A COMMUNITY HOSPITAL EXPERIENCE OF PERSISTENT DEPRESSIVE SYMPTOMS IN PATIENTS HOSPITALIZED FOR COVID-19 AT 6-WEEKS POST-DISCHARGE

Abstract

TOPIC: Chest Infections TYPE: Original Investigations PURPOSE: The COVID-19 pandemic is a growing public health concern, warranting extended social distancing as cases top 30 million in the United States. Between March and December 2020, the CDC reported up to 15% of COVID-19 cases necessitated hospitalization, entailing further social isolation. With increased acceptance of mental health's role in physical illness, the following represents a single-center study characterizing the prevalence and severity of depressive symptoms in patients hospitalized with COVID-19 at discharge and 6-weeks post-discharge. METHODS: Patients (n= 66, age= 59.45 ±1.47 years, 58% male) hospitalized for COVID-19 (8.79 ±0.66 days) at a community hospital were administered the Patient Health Questionnaire-9 (PHQ-9) to characterize depressive symptoms in the prior 2-weeks. Patients recalled depressive symptoms prior to COVID-19 diagnosis (PR), immediately post-discharge (PD), and 6-weeks post-discharge (PD+6). RESULTS: The mean depressive symptom number experienced more than half the days per week were 1.00 ±0.18 (PR), 3.82 ±0.29 (PD), and 2.30 ±0.25 (PD+6), with a mean PHQ-9 score of 3.50 ±0.47 (PR), 11.11 ±0.73 (PD), and 7.30 ±0.65 (PD+6). Compared to PR, at PD patients reported a significant increase in PHQ-9 score (Z= -6.60, p<0.01) and depressive symptom number (Z= -6.11, p<0.01). At PD+6, significant improvements were noted on both parameters (Z= -5.54, p<0.01 and Z= -5.14, p<0.01 respectively). However, this did not represent a return to PR values, with significant residual depression (Z= -4.39, p<0.01 and Z= -5.38, p<0.01 respectively). PHQ-9 scores were classified as possible Other Depressive Disorder (ODD) and Major Depressive Disorder (MDD) according to interpretation guidelines. At PR, 19.67% of patients experienced substantial depression, with 15.15% characterized as ODD (Mild severity, PHQ-9= 7.50 ±0.64) and 4.55% as MDD (Moderate severity, PHQ-9= 13 ±2.00). At PD, 69.70% experienced substantial depression, with a significant increase in the prevalence of ODD (33.34%, Z= -2.35, p<0.05) and MDD (36.37%, Z= -4.01, p<0.01). Symptom severity also increased, warranting category changes in ODD (Moderate, PHQ-9= 9.74 ±0.81) and MDD (Moderately-severe, PHQ-9= 17.77 ±0.73). At PD+6, 36.36% of patients still experienced substantial depression, with a significant prevalence reduction in MDD (16.67%, Z= -2.95, p<0.01) but not ODD (19.70%, Z= -1.51, p= 0.13). Symptom severity remained unchanged in MDD (Moderately-severe, PHQ-9= 15.55 ±0.81) while reducing in ODD (Mild, PHQ-9= 8.85 ±0.32). CONCLUSIONS: Hospitalized COVID-19 patients were found to have substantial increased prevalence and severity of depression at discharge. Whilst a moderate reduction was noted 6-weeks post-discharge, depressive symptoms were found to persist. CLINICAL IMPLICATIONS: The present study highlights the importance of addressing and supporting the mental health of hospitalized COVID-19 patients post-discharge. DISCLOSURES: No relevant relationships by Moustapha Doulaye Seydou, source=Web Response No relevant relationships by Mohsin Ijaz, source=Web Response No relevant relationships by Christian Karime, source=Web Response No relevant relationships by Amir Khan, source=Web Response No relevant relationships by Dar-Yin Li, source=Web Response No relevant relationships by Shahhan Spall, source=Web Response