Psychological Distress among Hospitalized COVID-19 Patients in Denmark during the First 12 Months of the Pandemic

Evidence of quality of life for hospitalised patients with COVID-19: a scoping review

Background

Information on the quality of life of people hospitalised with COVID-19 is important, both in assessing the burden of disease and the cost-effectiveness of treatments. However, there were potential barriers to collecting such evidence.

Objective

To review the existing evidence on quality of life for people hospitalised with COVID-19, with a focus on the amount of evidence available and methods used.

Design

A scoping review with systematic searches.

Results

A total of 35 papers were selected for data extraction. The most common study type was economic evaluation (N = 13), followed by cross-sectional (N = 10). All economic evaluations used published utility values for other conditions to represent COVID-19 inpatients' quality of life. The most popular quality-of-life survey measure was the Pittsburgh Sleep Quality Index (N = 8). There were 12 studies that used a mental health-related survey and 12 that used a sleep-related survey. Five studies used EQ-5D, but only one collected responses from people in the acute phase of COVID-19. Studies reported a negative impact on quality of life for people hospitalised with COVID-19, although many studies did not include a formal comparison group.

Limitations

Although it used systematic searches, this was not a full systematic review.

Conclusion

Quality-of-life data were collected from people hospitalised with COVID-19 from relatively early in the pandemic. However, there was a lack of consensus as to what survey measures to use, and few studies used generic health measures. Economic evaluations for COVID-19 treatments did not use utilities collected from people with COVID-19. In future health crises, researchers should be vigilant for opportunities to collect quality-of-life data from hospitalised patients but should try to co-ordinate as well as ensuring generic health measures are used more.

Funding

This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number NIHR132254.

Trajectories of mental health outcomes following COVID-19 infection: a prospective longitudinal study

BACKGROUND

The COVID-19 pandemic has triggered a global mental health crisis. Yet, we know little about the lasting effects of COVID-19 infection on mental health. This prospective longitudinal study aimed to investigate the trajectories of mental health changes in individuals infected with COVID-19 and to identify potential predictors that may influence these changes.

METHODS

A web-survey that targeted individuals that had been infected with COVID-19 was used at three time-points: T0 (baseline), T1 (six months), and T2 (twelve months). The survey included demographics, questions related to COVID-19 status, previous psychiatric diagnosis, post-COVID impairments, fatigue, and standardized measures of depression, anxiety, insomnia. Linear mixed models were used to examine changes in depression, anxiety, and insomnia over time and identify factors that impacted trajectories of mental health outcomes.

RESULTS

A total of 236 individuals completed assessments and was included in the longitudinal sample. The participants' age ranged between 19 and 81 years old (M = 48.71, SD = 10.74). The results revealed notable changes in mental health outcomes over time. The trajectory of depression showed significant improvement over time while the trends in anxiety and insomnia did not exhibit significant changes over time. Younger participants and individuals who experienced severe COVID-19 infection in the acute phase were identified as high-risk groups with worst mental ill-health. The main predictors of the changes in the mental health outcomes were fatigue and post-COVID impairments.

CONCLUSIONS

The findings of our study suggest that mental health outcomes following COVID-19 infection exhibit a dynamic pattern over time. The study provides valuable insights into the mental health trajectory following COVID-19 infection, emphasizing the need for ongoing assessment, support, and interventions tailored to the evolving mental health needs of this population.

The Psychological Impact of COVID-19 Admission on Families: Results from a Nationwide Sample in Greece

The aim of the present study was to assess the psychological impact of hospitalization during the COVID-19 pandemic on parents and their offspring. We performed a nationwide cross-sectional study in Greece based on an Internet questionnaire survey. A convenience sample of parents whose offspring had been hospitalized due to COVID-19 (including multisystem inflammatory syndrome in children, MIS-C), diagnosed with COVID-19 but not hospitalized, and hospitalized for another reason during the pandemic were enrolled. Parental stress was assessed using the Perceived Stress Scale (PSS) and the Revised Impact of Event Scale (IES-R) tools, and childhood mental wellbeing with the Children’s Revised Impact of Event 13 (CRIES-13) scale. Out of 214 received responses, stress levels were significantly higher in parents whose children had been admitted for COVID-19 or MIS-C versus those not admitted or admitted for other reasons (p < 0.001, for PSS/IES-R). Parental and childhood stress levels were correlated. In the multivariable linear regression analysis, children’s hospitalization because of COVID-19 or MIS-C, younger parental age, the existence of comorbidities, and another family member’s hospitalization because of COVID-19 were independent factors for higher stress. In light of the above, stricter hospital admission criteria for COVID-19 could be implemented, and psychological support for eventually admitted families may be beneficial.

The changes in psychological symptoms of COVID-19 patients after "re-positive"

Background

Previous studies have showed that individuals infected with COVID-19 were more likely to report psychological symptoms. However, little is known about the changes from testing positive to negative to positive again.

Methods

This survey was conducted through the questionnaires including the 7-item Generalized Anxiety Disorder (GAD-7), the 9-item Patient Health Questionnaire (PHQ-9), as well as the Self-Rating Scale of Sleep (SRSS) to explore the psychological status of COVID-19 and re-positive cases.″re-positive″ is defined as a positive RT-PCR test at any time during the recovery period after testing negative.

Results

A total of 94 COVID-19 patients presented the prevalence rates of anxiety, depression, insomnia, and any of the three psychological symptoms being 26.6, 8.6, 12.8, and 31.9%, respectively. Among these, 32 cases were re-tested positive during the recovery period, with the prevalence rates of anxiety, depression, insomnia, and any of the three psychological symptoms being 21.9, 18.7, 31.2, and 37.5%, respectively. The psychological status after re-positive showed a significant decrease in anxiety (P = 0.023), an increase in depression, and a significant rise in insomnia (P = 0.035). For those with no psychological symptoms during initial-positive, after re-positive, 5.88% reported anxiety, 5.88% reported depression, and 11.76% reported insomnia. For those who experienced only anxiety symptoms during initial-positive, after re-positive, 33.3% reported depression, and 33.3% reported insomnia.

Conclusions

Our findings encompassed the urgent concern for anxiety in initial-positive COVID-19 patients, depression in re-positive COVID-19 patients, and insomnia in both initial and re-positive patients, hence enabling targeted interventions for appeasing the psychological burden of COVID-19 patients.

Prevalence and Associated Factors of Depression, Anxiety, and Stress in University Students in Paraguay during the COVID-19 Pandemic

We aimed to determine the prevalence of depression, anxiety, and stress in university students in Paraguay during the COVID-19 pandemic. A cross-sectional study was conducted among 293 students from four universities in Paraguay in 2021. The DASS-21 mental health scale was used to measure the outcomes (depression, anxiety, and stress) and evaluate their association with socio-educational variables. A total of 77.1% of the participants were women and 136 (46.4%) were between 21 and 25 years old. The prevalence of depression, anxiety, and stress was 74.7%, 87.4%, and 57%, respectively. We found that being a woman and studying at a public university was positively associated with depression, anxiety, and stress. Receiving COVID-19 training increases the prevalence of mental health problems. In conclusion, high levels of anxiety, depression, and stress were found in university students during the COVID-19 pandemic. Being a woman, studying at a public university, and receiving training on COVID-19 were factors associated with a higher prevalence of presenting all the mental health problems evaluated. Furthermore, students aged 31 and over had a higher prevalence of depression and stress.