People admitted to the hospital for COVID-19 continued to have neuropsychiatric symptoms, including depression, anxiety, cognitive decline, and fatigue, which appeared to worsen over time up to three years post-discharge, according to an article in Lancet Psychiatry.
Maxime Taquet, Ph.D., at the University of Oxford, and colleagues recruited 475 adults who had been hospitalized for COVID-19 at one of 83 participating National Health Service hospitals in the United Kingdom between February 2020 and March 2021; all had been part of a larger earlier study for which they completed various neuropsychiatric testing at six and 12 months post-discharge.
For this study, conducted two to three years post-discharge, participants completed computerized cognitive tests covering eight cognitive domains, as well as separate assessments for depression, anxiety, fatigue, subjective cognitive decline, and occupation status.
“We aimed to assess how cognitive, psychiatric, and fatigue symptoms emerge and evolve over time, to identify which early aspects of COVID-19 illness predict these outcomes, and to establish how symptoms correlate with occupational change,” Taquet and colleagues wrote.
Up to three years after hospitalization, participants had worse cognitive scores than expected based on their sociodemographic factors across all domains tested. About 22% of respondents reported severe depression, about 24% reported severe fatigue, and nearly 25% reported severe cognitive decline.
Psychiatric and cognitive symptoms increased at two to three years post-hospitalization relative to earlier assessments due to both worsening of symptoms already present at six months and emergence of new symptoms. New symptoms occurred mostly in people with other symptoms already present at six months, researchers noted. Researchers also reported that 27% of participants changed occupations, with poor health being the most common reason given. Occupation change was strongly and specifically associated with objective and subjective cognitive deficit.
“Prompt interventions to treat symptoms present in the months after hospital discharge might prevent the emergence of additional symptoms and the development of a more complex syndrome,” Taquet and colleagues concluded. “Interventions promoting cognitive recovery or preventing cognitive decline might limit the occupational impact of SARS-CoV-2 infections, thereby improving functional and economic outcomes of COVID-19 for the individual and society as a whole.”
For related info, see the Psychiatric News article, “Psychiatrists Uniquely Suited for Helping Patients With Long-Haul COVID-19,” now on Newswire.
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