Mental Health Status of Survivors Following COVID-19 in Wuhan, China: A Descriptive Study

Abstract

Background: Inpatients with coronavirus disease 2019 (COVID-19) have been well depicted in clinical characteristics. However, few studies reported post-discharge conditions, especially mental health status, for survivors following COVID-19. In this study, we aimed to first report mental health status in COVID-19 survivors and explore relevant influence factors. Methods: In this descriptive case series, we enrolled a population of 370 COVID-19 survivors in Wuhan Jinyintan Hospital, China. Survivors were discharged during Jan 4 and Feb 12, 2020. Telephone follow-up was conducted. Readmission status and post-discharge symptoms and signs were inquired. Mental health conditions of anxiety and depression were assessed using The Generalized Anxiety Disorder Screener (GAD-7) and Patient Health Questionnaire-9 (PHQ-9), respectively. Results: The median post-discharge follow-up period was 22 days (interquartile range 20~30 days). Of the 370 COVID-19 survivors, no survivors were readmitted due to recurrence of SARS-CoV-2-positive pneumonia. Sixty (16.2%) survivors had post-discharge cough and 45 (12.2%) had breathlessness after activity. One hundred and seventy-three (46.8%) survivors worried about recurrence and 174 (47.0%) worried about infection to others such as their family. Two hundred and ninety-three (79.2%) survivors took a home quarantine lifestyle. Fifty (13.5%) survivors occurred anxiety and 40 (10.8%) survivors occurred depression. Survivors were most bothered by sleeping disorders (29.5%). Four survivors (1.1%) once had thoughts of suicide in several days. Three hundred and fifty-six (96.2%) survivors were willing to return to hospital for health examination. Anxiety was significantly associated with post-discharge respiratory symptoms, worry about recurrence and worry about infection to others (P<0.05). Depression was significantly associated with gender of female, post-discharge respiratory symptoms, worry about recurrence, worry about infection to others and home quarantine lifestyle (P<0.05). Interpretation: About 10 percent of COVID-19 survivors would develop anxiety or depression, because of post-discharge residual respiratory symptoms, worry about recurrence and infection to others. We clinicians and psychiatrists must pay attention to mental health care for these survivors. We need to explain to COVID-19 survivors that they should not be overly worried about residual respiratory symptoms and a rare event of recurrence. In addition, depression caused by home quarantine lifestyle should also be noted and relieved. Funding Statement: This study was supported by The National Natural Science Foundation of China (NSFC) (81972393, 81772705, 31570775), NSFC (81630001, 81770075), Shanghai Municipal Key Clinical Specialty (shslczdzk02201) and Shanghai Top-Priority Clinical Key Disciplines Construction Project (2017ZZ02013), Sub-specialist project of Qingpu Branch of Zhongshan Hospital, Fudan university (YZK 2019-04), 2019 Hospital-level National Natural Science Foundation Incubation Project (QYP 2019-03), Science and technology development fund of Qingpu district science and technology commission in 2018 (QKY 2018-01), Academic Leader of Shanghai Qingpu District Healthcare Commission (WD2019-36), Shanghai key discipline of medicine (ZK2019B07 SZ2019- 1), NSFC(81870035), Project of Shanghai municipal commission of health and family planning (201740210). Declaration of Interests: All authors declared that they have no Conflicts of Interest. Ethics Approval Statement: This study was approved by the Ethics Committee of Jinyintan Hospital in Wuhan, China.