Short‐term neuropsychiatric outcomes and quality of life in COVID‐19 survivors

  1. R. Méndez
  2. V. Balanzá‐Martínez
  3. S.C. Luperdi
  4. I. Estrada
  5. A. Latorre
  6. P. González‐Jiménez
  7. L. Feced
  8. L. Bouzas
  9. K. Yépez
  10. A. Ferrando
  11. D. Hervás
  12. E. Zaldívar
  13. S. Reyes
  14. M. Berk
  15. R. Menéndez

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Abstract

Background

The general medical impacts of coronavirus (COVID‐19) are increasingly appreciated. However, its impact on neurocognitive, psychiatric health and quality of life (QoL) in survivors after the acute phase is poorly understood. We aimed to evaluate neurocognitive function, psychiatric symptoms and QoL in COVID‐19 survivors shortly after hospital discharge.

Methods

This was a cross‐sectional analysis of a prospective study of hospitalized COVID‐19 survivors followed up for 2 months after discharge. A battery of standardized instruments evaluating neurocognitive function, psychiatric morbidity and QoL (mental and physical components) was administered by telephone.

Results

Of the 229 screened patients, 179 were included in the final analysis. Amongst survivors, the prevalence of moderately impaired immediate verbal memory and learning was 38%, delayed verbal memory (11.8%), verbal fluency (34.6%) and working memory (executive function) (6.1%), respectively. Moreover, 58.7% of patients had neurocognitive impairment in at least one function. Rates of positive screening for anxiety, depression and post‐traumatic stress disorder were 29.6%, 26.8% and 25.1%, respectively. In addition, 39.1% of the patients had psychiatric morbidity. Low QoL for physical and mental components was detected in 44.1% and 39.1% of patients respectively. Delirium and psychiatric morbidity were associated with neurocognitive impairment, and female gender was related with psychiatric morbidity.

Conclusion

Hospitalized COVID‐19 survivors showed a considerable prevalence of neurocognitive impairment, psychiatric morbidity and poor QoL in the short term. It is uncertain if these impacts persist over the long term.

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  1. Version published to 10.1111/joim.13262
  2. ScreenIT

    SciScore for 10.1101/2020.09.23.20190090: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementConsent: All patients provided written informed consent to participate in the study.
    IRB: The Biomedical Research Ethics Committee of La Fe University and Polytechnic Hospital reviewed and approved the study (2020-280-1).
    Randomizationnot detected.
    BlindingAn independent researcher, blind to clinical data and the study hypothesis, conducted pilot interviews under monitoring of her supervisors before enrolment.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    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:
    Our study has several limitations: 1) This is a single center study and the application of our findings to other populations should be extrapolated with caution, requiring external validation. 2) The tests were administered by telephone. The psychiatric screening for symptoms of anxiety, depression, and PTSD used self-reported measures after administering validated questionnaires. A face-to-face approach to the neurocognitive function and psychiatric morbidity may provide more precise information. 3) Although a drop-out rate of 21.8% is not likely to bias the present results, drop-outs might correspond to those patients with higher disabilities. If that were the case, the present findings would even underestimate the true prevalence of the outcomes. 4) Finally, the study lacked a control group to compare COVID-19 survivors with survivors of other acute diseases since most studies have focused on ICU survivors. Study strengths not previously mentioned include the methodologically rigorous assessment of the outcomes. In previous studies, cognitive deficits were based on self-report (5). Therefore, no study has used neuropsychological tests to objectively establish cognitive deficits. All the selected tests were previously validated in the Spanish general population and included cut-off points for cognitive impairment or psychiatric screening. Moreover, confounding variables such as age and educational level were controlled in the case of cognitive performance. The study was per...

    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.

  3. Version published to 10.1101/2020.09.23.20190090v1 on medRxiv