Abstract
BackgroundThe psychological impact of COVID-19 can be substantial. However, knowledge about long-term psychological outcomes in patients with COVID-19 is scarce.ObjectiveIn this longitudinal, observational study, we aimed to reveal symptoms of posttraumatic stress disorder (PTSD) and symptoms of anxiety and depression up to 6 months after the onset of COVID-19–related symptoms in patients with confirmed COVID-19 and persistent complaints. To demonstrate the impact in nonhospitalized patients, we further aimed to compare these outcomes between nonhospitalized and hospitalized patients.MethodsDemographics, symptoms of PTSD (Trauma Screening Questionnaire [TSQ] ≥6 points) and symptoms of anxiety and depression (Hospital Anxiety and Depression Scale [HADS] ≥8 points) were assessed at 3 and 6 months after the onset of COVID-19–related symptoms in members of online long COVID-19 peer support groups.ResultsData from 239 patients with confirmed COVID-19 (198/239, 82.8% female; median age: 50 [IQR 39-56] years) were analyzed. At the 3-month follow-up, 37.2% (89/239) of the patients had symptoms of PTSD, 35.6% (85/239) had symptoms of anxiety, and 46.9% (112/239) had symptoms of depression, which remained high at the 6-month follow-up (64/239, 26.8%, P=.001; 83/239, 34.7%, P=.90; 97/239, 40.6%, P=.08, respectively; versus the 3-month follow-up). TSQ scores and HADS anxiety and depression scores were strongly correlated at the 3- and 6-month follow-ups (r=0.63-0.71, P<.001). Symptoms of PTSD, anxiety, and depression were comparable between hospitalized (n=62) and nonhospitalized (n=177) patients.ConclusionsA substantial percentage of patients with confirmed COVID-19 and persistent complaints reported symptoms of PTSD, anxiety, or depression 3 and 6 months after the onset of COVID-19–related symptoms. The prevalence rates of symptoms of PTSD, anxiety, and depression were comparable between hospitalized and nonhospitalized patients and merely improved over time. Health care professionals need to be aware of these psychological complications and intervene on time in post-COVID-19 patients with persistent complaints.Trial RegistrationNetherlands Trial Register NTR8705; https://www.trialregister.nl/trial/8705.
Highlights
A traumatic event is an incident that causes physical, emotional, spiritual, or psychological harm [1]
At the 3-month follow-up, 37.2% (89/239) of the patients had symptoms of posttraumatic stress disorder (PTSD), 35.6% (85/239) had symptoms of anxiety, and 46.9% (112/239) had symptoms of depression, which remained high at the 6-month follow-up (64/239, 26.8%, P=.001; 83/239, 34.7%, P=.90; 97/239, 40.6%, P=.08, respectively; versus the 3-month follow-up)
Trauma Screening Questionnaire (TSQ) scores and Hospital Anxiety and Depression scale (HADS) anxiety and depression scores were strongly correlated at the 3- and 6-month follow-ups (r=0.63-0.71, P
Summary
A traumatic event is an incident that causes physical, emotional, spiritual, or psychological harm [1]. The impact of a traumatic event varies between individuals. Some experience symptoms such as unwanted upsetting memories, flashbacks, nightmares, emotional distress, or physical reactivity after exposure to traumatic reminders. If symptoms last for more than 1 month, create distress, or interfere with daily functioning, posttraumatic stress disorder (PTSD) needs to be considered [2]. PTSD has major negative consequences for patients and their families [2,3] and is associated with long-term comorbid depression and substance abuse [2], underlining the need to detect and treat the disorder. Knowledge about long-term psychological outcomes in patients with COVID-19 is scarce
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