In a new study, researchers found that people taken ill by coronavirus infections may experience psychiatric problems while hospitalized and potentially after they recover.
The study compiled results from short- and long-term studies of people hospitalized by recent coronaviruses, namely SARS (Severe acute respiratory syndrome) in 2002-2004, MERS (Middle East respiratory syndrome) in 2012, as well as COVID-19 this year.
The research was led by the UCL Institute of Mental Health with King’s College London scientists.
COVID-19 is caused by the SARS-CoV-2 virus, a type of coronavirus.
Some coronaviruses only cause mild symptoms of the common cold, but SARS-CoV-2 can cause severe respiratory illness, as did SARS-CoV-1 (the virus implicated in the 2002-2004 SARS epidemic) and MERS-CoV, which caused MERS in 2012.
The team analyzed 65 peer-reviewed studies and seven recent pre-prints that are awaiting peer review, which included data from over 3,500 people who have had one of the three related illnesses.
The analysis found that one in four people hospitalized with COVID-19 may experience delirium during their illness, a known problem among hospital patients, which can increase the risk of death or extend time in hospital.
The post-recovery effects of COVID-19 are not yet known, so long-term risks such as post-traumatic stress disorder (PTSD), chronic fatigue, depression, and anxiety are based on SARS and MERS studies, which may or may not apply to COVID-19 as well.
The review only included results from people who were hospitalized and not people with more mild cases.
The findings cover both acute symptoms during the illness and long-term outcomes from two months to 12 years.
Almost one in three people hospitalized with SARS or MERS went on to develop PTSD, at an average follow-up time of almost three years, especially if they had ongoing physical health problems.
Rates of depression and anxiety were also high, at roughly 15% one year or longer after the illness, with a further 15% also experiencing some symptoms of depression and anxiety without a clinical diagnosis.
More than 15% also experienced chronic fatigue, mood swings, sleep disorder, or impaired concentration and memory.
While in hospital, a significant minority of people with coronavirus infections experienced delirium symptoms such as confusion, agitation, and altered consciousness.
Almost 28% of people hospitalized for SARS and MERS experienced confusion, and early evidence from the ongoing pandemic suggests that delirium could be similarly common in COVID-19 patients.
The authors found some preliminary evidence that delirium may have been associated with raised mortality during the MERS outbreak.
The research also identified some of the risk factors linked to worse mental health outcomes.
Researchers found that worrying a lot about the illness was linked to worse mental health in the long run, and healthcare workers had worse long-term mental health outcomes than other groups while making a good physical recovery predicted better long-term mental health.
One author of the study is Dr. Jonathan Rogers (UCL Psychiatry and South London and Maudsley NHS Foundation Trust).
The study is published in The Lancet Psychiatry.
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