Xiao Yian, Zhang Libo, Yang Quanqi, Pan Xinyu, Lu Zhijie, Bi Yanzhi, Hu Li
CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, 100101, China.
Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China.
Eur Arch Psychiatry Clin Neurosci. 2024 Dec 23. doi: 10.1007/s00406-024-01947-0.
The COVID-19 pandemic has a profound and lasting impact on the mental health of recovered individuals. To investigate the clinical risk factors associated with long-term post-traumatic stress symptoms (PTSS), anxiety, and depression in COVID-19 survivors, demographic information and medical records were collected during February 19 and March 20, 2020. Assessments of PTSS, anxiety, and depressive symptoms were conducted at two months (April to May 2020, Session 1) and two years (April to May 2022, Session 2) post-discharge. Session 1 included 127 survivors who were infected with the early strains of SARS-CoV-2, and 54 of these participants took part in Session 2. PTSS (median: Session 1 = 9, Session 2 = 7; p = 0.522) and depression (median: Session 1 = 5, Session 2 = 4; p = 0.127) remained unchanged over the two years following COVID-19 infection, while anxiety (median: Session 1 = 5, Session 2 = 2; p < 0.001) significantly decreased at the two-year mark. Severe COVID-19 symptoms were consistently identified as significant risk factors for depression at both time points (Session 1: dyspnea [beta = -0.268, p = 0.016], nausea or vomiting [beta = 0.239, p = 0.031]; Session 2: headache [beta = 0.414, p = 0.014]). They also emerged as risk factors for PTSS and anxiety at the two-month mark (PTSS: cough [beta = -0.334, p = 0.002]; anxiety: continued oxygen therapy [beta = 0.343, p = 0.002], cough [beta = -0.267, p = 0.013]). At the two-year mark, blood sample characteristics were identified as risk factors for PTSS (albumin: beta = 0.455, p = 0.010), anxiety (total bilirubin: beta = 0.440, p = 0.013), and depression (total bilirubin: beta = 0.386, p = 0.021). Mann-Whitney U-tests showed that female survivors had higher anxiety (p = 0.012) and depression (p = 0.046) levels than males at the two-month mark. The sample size was relatively small, and further investigation is needed to determine whether our findings can be directly applied to other samples, including those involving different variants of SARS-CoV-2. Our study may highlight the differences between short-term and long-term clinical risk factors for PTSS, anxiety, and depression in COVID-19 survivors. The identified predictors could provide valuable insights for tailoring interventions to improve the PTSS, anxiety, and depression outcomes at different stages of recovery in COVID-19 survivors.
新冠疫情对康复者的心理健康产生了深远而持久的影响。为了调查与新冠病毒幸存者长期创伤后应激症状（PTSS）、焦虑和抑郁相关的临床风险因素，在2020年2月19日至3月20日期间收集了人口统计学信息和医疗记录。在出院后两个月（2020年4月至5月，第1阶段）和两年（2022年4月至5月，第2阶段）对PTSS、焦虑和抑郁症状进行评估。第1阶段包括127名感染了早期新冠病毒毒株的幸存者，其中54名参与者参加了第2阶段。新冠病毒感染后的两年里，PTSS（中位数：第1阶段 = 9，第2阶段 = 7；p = 0.522）和抑郁（中位数：第1阶段 = 5，第2阶段 = 4；p = 0.127）保持不变，而焦虑（中位数：第1阶段 = 5，第2阶段 = 2；p < 0.001）在两年时显著下降。严重的新冠症状在两个时间点均被一致确定为抑郁的显著风险因素（第1阶段：呼吸困难[β = -0.268，p = 0.016]，恶心或呕吐[β = 0.239，p = 0.031]；第2阶段：头痛[β = 0.414，p = 0.014]）。它们在两个月时也成为PTSS和焦虑的风险因素（PTSS：咳嗽[β = -0.334，p = 0.002]；焦虑：持续吸氧治疗[β = 0.343，p = 0.002]，咳嗽[β = -0.267，p = 0.013]）。在两年时，血液样本特征被确定为PTSS（白蛋白：β = 0.455，p = 0.010）、焦虑（总胆红素：β = 0.440，p = 0.0
