Self-reported mental health in hospitalized patients with COVID-19: A 1-year follow-up

Authors

  • Linda Ashman Kröönström Rehabilitation Medicine, Section of Clinical Neuroscience, Department of Neuroscience, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Health and Rehabilitation/Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Occupational and Physical Therapy, Sahlgrenska University Hospital, Gothenburg, Sweden
  • David Krabbe Rehabilitation Medicine, Section of Clinical Neuroscience, Department of Neuroscience, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Neurocare, Sahlgrenska University Hospital, Gothenburg, Sweden
  • Alexandra Larsson Rehabilitation Medicine, Section of Clinical Neuroscience, Department of Neuroscience, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Occupational and Physical Therapy, Sahlgrenska University Hospital, Gothenburg, Sweden
  • Lena Rafsten Rehabilitation Medicine, Section of Clinical Neuroscience, Department of Neuroscience, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Occupational and Physical Therapy, Sahlgrenska University Hospital, Gothenburg, Sweden
  • Annie Palstam Rehabilitation Medicine, Section of Clinical Neuroscience, Department of Neuroscience, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Neurocare, Sahlgrenska University Hospital, Gothenburg, Sweden; School of Health and Welfare, Dalarna University, Falun, Sweden
  • Katharina S Sunnerhagen Rehabilitation Medicine, Section of Clinical Neuroscience, Department of Neuroscience, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Neurocare, Sahlgrenska University Hospital, Gothenburg, Sweden
  • Hanna C Persson Rehabilitation Medicine, Section of Clinical Neuroscience, Department of Neuroscience, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Occupational and Physical Therapy, Sahlgrenska University Hospital, Gothenburg, Sweden

DOI:

https://doi.org/10.2340/jrm.v56.40654

Keywords:

SARS-CoV-2, COVID-19, mental health, posttraumatic stress disorder, post-acute COVID-19 syndrome, fatigue

Abstract

Objectives: This study aimed to longitudinally follow self-reported symptoms of depression, anxiety, post-traumatic stress disorder, and fatigue during the first year after hospitalization because of COVID-19.

Design: The study was an observational longitudinal study.

Methods and participants: Between July 2020, and February 2021, 211 patients aged ≥ 18 years, hospitalized ≥ 5 days at 5 hospitals in Region Västra Götaland, who had COVID-19, and were non-contagious (at study enrolment) were included in the baseline assessment. Of these, 168 (79.6%) patients completed mental health questionnaires at a 3-month follow-up, and 172 (83.1%) at a 12-month follow-up. A total of 120 (56.9%) participants who completed at least 1 questionnaire at both the 3- and 12-month follow-ups were analysed; the majority were male (n = 78, 65.0%).

Results: There was an improvement in all patients from 3 to 12 months on the fatigue subscales “reduced activity” (p = 0.02) and “physical fatigue” (p = 0.04). No other significant mental health improvements were found. At 12 months, 34 (28.4%) were classified as having anxiety symptoms, 29 (24.1%) as having depression symptoms, and 40 (33.3%) had symptoms of probable post-traumatic stress disorder.

Conclusions: Participants in the present study did not report full mental health recovery 1 year after hospitalization for COVID-19.

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References

Fernández-de-Las-Peñas C, Palacios-Ceña D, Gómez-Mayordomo V, Florencio LL, Cuadrado ML, Plaza-Manzano G, et al. Prevalence of post-COVID-19 symptoms in hospitalized and non-hospitalized COVID-19 survivors: a systematic review and meta-analysis. Eur J Intern Med 2021; 92: 55-70.

https://doi.org/10.1016/j.ejim.2021.06.009 DOI: https://doi.org/10.1016/j.ejim.2021.06.009

Lopez-Leon S, Wegman-Ostrosky T, Perelman C, Sepulveda R, Rebolledo PA, Cuapio A, et al. More than 50 long-term effects of COVID-19: a systematic review and meta-analysis. Sci Rep 2021; 11: 16144.

https://doi.org/10.1038/s41598-021-95565-8 DOI: https://doi.org/10.1038/s41598-021-95565-8

Soriano JB, Murthy S, Marshall JC, Relan P, Diaz JV. A clinical case definition of post-COVID-19 condition by a Delphi consensus. Lancet Infect Dis 2022; 22: e102-e107.

https://doi.org/10.1016/S1473-3099(21)00703-9 DOI: https://doi.org/10.1016/S1473-3099(21)00703-9

World Health Organization. The world health report 2001. Mental health: new understanding, new hope. [accessed Jan 11 2023]Available from: https://apps.who.int/iris/bitstream/handle/10665/42390/WHR_2001.pdf?sequence=1&isAllowed=y.

