Dynamics of Anxiety, Depression, and Sleep Quality Following COVID-19 Hospitalization in Romania

Background: COVID-19 has been associated with neurological and psychiatric manifestations, both at disease onset and during post-infectious sequelae, such as anxiety, depression, and sleep disturbances. Previous pandemics suggest potential for long-term neuropsychiatric consequences. Materials and Methods: We conducted a prospective longitudinal study in patients hospitalized with non-critical COVID-19, evaluating symptoms using validated psychometric instruments at discharge and after 3–6 and 12 months post-infection. Additionally, a four-year follow-up was performed through telephone interviews to document newly diagnosed psychiatric disorders and mortality. Results: At baseline, 22% of patients reported anxiety, 8% depression, and 16% poor sleep. Most symptoms improved within the first year, particularly during the first 3–6 months. At four-year follow-up, mortality reached 5%, while clinician-diagnosed psychiatric disorders increased to 6% for anxiety, 11% for depression, and 3% for mixed disorders. Anxiety and poor sleep—but not depression—were associated with the severity of the acute episode. Conclusions: Overall, post-COVID-19 anxiety, depression, and sleep disturbances were more prevalent than in the general population, though the rates were lower than those reported in other studies. Most symptoms resolved within the first year. However, new-onset cases of depression and other psychiatric disorders emerged during long-term follow-up, suggesting distinct trajectories of post-COVID-19 psychiatric morbidity.