Neuropsychiatric post-acute sequelae of COVID-19: prevalence, severity, and impact of vaccination

Eur Arch Psychiatry Clin Neurosci. 2023 Sep;273(6):1349-1358. doi: 10.1007/s00406-023-01557-2. Epub 2023 Jan 27.

Abstract

The potential long-term neuropsychiatric effects of COVID-19 are of global concern. This study aimed to determine the prevalence and predictors of neuropsychiatric post-acute sequelae of COVID-19 among Egyptian COVID-19 survivors and to study the impact of full vaccination before COVID-19 infection on the occurrence and severity of these manifestations. Three months after getting COVID-19 infection, 1638 COVID-19 survivors were screened by phone for possible neuropsychiatric sequelae. Subjects suspected to suffer from these sequelae were invited to a face-to-face interview for objective evaluation. They were requested to rate the severity of their symptoms using visual analogue scales (VAS). The mean age of participants was 38.28 ± 13 years. Only 18.6% were fully vaccinated before COVID-19 infection. Neuropsychiatric post-acute sequelae of COVID-19 were documented in 598 (36.5%) subjects, fatigue was the most frequent one (24.6%), followed by insomnia (16.4%), depression (15.3%), and anxiety (14.4%). Moderate and severe COVID-19 infection and non-vaccination increased the odds of developing post-COVID-19 neuropsychiatric manifestations by 2 times (OR 1.95, 95% CI = 1.415-2.683), 3.86 times (OR 3.86, 95% CI = 2.358-6.329), and 1.67 times (OR 1.67, 95% CI = 1.253-2.216), respectively. Fully vaccinated subjects before COVID-19 infection (n = 304) had significantly lesser severity of post-COVID-19 fatigue, ageusia/hypogeusia, dizziness, tinnitus, and insomnia (P value = 0.001, 0.008, < 0.001, 0.025, and 0.005, respectively) than non-vaccinated subjects. This report declared neuropsychiatric sequelae in 36.5% of Egyptian COVID-19 survivors, fatigue being the most prevalent. The effectiveness of COVID-19 vaccines in reducing the severity of some post-COVID-19 neuropsychiatric manifestations may improve general vaccine acceptance.

Keywords: Fatigue; Long COVID-19; Neuropsychiatric sequelae; SARS-CoV-2; Vaccines.

MeSH terms

  • Adult
  • COVID-19 Vaccines / adverse effects
  • COVID-19* / complications
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Disease Progression
  • Fatigue / epidemiology
  • Fatigue / etiology
  • Humans
  • Middle Aged
  • Prevalence
  • Sleep Initiation and Maintenance Disorders*

Substances

  • COVID-19 Vaccines