Yunitri N, Chu H, Kang XL, Jen HJ, Pien LC, Tsai HT, et al. Global prevalence and associated risk factors of posttraumatic stress disorder during COVID-19 pandemic: a meta-analysis. Int J Nurs Stud 2022; 126: 104136.

https://doi.org/10.1016/j.ijnurstu.2021.104136 DOI: https://doi.org/10.1016/j.ijnurstu.2021.104136

Ceban F, Ling S, Lui LMW, Lee Y, Gill H, Teopiz KM, et al. Fatigue and cognitive impairment in Post-COVID-19 Syndrome: a systematic review and meta-analysis. Brain Behav Immun 2022; 101: 93-135.

https://doi.org/10.1016/j.bbi.2021.12.020 DOI: https://doi.org/10.1016/j.bbi.2021.12.020

Joli J, Buck P, Zipfel S, Stengel A. Post-COVID-19 fatigue: a systematic review. Front Psychiatry 2022; 13: 947973.

https://doi.org/10.3389/fpsyt.2022.947973 DOI: https://doi.org/10.3389/fpsyt.2022.947973

Malik P, Patel K, Pinto C, Jaiswal R, Tirupathi R, Pillai S, et al. Post-acute COVID-19 syndrome (PCS) and health-related quality of life (HRQoL): a systematic review and meta-analysis. J Med Virol 2022; 94: 253-262.

https://doi.org/10.1002/jmv.27309 DOI: https://doi.org/10.1002/jmv.27309

Deng J, Zhou F, Hou W, Silver Z, Wong CY, Chang O, et al. The prevalence of depression, anxiety, and sleep disturbances in COVID-19 patients: a meta-analysis. Ann N Y Acad Sci 2021; 1486: 90-111.

https://doi.org/10.1111/nyas.14506 DOI: https://doi.org/10.1111/nyas.14506

Houben-Wilke S, Goërtz YM, Delbressine JM, Vaes AW, Meys R, Machado FV, et al. The impact of long COVID-19 on mental health: observational 6-month follow-up study. JMIR Ment Health 2022; 9: e33704.

https://doi.org/10.2196/33704 DOI: https://doi.org/10.2196/33704

Utzon-Frank N, Breinegaard N, Bertelsen M, Borritz M, Eller NH, Nordentoft M, et al. Occurrence of delayed-onset post-traumatic stress disorder: a systematic review and meta-analysis of prospective studies. Scand J Work Environ Health 2014; 40: 215-229.

https://doi.org/10.5271/sjweh.3420 DOI: https://doi.org/10.5271/sjweh.3420

Huang L, Yao Q, Gu X, Wang Q, Ren L, Wang Y, et al. 1-year outcomes in hospital survivors with COVID-19: a longitudinal cohort study. Lancet 2021; 398: 747-758.

https://doi.org/10.1016/S0140-6736(21)01755-4 DOI: https://doi.org/10.1016/S0140-6736(21)01755-4

Larsson AC, Palstam A, Persson HC. Physical function, cognitive function, and daily activities in patients hospitalized due to COVID-19: a descriptive cross-sectional study in Sweden. Int J Environ Res Public Health 2021; 18: 11600.

https://doi.org/10.3390/ijerph182111600 DOI: https://doi.org/10.3390/ijerph182111600

Larsson AC, Engwall M, Palstam A, Persson HC. Self-assessed aspects of health 3 months after COVID-19 hospitalization: a Swedish cross-sectional study. Int J Environ Res Public Health 2022; 19: 8020.

https://doi.org/10.3390/ijerph19138020 DOI: https://doi.org/10.3390/ijerph19138020

von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 2007; 370: 1453-1457.

https://doi.org/10.1016/S0140-6736(07)61602-X DOI: https://doi.org/10.1016/S0140-6736(07)61602-X

Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 1983; 67: 361-370.

https://doi.org/10.1111/j.1600-0447.1983.tb09716.x DOI: https://doi.org/10.1111/j.1600-0447.1983.tb09716.x

Weiss DS. The Impact of Event Scale-Revised. In: Wilson JP, Keane TM, editors. Assessing psychological trauma and PTSD: a practitioner's handbook. 2nd ed. New York: Guilford Press; 2007: p. 168-189.

