Erlangen was assessed 17.1 (T0) 22.5 months after infection (T1). An online survey validated questionnaires for (Post-COVID-Syndrome-Score), depression (Patient-Health-Questionnaire 9), somatic 15), anxiety (Generalized-Anxiety-Disorder 7), fatigue (Fatigue-Severity-Scale) Post-Exertional Malaise (PEM) (DePaul Post-Exertional-Malaise Screening) conducted home environment. Results: 80% experienced at follow up. Clinically relevant depression, persistent symptoms, anxiety, were reported by 55.8%, 72.5%, 18.9% 89.4% respectively. Depressive, symptom severity decreased significantly over time; PEM remained an unchanged high level. Risk factor higher scores older age; prior psychiatric illness treated psychotherapy more depressive, somatic, symptoms. longer between acute initial presentation centre. Conclusion: findings align previous research, claiming syndrome, lasting infection. In-depth assessment implications needed planning services disease prevention.

Language: Английский

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Anxiety and depression among individuals with long COVID: Associations with social vulnerabilities

Journal of Affective Disorders, Journal Year: 2024, Volume and Issue: 367, P. 286 - 296

Published: Sept. 2, 2024

Language: Английский

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