Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brazil.
Departamento e Instituto de Psiquiatria, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo HCFMUSP, São Paulo, SP, Brazil.
Gen Hosp Psychiatry. 2022 Mar-Apr;75:38-45. doi: 10.1016/j.genhosppsych.2022.01.002. Epub 2022 Jan 6.
The present study aims to investigate the occurrence of psychiatric and cognitive impairments in a cohort of survivors of moderate or severe forms of COVID-19.
425 adults were assessed 6 to 9 months after hospital discharge with a structured psychiatric interview, psychometric tests and a cognitive battery. A large, multidisciplinary, set of clinical data depicting the acute phase of the disease, along with relevant psychosocial variables, were used to predict psychiatric and cognitive outcomes using the 'Least Absolute Shrinkage and Selection Operator' (LASSO) method.
Diagnoses of 'depression', 'generalized anxiety disorder' and 'post-traumatic stress disorder' were established respectively in 8%, 15.5% and 13.6% of the sample. After pandemic onset (i.e., within the previous year), the prevalence of 'depression' and 'generalized anxiety disorder' were 2.56% and 8.14%, respectively. Memory decline was subjectively reported by 51.1% of the patients. Psychiatric or cognitive outcomes were not associated with any clinical variables related to the severity of acute-phase disease, nor by disease-related psychosocial stressors.
This is the first study to access rates of psychiatric and cognitive morbidity in the long-term outcome after moderate or severe forms of COVID-19 using standardized measures. As a key finding, there was no significant association between clinical severity in the acute-phase of SARS-CoV-2 infection and the neuropsychiatric impairment 6 to 9 months thereafter.
本研究旨在调查中度或重度 COVID-19 幸存者队列中出现的精神和认知障碍情况。
425 名成年人在出院后 6 至 9 个月接受了结构化精神病学访谈、心理测试和认知测试。使用“最小绝对收缩和选择算子”（LASSO）方法，利用一组大型、多学科的临床数据来描述疾病的急性期，以及相关的心理社会变量，来预测精神和认知结局。
分别在 8%、15.5%和 13.6%的样本中诊断出“抑郁症”、“广泛性焦虑障碍”和“创伤后应激障碍”。大流行发生后（即前一年），“抑郁症”和“广泛性焦虑障碍”的患病率分别为 2.56%和 8.14%。51.1%的患者主观报告记忆力下降。精神或认知结局与急性疾病严重程度相关的任何临床变量或与疾病相关的心理社会压力源均无关联。
这是第一项使用标准化措施评估中度或重度 COVID-19 后长期结局中精神和认知发病率的研究。作为一个关键发现，在 SARS-CoV-2 感染急性期的临床严重程度与之后 6 至 9 个月的神经精神损伤之间没有显著关联。
