Mental health outcomes of adults hospitalized for COVID-19: A systematic review.

Abstract

BackgroundPatients hospitalized for COVID-19 may be at high risk of mental health (MH) disorders. This systematic review assesses MH outcomes among adults during and after hospitalization for COVID-19 and ascertains MH care utilization and resource needs.MethodsWe searched multiple medical literature databases for studies published December 2019 to March 2021. Studies of ≥ 200 participants were synthesized. One reviewer completed article selection, data abstraction and assessed study quality and strength of evidence, with verification by a second.ResultsFifty articles met preliminary inclusion criteria; 19 articles that included ≥ 200 participants were synthesized. Evidence from these primarily fair-quality studies suggests many patients experience symptoms of depression (9–66%), anxiety (30–39%), and insomnia (24–40%) during and 3 months after hospitalization for COVID-19. However, patients infrequently receive a new MH disorder diagnosis 6 months after hospitalization (5% are diagnosed with a new mood disorder, 7% anxiety disorder, and 3% insomnia). Some hospitalized patients – including women and those with more severe COVID-19 – may be at higher risk of poor MH outcomes. Data on MH care utilization and resource needs are currently limited.LimitationsMost included studies were small, did not report the proportion of participants with preexisting MH disorders, and did not use comparison groups.ConclusionsWhile many patients experience MH symptoms after hospitalization for COVID-19, most do not go on to develop a new MH disorder. Future studies should report whether participants have preexisting MH disorders and compare patients hospitalized for COVID-19 to patients hospitalized for other causes.