Psychiatric morbidity and protracted symptoms in recovered COVID-19 patients

  1. Burç Çağrı Poyraz
  2. Cana Aksoy Poyraz
  3. Yeşim Olğun
  4. Özge Gürel
  5. Sena Alkan
  6. Yusuf Emre Özdemir
  7. İlker İnanç Balkan
  8. Rıdvan Karaali

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Abstract

We investigated the psychiatric symptomatology and the protracted symptoms in recently recovered COVID-19 patients. This cross-sectional study assessed 284 patients recruited from a tertiary hospital. Patients completed a web-based survey on socio-demographic data, past medical/psychiatric history, and additional information relevant to the outbreak conditions. The psychiatric status was assessed using the Impact of Events Scale-Revised (IES-R), Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI), and MINI suicidality scale. Patients completed a checklist for the acute symptom burden and protracted symptoms that were experienced after the acute infection. After a mean of 50 days following the diagnosis of COVID-19, 98 patients (34.5%) reported clinically significant PTSD, anxiety, and/or depression, with PTSD being the most common condition reported (25.4%). One hundred and eighteen patients (44.3%) reported one or more protracted symptom(s), with fatigue, muscle aches, alteration of smell/taste, headache and difficulty in concentration, being the most common symptoms reported. Predictors of PTSD symptom severity were the female gender, past traumatic events, protracted symptoms, perceived stigmatization, and a negative view on the seriousness of the COVID-19 pandemic. Binary logistic regression analysis showed that PTSD symptom severity was the sole independent predictor of the presence of protracted symptoms. Our results suggest that COVID-19 patients may be prone to substantial psychological distress in the first months after the infection. The protracted symptoms were also frequent in this period, and these were related to the posttraumatic psychiatric morbidity. Both the psychiatric morbidity and the protracted symptoms were independent of the initial infection severity. Further research on the neurobiological commonalities between the protracted symptoms and PTSD in COVID-19 patients is warranted.

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    SciScore for 10.1101/2020.10.07.20208249: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical analysis was performed using SPSS Statistic 23.0 (IBM SPSS Statistics, New York, United States).
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    There are several limitations to our study. First, we used a convenience sample, and caution must be exercised in generalization of our findings to the broader population of patients with COVID-19. In our sample, the great majority of patients (98.8%) were rated as ‘non-critical’ based on the COVID-19 severity index, hence, further work on the most critical patients is desirable. Second, this was a cross-sectional study which limits our ability to infer causality. Third, this study depended on self-report of patients instead of a structured clinical interview which could provide a better picture of the psychological distress in our patients. Also, a detailed medical examination of the patients with the protracted symptoms could yield additional clues to the cause(s) of persistence of these symptoms, in addition to the psychiatric morbidity. Finally, we did not specifically question the symptom of dyspnea in our protracted symptoms checklist, which may have led to a lower reported frequency of this symptom (4%) in our sample, compared to other studies. In summary, patients with COVID-19 are prone to substantial psychological distress after the infection. PTSD symptoms and comorbid depression, as well as anxiety, and impaired sleep comprise a substantial part of the distress described by these individuals. Various personal (i.e., gender and prior trauma history) and psychosocial factors (i.e., perceived stigmatization and a personal view on seriousness of the threat posed by th...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.10.07.20208249v1 on medRxiv