Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany.
Post-COVID Centre, University Hospital Erlangen, 91054 Erlangen, Germany.
Int J Environ Res Public Health. 2024 Aug 16;21(8):1076. doi: 10.3390/ijerph21081076.
The impairments and duration of PASC (post-acute sequelae of COVID-19) symptoms in mental health have, to date, not been comprehensively examined. Our objective is to provide longitudinal data on the mental health of Post-COVID patients and to identify risk and protective factors associated with a severe or prolonged course.
The mental health of 265 Post-COVID patients of the outpatient Post-COVID centre of the University Hospital Erlangen was assessed 17.1 (T0) and 22.5 months after infection (T1). An online survey with validated questionnaires for Post-COVID symptoms (Post-COVID Syndrome Score), depression (Patient Health Questionnaire-9), somatic symptoms (Patient Health Questionnaire-15), anxiety (Generalized Anxiety Disorder-7), fatigue (Fatigue Severity Scale) and Post-Exertional Malaise (PEM) (DePaul Post-Exertional Malaise Screening) was conducted in the home environment.
In total, 80% of patients experienced severe PASC at follow-up. Clinically relevant symptoms of depression, persistent somatic symptoms, anxiety and fatigue were reported by 55.8%, 72.5%, 18.9% and 89.4% of patients, respectively. Depressive, anxiety and somatic symptom severity decreased significantly over time; fatigue and PEM remained at an unchanged high level. The risk factor for higher depression scores was older age; prior psychiatric illness treated with psychotherapy was associated with more severe depressive, somatic, anxiety and PASC symptoms. PEM symptoms were significantly associated with longer duration between acute infection and initial presentation in the Post-COVID centre.
Our findings align with previous research, claiming severe mental health symptoms in PASC syndrome, lasting for months after infection. In-depth assessment of risk and protective factors for the mental health implications of PASC is needed for the planning of health services and disease prevention.
目前,新冠病毒感染后疾病(post-acute sequelae of COVID-19,PASC)对心理健康的损害及其持续时间尚未得到全面研究。我们的目的是提供新冠后患者心理健康的纵向数据,并确定与严重或延长病程相关的风险和保护因素。
对埃尔朗根大学医院门诊新冠后中心的 265 名新冠后患者的心理健康进行评估,分别在感染后 17.1 个月(T0)和 22.5 个月(T1)进行。通过在线调查,使用经过验证的新冠后症状问卷(新冠后综合征评分)、抑郁(患者健康问卷-9)、躯体症状(患者健康问卷-15)、焦虑(广泛性焦虑障碍-7)、疲劳(疲劳严重程度量表)和过度劳累后不适(DePaul 过度劳累后不适筛查)进行评估。
在随访时,80%的患者出现严重的 PASC。55.8%、72.5%、18.9%和 89.4%的患者分别报告有临床相关的抑郁症状、持续的躯体症状、焦虑和疲劳。抑郁、焦虑和躯体症状严重程度随时间显著下降;疲劳和过度劳累后不适仍处于不变的高水平。较高抑郁评分的风险因素是年龄较大;既往接受过心理治疗的精神疾病与更严重的抑郁、躯体、焦虑和 PASC 症状有关。过度劳累后不适症状与急性感染与首次就诊于新冠后中心之间的时间间隔较长显著相关。
我们的发现与之前的研究一致,即 PASC 综合征存在严重的心理健康症状,感染后持续数月。需要深入评估 PASC 对心理健康影响的风险和保护因素,以规划卫生服务和疾病预防。