Creamer M, Bell R, Failla S. Psychometric properties of the Impact of Event Scale - Revised. Behav Res Ther 2003; 41: 1489-1496.

https://doi.org/10.1016/j.brat.2003.07.010 DOI: https://doi.org/10.1016/j.brat.2003.07.010

Kawamura N, Kim Y, Asukai N. Suppression of cellular immunity in men with a past history of posttraumatic stress disorder. Am J Psychiatry 2001; 158: 484-486.

https://doi.org/10.1176/appi.ajp.158.3.484 DOI: https://doi.org/10.1176/appi.ajp.158.3.484

Smets EM, Garssen B, Bonke B, De Haes JC. The Multidimensional Fatigue Inventory (MFI): psychometric qualities of an instrument to assess fatigue. J Psychosom Res 1995; 39: 315-325.

https://doi.org/10.1016/0022-3999(94)00125-O DOI: https://doi.org/10.1016/0022-3999(94)00125-O

WHO working group on the clinical characterisation and management of COVID-19 infection. A minimal common outcome measure set for COVID-19 clinical research. Lancet Infect Dis 2020; 20: e192-e197.

Sundararajan V, Henderson T, Perry C, Muggivan A, Quan H, Ghali WA. New ICD-10 version of the Charlson comorbidity index predicted in-hospital mortality. J Clin Epidemiol 2004; 57: 1288-1294.

https://doi.org/10.1016/j.jclinepi.2004.03.012 DOI: https://doi.org/10.1016/j.jclinepi.2004.03.012

Engberg I, Segerstedt J, Waller G, Wennberg P, Eliasson M. Fatigue in the general population: associations to age, sex, socioeconomic status, physical activity, sitting time and self-rated health: the northern Sweden MONICA study 2014. BMC Public Health 2017; 17: 654.

https://doi.org/10.1186/s12889-017-4623-y DOI: https://doi.org/10.1186/s12889-017-4623-y

Schwarz R, Krauss O, Hinz A. Fatigue in the general population. Onkologie 2003; 26: 140-144.

https://doi.org/10.1159/000069834 DOI: https://doi.org/10.1159/000069834

Hartung TJ, Neumann C, Bahmer T, Chaplinskaya-Sobol I, Endres M, Geritz J, et al. Fatigue and cognitive impairment after COVID-19: a prospective multicentre study. EClinicalMedicine 2022; 53: 101651.

https://doi.org/10.1016/j.eclinm.2022.101651 DOI: https://doi.org/10.1016/j.eclinm.2022.101651

Weathers FW, Bovin MJ, Lee DJ, Sloan DM, Schnurr PP, Kaloupek DG, et al. The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5): development and initial psychometric evaluation in military veterans. Psychol Assess 2018; 30: 383-395.

https://doi.org/10.1037/pas0000486 DOI: https://doi.org/10.1037/pas0000486

Zeng N, Zhao YM, Yan W, Li C, Lu QD, Liu L, et al. A systematic review and meta-analysis of long term physical and mental sequelae of COVID-19 pandemic: call for research priority and action. Mol Psychiatry 2023; 28: 423-433.

https://doi.org/10.1038/s41380-022-01614-7 DOI: https://doi.org/10.1038/s41380-022-01614-7

Statistics Sweden. Utrikes födda i Sverige. Available from: https://www.scb.se/hitta-statistik/sverige-i-siffror/manniskorna-i-sverige/utrikes-fodda-i-sverige/#utrikes-fodda-over-tid (accessed May 30 2024).

Watt T, Groenvold M, Bjorner JB, Noerholm V, Rasmussen NA, Bech P. Fatigue in the Danish general population: influence of sociodemographic factors and disease. J Epidemiol Community Health 2000; 54: 827-833.

https://doi.org/10.1136/jech.54.11.827 DOI: https://doi.org/10.1136/jech.54.11.827

Ware JE, Snow KK, Kosinski M, Gandek B. SF-36 health survey: manual and interpretation guide. Boston, MA: Nimrod Press; 1993.

Bell ML, Fairclough DL, Fiero MH, Butow PN. Handling missing items in the Hospital Anxiety and Depression Scale (HADS): a simulation study. BMC Res Notes 2016; 9: 479.

https://doi.org/10.1186/s13104-016-2284-z DOI: https://doi.org/10.1186/s13104-016-2284-z

Morin L, Savale L, Pham T, Colle R, Figueiredo S, Harrois A, et al. Four-month clinical status of a cohort of patients after hospitalization for COVID-19. JAMA 2021; 325: 1525-1534.

https://doi.org/10.1001/jama.2021.3331 DOI: https://doi.org/10.1001/jama.2021.3331

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Published

2024-09-24

How to Cite

Ashman Kröönström, L., Krabbe , D., Larsson, A., Rafsten, L., Palstam, A., Sunnerhagen, K. S., & Persson, H. C. (2024). Self-reported mental health in hospitalized patients with COVID-19: A 1-year follow-up. Journal of Rehabilitation Medicine, 56, jrm40654. https://doi.org/10.2340/jrm.v56.40654

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