Persistent psychopathology in covid-19 survivors at one-year follow-up

Introduction: The effects of COVID-19 are highly variable, with potential involvement of almost all organs and systems. While the acute and sub-acute symptoms have been well described, the possible long-term sequelae of COVID-19 have become an increasing concern [1]. One, three, and six-months follow-up studies have reported highly prevalent post COVID neuropsychiatric sequelae [2,3,4,5]. The aim of the present study is to investigate the psychopathological impact of COVID-19 in survivors at one-year follow-up, also considering the effect of possible risk factors. Methods: We prospectively evaluated the psychopathological status of 160 COVID-19 survivors one year after hospital discharge during an ongoing prospective cohort study. To keep a naturalistic study design, exclusion criteria were limited to patients under 18 years. Sociodemographic and clinical data were collected. Current psychopathology was measured using the following self-report questionnaire: Zung Self-Rating Depression Scale (ZSDS), Impact of Events Scale-Revised (IES-R), State-Trait Anxiety Inventory form Y (STAI-Y), and Fatigue Severity Score (FSS). Need of antidepressant or anxiolytic treatment in the last year was collected. Statistical analyses to compare group means and frequencies (Student's t-test, Pearson χ2 test) exploring effects of sex, psychiatric history, and hospitalization for COVID-19 were performed. Results: Overall, 77 patients (48%) scored in the clinical range in at least one psychopathological dimension among depression, anxiety, and PTSD. Females and patients with a positive previous psychiatric diagnosis showed an increased score on most measures (Table). Hospitalization for COVID-19 did not affect psychopathology. During the year after COVID-19, 25 (16%) and 23 (14%) patients started an antidepressant or anxiolytic treatment respectively.Discussion: This is the first study that investigates psychopathology in a sample of COVID-19 survivors at one-year follow-up after hospital treatment. We reported high rates of persistent psychopathology consistently with previous coronavirus outbreaks. Psychiatric consequences to SARS-CoV-2 infection can be caused by the immune-inflammatory response to the virus itself or by psychological stressors such as social isolation, concerns about infecting others, and stigma. Considering that neuropsychiatric sequelae associates with a markedly increased risk of all-cause mortality, and given the alarming prevalence of post-COVID psychopathology, we now suggest to routinely asses psychopathology of COVID-19 survivors in order to promptly diagnose emergent disorders and to treat them to reduce the disease burden and related years of life lived with disability. No conflict of interest