People recovering from severe COVID-19 illness have been found to have a high risk of conditions including anxiety, depression and post-traumatic stress disorder (PTSD).

An Italian study included 402 adults who had presented to hospital with COVID-19. One month later, 56% met recognised criteria for a mental health condition, including 42% with anxiety and 28% with PTSD. Women, and people who’d previously had mental health problems, were more likely to be affected.

The findings do not necessarily mean that COVID-19 infection has directly caused mental health problems. It is possible that inflammation in the brain could have effects on neurological and mental health in some cases, but doctors are still building an understanding of this. It is most likely that mental health is being influenced by multiple other factors such as the stress and anxiety of having a severe, life-threatening illness, isolation due to infection risk, stigma or work-related factors.

The researchers call for people recovering from COVID-19 to have their mental health monitored so that they can receive any care and treatment that they need.

 

Where did the story come from?

The Guardian reported on the study which was conducted by researchers at San Raffaele Hospital and University in Milan, Italy, and published in the peer-reviewed journal Brain Behaviour and Immunity.

 

What is the basis for the claim?

The study included 402 adults with COVID-19 who presented to the hospital’s accident and emergency department between April and June 2020. Three hundred were admitted to hospital for COVID-19 pneumonia while the others were managed at home.

All patients were assessed by a psychiatrist and completed symptom questionnaires to assess a range of mental health disorders, one month after hospital discharge or A&E assessment.

More than half (56%) met recognised criteria for at least one mental health condition:

  • 42% had symptoms of anxiety disorder
  • 40% had symptoms of insomnia
  • 31% had symptoms of depression
  • 28% had symptoms of post-traumatic stress disorder (PTSD)
  • 20% had symptoms of obsessive-compulsive disorder

Women, people who had a history of mental health problems, and people who were managed at home, were all found more likely to have mental health symptoms.

There was no clear link with markers of COVID-19 severity in terms of blood inflammatory markers or blood oxygen levels.

Previous studies of people with the coronavirus illnesses of 2004 SARS and 2012 MERS (Middle Eastern Respiratory Syndrome) also found they had a raised risk of mental health disorders after their illness. However, it is not possible to know the direct cause of mental health problems from this study, and onset may be influenced by multiple factors.

 

What do trusted sources say?

NHS England has published guidance on the rehabilitation needs of people hospitalised with COVID-19.

This states that ‘All patients and their families should be given written and verbal information at discharge detailing the potential psychological impact of critical illness and critical care treatment, including details of rehabilitation support and how to seek additional help if psychological problems persist. These are most likely to include anxiety, depression and post-traumatic stress disorder.’

 

Analysis by EIU Healthcare, supported by Reckitt Benckiser

 

Citation

  1. Mazza MG et al. Anxiety and depression in COVID-19 survivors: role of inflammatory and clinical predictors. Brain Behaviour and Immunity 2020. https://doi.org/10.1016/j.bbi.2020.07.037 (Accessed 14 August 2020).

 

Reading list

  1. NHS England: Aftercare needs of inpatients recovering from COVID-19. 3 August 2020. https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/06/C0705-aftercare-needs-of-inpatients-recovering-from-covid-19-aug-2020.pdf (Accessed 14 August 2020).