Psychiatric Symptoms and Fatigue in COVID-19 Survivors

Introduction: Psychiatric symptoms and fatigue are common after the coronavirus disease 2019 (COVID-19) illness. The cause of these symptoms is direct neuronal injury and indirect injury with immune-mediated inflammation. In addition, social factors also affect mental health. Objective: We aim to compare psychiatric symptoms and fatigue between COVID-19 survivors and healthy controls. Material and methods: We prospectively evaluated 100 COVID-19 survivors for anxiety, depression, positive affect, and behavior control using the Mental Health Inventory (MHI). Fatigue is assessed using the Modified Fatigue Impact Scale (MFIS) score. We compared them with 100 healthy controls. Results: There was a significant statistical difference between the MHI score and individual components of MHI. Overall, MHI scores in cases and controls were 79.41 and 93.31, respectively, with a P value of less than 0.0001. Computed scores for anxiety, depression, behavior control, and positive affect of COVID-19 survivors showed statistically significant differences as compared to healthy controls. There was a weak association between hospital stay duration and poor MHI scores. Fatigue was significantly worse in COVID-19 survivors, with a mean score of 6.93 in cases and 5.35 in controls, with a P value of 0.0001. This was a cross-sectional study evaluating psychiatric symptom scores, but not establishing the diagnosis. It is suggested that appropriate treatment and counseling for these symptoms should be done. Conclusions: Psychiatric symptoms and fatigue were significantly more common in COVID-19 patients after recovery from acute illness. It is a major contributing cause of morbidity other than organic complications of COVID-19 and requires attention in management.

[1]  V. Skirbekk,et al.  Job loss and psychological distress during the COVID-19 pandemic: a national prospective cohort study , 2023, BMC Public Health.

[2]  Se Joo Kim,et al.  Psychological factors associated with COVID-19 related anxiety and depression in young adults during the COVID-19 pandemic , 2023, PloS one.

[3]  J. Moorman,et al.  Inflammatory and mental health sequelae of COVID-19 , 2023, Comprehensive Psychoneuroendocrinology.

[4]  Ashutosh Kumar,et al.  A Bioinformatics Tool for Predicting Future COVID-19 Waves Based on a Retrospective Analysis of the Second Wave in India: Model Development Study , 2022, JMIR bioinformatics and biotechnology.

[5]  S. Lee,et al.  The Psychological Burden of COVID-19 Stigma: Evaluation of the Mental Health of Isolated Mild Condition COVID-19 Patients , 2021, Journal of Korean medical science.

[6]  T. Pollak,et al.  Neuropsychiatric complications of covid-19 , 2020, BMJ.

[7]  Manoj Sivan,et al.  Postdischarge symptoms and rehabilitation needs in survivors of COVID‐19 infection: A cross‐sectional evaluation , 2020, Journal of medical virology.

[8]  F. Benedetti,et al.  Anxiety and depression in COVID-19 survivors: Role of inflammatory and clinical predictors , 2020, Brain, Behavior, and Immunity.

[9]  M. Benros,et al.  COVID-19 pandemic and mental health consequences: Systematic review of the current evidence , 2020, Brain, Behavior, and Immunity.

[10]  Paolo Fusar-Poli,et al.  Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic , 2020, The Lancet Psychiatry.

[11]  Naiara Ozamiz-Etxebarria,et al.  Stress, anxiety, and depression levels in the initial stage of the COVID-19 outbreak in a population sample in the northern Spain. , 2020, Cadernos de saude publica.

[12]  R. Rajkumar.  COVID-19 and mental health: A review of the existing literature , 2020, Asian Journal of Psychiatry.

[13]  Q. Ye,et al.  The pathogenesis and treatment of the `Cytokine Storm' in COVID-19 , 2020, Journal of Infection.

[14]  Roberto Furlan,et al.  Neuroinflammation in Bipolar Depression , 2020, Frontiers in Psychiatry.

[15]  G. Rubin,et al.  The psychological impact of quarantine and how to reduce it: rapid review of the evidence , 2020, The Lancet.

[16]  S. Perlman,et al.  Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology , 2017, Seminars in Immunopathology.

[17]  Eva D'Souza.  Modified Fatigue Impact Scale - 5-item version (MFIS-5). , 2016, Occupational medicine.

[18]  R. Dantzer,et al.  The neuroimmune basis of fatigue , 2014, Trends in Neurosciences.

[19]  J. Newton,et al.  Fatigue Impact Scale. , 2010, Occupational medicine.

[20]  Ali Danesh,et al.  Human immunopathogenesis of severe acute respiratory syndrome (SARS) , 2007, Virus Research.

[21]  A. Gottlieb,et al.  Etanercept and clinical outcomes, fatigue, and depression in psoriasis: double-blind placebo-controlled randomised phase III trial , 2006, The Lancet.

[22]  C. Nemeroff,et al.  Neurobehavioral Effects of Interferon-α in Cancer Patients: Phenomenology and Paroxetine Responsiveness of Symptom Dimensions , 2002, Neuropsychopharmacology.

[23]  J. Ware,et al.  The structure of psychological distress and well-being in general populations , 1983 .