Indonesia: Long COVID Psychiatric Symptoms Meta-Analysis

A meta-analysis of 23 studies has reported the most prevalent psychiatric symptoms of long COVID, from the least to the most prevalent, as cognitive deficits, somatic symptoms, poor sleep qualities, PTSD (post-traumatic stress disorder), depression, and anxiety.

Women and those having previous psychiatric diagnoses were found to be at higher risk for these symptoms. The findings were published in PLoS One on April 7, 2023.

Long COVID-19, defined as prolonged symptoms of COVID-19, has been found in many patients. Psychiatric symptoms are commonly observed in Long COVID patients and could last for weeks or months after recovery. However, there is no clarity on the risk factors and associated symptoms.

Halwa Zakia, Hasan Sadikin General Hospital, Bandung, Indonesia, and colleagues provide an overview of psychiatric symptoms in patients with Long COVID and the risk factors associated with developing those symptoms.

For this purpose, the researchers systematically searched for articles on online databases up to October 2021. They included studies involving geriatric and adult participants with a confirmed history of COVID-19 diagnosis and reported psychiatric symptoms that remained for more than four weeks after the initial infection. The risk of bias was evaluated through the NOS (Newcastle-Ottawa Scale) for observational studies. Prevalence rates and risk factors linked with psychiatric symptoms were collected. A total of 23 studies were included.

Findings

• Nineteen studies reported prevalence rates of anxiety to be 6.8% to 47.8%, 7 found PTSD rates of 13.0% to 42.8%, 17 studies identified depression rates of 4.4% to 35.9%, and 13 showed rates of sleep disturbances, poor sleep and insomnia in 4.4% to 50.0%.
• One article found a 35.2% cognitive-deficit rate, one identified an OCD rate of 26.0%, and one showed a 73.2% rate of impaired cognition.

The researchers noted that psychiatric and physical symptoms may have a reciprocal relationship. "Mental health issues in patients with long COVID are known to be linked with persistent physical symptoms, such as shortness of breath and myalgia," they wrote. "This may be bidirectional. The physical symptoms could lead to psychiatric symptoms, which may show as physical symptoms."

The authors said these COVID-related psychiatric complications could lead to a long-term public health burden. "In the medium to long term, the condition should be considered the potential cause of a delayed pandemic," they wrote. "Therefore, closely monitoring people experiencing long COVID in the long term is recommended."

Most studies included in the meta-analysis were based on self-report questionnaires. The authors noted the study's heterogeneous nature, designs and outcomes, which may complicate the interpretation of the results.

Reference

Zakia, H., Pradana, K., & Iskandar, S. (2023). Risk factors for psychiatric symptoms in patients with long COVID: A systematic review. PLOS ONE, 18(4), e0284075. https://doi.org/10.1371/journal.pone.0284075