Bottemanne Hugo, Gouraud Clément, Hulot Jean-Sébastien, Blanchard Anne, Ranque Brigitte, Lahlou-Laforêt Khadija, Limosin Frédéric, Günther Sven, Lebeaux David, Lemogne Cédric
Paris Brain Institute - Institut du Cerveau et de la Moelle Épiniére, UMR 7225, UMR_S 1127, CNRS, INSERM, Sorbonne University, Service de Psychiatrie de l'Adulte, Hôpital de la Pitié-Salpêtriére, DMU Neurosciences, Assistance Publique-Hôpitaux De Paris, Paris, France.
Service de Psychiatrie de l'Adulte, DMU Psychiatrie et Addictologie, Hôpital Hôtel-Dieu, Université de Paris, Assistance Publique-Hopitaux de Paris, Paris, Paris, France.
Front Psychiatry. 2021 Nov 10;12:757685. doi: 10.3389/fpsyt.2021.757685. eCollection 2021.
Persistent physical symptoms are common after a coronavirus disease 2019 (COVID-19) episode, but their pathophysiological mechanisms remain poorly understood. In this study, we aimed to explore the association between anxiety and depression at 1-month after acute infection and the presence of fatigue, dyspnea, and pain complaints at 3-month follow-up. We conducted a prospective study in patients previously hospitalized for COVID-19 followed up for 3 months. The Hospital Anxiety and Depression Scale (HAD-S) was administered by physicians at 1-month follow-up, and the presence of fatigue, dyspnea, and pain complaints was assessed at both 1 month and 3 months. Multivariable logistic regressions explored the association between anxiety and depression subscores and the persistence of each of the physical symptom at 3 months. A total of 84 patients were included in this study (Median age: 60 years, interquartile range: 50.5-67.5 years, 23 women). We did not find any significant interaction between anxiety and the presence of fatigue, dyspnea, or pain complaints at 1 month in predicting the persistence of these symptoms at 3 months (all ≥ 0.36). In contrast, depression significantly interacted with the presence of pain at 1 month in predicting the persistence of pain at 3 months (OR: 1.60, 95% CI: 1.02-2.51, = 0.039), with a similar trend for dyspnea (OR: 1.51, 95% CI: 0.99-2.28, = 0.052). Contrary to anxiety, depression after an acute COVID-19 episode may be associated with and increased risk of some persistent physical symptoms, including pain and dyspnea.
2019冠状病毒病（COVID-19）发作后，持续的身体症状很常见，但其病理生理机制仍知之甚少。在本研究中，我们旨在探讨急性感染后1个月时焦虑和抑郁与3个月随访时疲劳、呼吸困难和疼痛症状之间的关联。我们对之前因COVID-19住院的患者进行了一项为期3个月的前瞻性研究。在1个月随访时由医生使用医院焦虑抑郁量表（HAD-S）进行评估，并在1个月和3个月时评估疲劳、呼吸困难和疼痛症状的存在情况。多变量逻辑回归分析探讨了焦虑和抑郁亚评分与3个月时每种身体症状持续存在之间的关联。本研究共纳入84例患者（中位年龄：60岁，四分位间距：50.5 - 67.5岁，23例女性）。我们未发现1个月时焦虑与疲劳、呼吸困难或疼痛症状的存在之间在预测这些症状3个月时的持续存在方面有任何显著交互作用（均≥0.36）。相比之下，抑郁与1个月时疼痛的存在在预测3个月时疼痛的持续存在方面有显著交互作用（比值比：1.60，95%置信区间：1.02 - 2.51，P = 0.039），呼吸困难也有类似趋势（比值比：1.51，95%置信区间：0.99 - 2.28，P = 0.052）。与焦虑相反，急性COVID-19发作后的抑郁可能与某些持续身体症状（包括疼痛和呼吸困难）的风险增加有关。
