Impact of COVID-19 on mental health: a traumatic event

Background: Knowledge about long-term psychological outcomes in hospitalized as well as non-hospitalized patients with COVID-19 is scarce. We aimed to reveal the prevalence of symptoms of post-traumatic stress disorder (PTSD) and symptoms of anxiety and depression up to 24 weeks after the onset of symptoms in hospitalized and non-hospitalized patients with confirmed COVID-19 and persistent complaints. Methods: Demographics, symptoms of anxiety and depression (Hospital Anxiety and Depression Scale, HADS ≥8 points) and symptoms of PTSD (Trauma Screening Questionnaire, TSQ ≥5 points) were assessed at 11 and 24 weeks after the onset of COVID-19 related symptoms in members of online long COVID peer support groups. Results: Data of 239 patients with confirmed COVID-19 (82.8% female; median (IQR) age: 50 (39-56) years) were analyzed. Non-hospitalized patients (n=177) were more often women, younger and reported fewer pre-existing comorbidities compared to hospitalized patients (n=62). Of all patients, 37.2% had symptoms of PTSD, 35.6% had symptoms of anxiety and 46.9% had symptoms of depression, which remained high at 24 weeks follow-up (26.8%, p≤0.05; 34.7%, p≥0.05 and 40.6%, p≤0.05, versus week 11, respectively). Symptoms of PTSD, anxiety and depression were comparable between hospitalized and non-hospitalized patients. Conclusion: Although symptoms may improve over time, a substantial percentage of hospitalized as well as non-hospitalized patients still reported symptoms of PTSD, anxiety and/or depression 24 weeks after the onset of COVID-19 related symptoms. Healthcare professionals need to be aware of these extrapulmonary manifestations and intervene on time in post-COVID-19 patients with persistent complaints.