Background

It remains unclear whether COVID-19 is associated with psychiatric symptoms during or after the acute illness phase. Being affected by the disease exposes the individual to an uncertain prognosis and a state of quarantine. These factors can predispose individuals to the development of mental symptoms during or after the acute phase of the disease. There is a need for prospective studies assessing psychiatric symptoms in COVID-19 patients in the post-infection period.

Methods

In this prospective cohort study, nasopharyngeal swabs for COVID-19 tests were collected at patients' homes under the supervision of trained healthcare personnel. Patients who tested positive for COVID-19 and were classified as mild cases (N = 895) at treatment intake were further assessed for the presence of psychiatric symptoms (on average, 56.6 days after the intake). We investigated the association between the number of COVID-19 symptoms at intake and depressive, anxiety and post-traumatic symptoms approximately two months later, adjusting for previous mental health status, time between baseline and outcome, and other confounders. Multivariate logistic regression and generalized linear models were employed for categorical and continuous outcomes, respectively.

Results

A clinically significant level of depressive, anxiety and post-traumatic stress symptoms were reported by 26.2% (N = 235), 22.4% (N = 201), and 17.3% (N = 155) of the sample. Reporting an increased number of COVID-related symptoms was associated with the presence of clinically significant levels of depressive (aOR = 1.059;95%CI = 1.002–1.119), anxiety (aOR = 1.072;95%CI = 1.012–1.134), and post-traumatic stress (aOR = 1.092;95%CI = 1.024–1.166) symptoms. Sensitivity analyses supported findings for both continuous and categorical measures.

Conclusion

Exposure to an increased number of COVID-19 symptoms may be associated with depressive, anxiety and post-traumatic symptoms after the acute phase of the disease. These patients should be monitored for the development of psychiatric symptoms after COVID-19 treatment discharge. Early interventions, such as brief interventions of psychoeducation on coping strategies, could benefit these individuals.

中文翻译：

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感染后抑郁、焦虑和创伤后应激症状：一项针对轻度 COVID-19 患者的前瞻性队列研究

背景

目前尚不清楚 COVID-19 是否与急性疾病阶段期间或之后的精神症状相关。受到这种疾病的影响会使个体面临不确定的预后和隔离状态。这些因素可能使个体在疾病的急性期期间或之后容易出现精神症状。需要进行前瞻性研究来评估感染后 COVID-19 患者的精神症状。

方法

在这项前瞻性队列研究中，在受过训练的医护人员的监督下，在患者家中收集了用于 COVID-19 检测的鼻咽拭子。对 COVID-19 检测呈阳性并在接受治疗时被归类为轻度病例 (N = 895) 的患者进一步评估是否存在精神症状（平均在接受治疗后 56.6 天）。我们调查了摄入时 COVID-19 症状的数量与大约两个月后的抑郁、焦虑和创伤后症状之间的关系，并根据之前的心理健康状况、基线和结果之间的时间以及其他混杂因素进行了调整。多元逻辑回归和广义线性模型分别用于分类和连续结果。

结果

26.2% (N = 235)、22.4% (N = 201) 和 17.3% (N = 155) 的样本报告了具有临床意义的抑郁、焦虑和创伤后应激症状。报告 COVID 相关症状数量增加与临床显着水平的抑郁（aOR = 1.059；95%CI = 1.002–1.119）、焦虑（aOR = 1.072；95%CI = 1.012–1.134）和创伤后压力 (aOR = 1.092;95%CI = 1.024–1.166) 症状。敏感性分析支持连续和分类测量的结果。

结论

接触更多的 COVID-19 症状可能与疾病急性期后的抑郁、焦虑和创伤后症状有关。在 COVID-19 治疗出院后，应监测这些患者是否出现精神症状。早期干预，例如对应对策略进行心理教育的简短干预，可能会使这些人受益。