Cardiovascular Abnormalities and Mental Health Difficulties Result in a Reduced Quality of Life in the Post-Acute COVID-19 Syndrome.

Catalina Giurgi-Oncu,Cristina Bredicean,Silvius Alexandru Pescariu,Mariana Tudoran,Ana Giurgiuca,Cristina Tudoran,Gheorghe Nicusor Pop

doi:10.3390/brainsci11111456

Abstract

(1) Background: Post-acute COVID-19 syndrome, characterized by persisting symptoms up to 12 weeks after the acute illness, impairs numerous people’s physical and mental health. (2) Methods: 64 inpatients and 79 outpatients, aged under 55 years, with post-acute COVID-19, were evaluated by a transthoracic echocardiography (TTE), mental health examination, Quality of Life (QoL) questionnaire, post-COVID-19 functional status scale (PCFS) and Hospital Anxiety and Depression Scale (HADS). (3) Results: all inpatients had mild/moderate pulmonary injury during acute COVID-19, in contrast to 37.97% of outpatients. Inpatients who reported an average of 5 persisting symptoms, had, predominantly, level 3 PCFS and a median QoL of 62, compared to outpatients, who reported an average of 3 symptoms, level 1 PCFS and a median QoL score of 70. Increased pulmonary artery pressure was detected in 28.11% of inpatients, compared to 17.72% of outpatients, while diastolic dysfunction was diagnosed in 28.12% of inpatients, in comparison with 20.25% of outpatients (p = 0.02). Abnormal systolic function was assessed in 9.37% of inpatients, and 7.58% of outpatients. According to the HADS depression subscale, 46.87% of inpatients and 27.84% of outpatients had clinical depression. Concomitantly, anxiety was detected in 34.37% of inpatients and 40.5% of outpatients (4) Conclusions: cardiovascular and mental health difficulties were frequently detected in patients with post-acute symptoms of COVID-19, which correlated with the number and intensity of persisting symptoms and reduced QoL scores.

Highlights

In recent months, since the start of the coronavirus (COVID-19) pandemic, it has become increasingly evident that there are far more health sequelae than previously suggested, even after an apparent recovery from the acute phase of the infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1]
This study aims to highlight the frequent association between the severity of the acute illness, expressed by the degree of the initial pulmonary injury and the inflammatory response, with the consecutive amplitude of CV and mental health impairments, as well as their impact on the quality of life in subjects who were hospitalized or treated as outpatients for a mild/moderate SARS-CoV-2 pulmonary infection and are currently suffering from post-acute COVID-19
Based on the persistence of symptoms, all patients were diagnosed with post-acute COVID-19

Summary

Introduction

Since the start of the coronavirus (COVID-19) pandemic, it has become increasingly evident that there are far more health sequelae than previously suggested, even after an apparent recovery from the acute phase of the infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1]. In the aftermath of this unprecedented global health crisis, there are increasing numbers of patients who report, even at 3 months after the acute phase of illness, persisting distress in association with nonspecific, wide-ranging and, sometimes, even debilitating, residual symptoms, such as fatigue, dyspnea/persistent oxygen requirement, chest pain, post-viral chronic malaise, headaches, neurocognitive (brain fog), and mental health difficulties, such as anxiety, depression, disturbed/nonrestorative sleep, or psychotic episodes [2,3] This clinical presentation is not dissimilar to that described by survivors of the SARS epidemic from 2003 [2,4]. Neurological and mental disorders have been frequently described long after the improvement from the acute phase of COVID-19 and may contribute to a persistently impaired health status [5,6,7,8]

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