Heart and Mind (Jan 2023)

Mental health symptoms and illness trajectory following COVID-19 hospitalization: A cohort study

  • Harriet Lomholt-Welch,
  • Andrew J Morrow,
  • Robert Sykes,
  • Merna Saleh,
  • Baryab Zahra,
  • Alasdair MacIntosh,
  • Anna Kamdar,
  • Catherine Bagot,
  • Hannah K Bayes,
  • Kevin G Blyth,
  • Heerajnarain Bulluck,
  • David Carrick,
  • Colin Church,
  • David Corcoran,
  • Iain Findlay,
  • Vivienne B Gibson,
  • Lynsey Gillespie,
  • Douglas Grieve,
  • Pauline Hall Barrientos,
  • Antonia Ho,
  • Ninian N Lang,
  • David J Lowe,
  • Vera Lennie,
  • Peter W Macfarlane,
  • Kaitlin J Mayne,
  • Patrick B Mark,
  • Alex McConnachie,
  • Ross McGeoch,
  • Sabrina Nordin,
  • Alexander Payne,
  • Alastair J Rankin,
  • Keith Robertson,
  • Nicola Ryan,
  • Giles Roditi,
  • Naveed Sattar,
  • David Stobo,
  • Sarah Allwood-Spiers,
  • Rhian M Touyz,
  • Gruschen Veldtman,
  • Sarah Weeden,
  • Robin Weir,
  • Stuart Watkins,
  • Paul Welsh,
  • Kenneth Mangion,
  • Colin Berry

DOI
https://doi.org/10.4103/hm.HM-D-23-00037
Journal volume & issue
Vol. 7, no. 4
pp. 235 – 245

Abstract

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Background: The multisystem associations between baseline mental health status and coronavirus disease-19 (COVID)-19 illness trajectory are uncertain. Objectives: This article will investigate the associations between baseline mental health status and disease trajectory following COVID-19 hospitalization, which may have implications for practice and future research. Methods: The Chief Scientist Office Cardiovascular and Pulmonary Imaging in severe acute respiratory syndrome (SARS) COVID-19 study is a prospective, observational, multicenter, longitudinal, secondary care cohort study that assessed the time-course of multi-organ injury in posthospital survivors of COVID-19. Patients were assessed in-hospital, at 28–60 days after discharge and in the longer term using electronic health record linkage. Results: One hundred and fifty-two patients (mean ± standard deviation [SD] age 54.3 ± 11.8 years, 43% female, 40% most socio-economically deprived quintile, 33% history of mental health history) were enrolled and had mental health serially assessed using the Patient Health Questionnaire-4 (PHQ-4) questionnaire. Fifty-three (35%) had PHQ-4 score of 6–12 consistent with moderate-severe symptoms of anxiety or depression and this was associated with diagnostic criteria for myocarditis (P = 0.0498). Moderate-severe symptoms of anxiety or depression were positively associated with higher perception of illness, lower health-related quality of life (HRQoL), and poorer physical function. The mean (SD) duration of follow-up after hospital discharge was 428 (86) days (range, 290–627 days). PHQ-4 score was not associated with clinical outcomes at follow-up. Conclusions: In patients who have been hospitalized with COVID-19, moderate-severe symptoms of anxiety or depression were associated with myocarditis, worse HRQoL, higher perception of illness, and lower levels of physical function. Public Registration: ClinicalTrials.gov identifier is NCT04403607.

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