The Impact of Long COVID-19 on Mental Health: Observational 6-Month Follow-Up Study

Sarah Houben-Wilke; Yvonne Mj Goërtz; Jeannet M Delbressine; Anouk W Vaes; Roy Meys; Felipe Vc Machado; Maarten van Herck; Chris Burtin; Rein Posthuma; Frits Me Franssen; Herman Vijlbrief; Yvonne Spies; Alex J van 't Hul; Martijn A Spruit; Daisy Ja Janssen

doi:10.2196/33704

The Impact of Long COVID-19 on Mental Health: Observational 6-Month Follow-Up Study

JMIR Ment Health. 2022 Feb 24;9(2):e33704. doi: 10.2196/33704.

Authors

Sarah Houben-Wilke¹, Yvonne Mj Goërtz^{1

2

3}, Jeannet M Delbressine¹, Anouk W Vaes¹, Roy Meys^{1

2

3}, Felipe Vc Machado^{1

2

3}, Maarten van Herck^{1

2

3

4}, Chris Burtin⁴, Rein Posthuma^{1

2

3}, Frits Me Franssen^{1

2

3}, Herman Vijlbrief⁵, Yvonne Spies⁵, Alex J van 't Hul⁶, Martijn A Spruit^{1

2

3}, Daisy Ja Janssen^{1

7}

Affiliations

¹ Department of Research and Education, Ciro, Horn, Netherlands.
² School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.
³ Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, Netherlands.
⁴ REVAL Rehabilitation Research Center, BIOMED Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium.
⁵ Lung Foundation Netherlands, Amersfoort, Netherlands.
⁶ Department of Pulmonary Disease, Radboud University Medical Center, Nijmegen, Netherlands.
⁷ Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.

PMID: 35200155
PMCID: PMC8914795
DOI: 10.2196/33704

Abstract

Background: The psychological impact of COVID-19 can be substantial. However, knowledge about long-term psychological outcomes in patients with COVID-19 is scarce.

Objective: In this longitudinal, observational study, we aimed to reveal symptoms of posttraumatic stress disorder (PTSD) and symptoms of anxiety and depression up to 6 months after the onset of COVID-19-related symptoms in patients with confirmed COVID-19 and persistent complaints. To demonstrate the impact in nonhospitalized patients, we further aimed to compare these outcomes between nonhospitalized and hospitalized patients.

Methods: Demographics, symptoms of PTSD (Trauma Screening Questionnaire [TSQ] ≥6 points) and symptoms of anxiety and depression (Hospital Anxiety and Depression Scale [HADS] ≥8 points) were assessed at 3 and 6 months after the onset of COVID-19-related symptoms in members of online long COVID-19 peer support groups.

Results: Data from 239 patients with confirmed COVID-19 (198/239, 82.8% female; median age: 50 [IQR 39-56] years) were analyzed. At the 3-month follow-up, 37.2% (89/239) of the patients had symptoms of PTSD, 35.6% (85/239) had symptoms of anxiety, and 46.9% (112/239) had symptoms of depression, which remained high at the 6-month follow-up (64/239, 26.8%, P=.001; 83/239, 34.7%, P=.90; 97/239, 40.6%, P=.08, respectively; versus the 3-month follow-up). TSQ scores and HADS anxiety and depression scores were strongly correlated at the 3- and 6-month follow-ups (r=0.63-0.71, P<.001). Symptoms of PTSD, anxiety, and depression were comparable between hospitalized (n=62) and nonhospitalized (n=177) patients.

Conclusions: A substantial percentage of patients with confirmed COVID-19 and persistent complaints reported symptoms of PTSD, anxiety, or depression 3 and 6 months after the onset of COVID-19-related symptoms. The prevalence rates of symptoms of PTSD, anxiety, and depression were comparable between hospitalized and nonhospitalized patients and merely improved over time. Health care professionals need to be aware of these psychological complications and intervene on time in post-COVID-19 patients with persistent complaints.

Trial registration: Netherlands Trial Register NTR8705; https://www.trialregister.nl/trial/8705.

Keywords: COVID-19; PASC; SARS-CoV-2; anxiety; corona; depression; post-traumatic stress disorder.

©Sarah Houben-Wilke, Yvonne MJ Goërtz, Jeannet M Delbressine, Anouk W Vaes, Roy Meys, Felipe VC Machado, Maarten van Herck, Chris Burtin, Rein Posthuma, Frits ME Franssen, Herman Vijlbrief, Yvonne Spies, Alex J van 't Hul, Martijn A Spruit, Daisy JA Janssen. Originally published in JMIR Mental Health (https://mental.jmir.org), 24.02.2022.