Abstract Details

Neuropsychiatric symptoms may persist after the COVID-19 infection.

To assess depression/anxiety symptoms, fatigue and daytime sleepiness in individuals previously affected by the COVID-19 infection.

We included 1183 cases of post-Covid infection (79% women; median age 41 [12-77]) who answered an interview of our online survey (median interval 191 days [50-503] after the infection). We used the Hamilton Anxiety and Depression Scale to evaluate anxiety (HADS-A) and depression symptoms (HADS-D), the Chalder Fatigue Scale to measure the fatigue severity and the Epworth Sleepiness Scale to assess daytime sleepiness. Individuals also answered the PHQ-9 (Patient Health Questionnaire-9). Patients were separated according to the treatment type (home [1046, median 41 years], ward [87, median 45.5 years] or ICU [50, median 48.5 years]). We performed Mann-Whitney tests to compare continuous variables among groups and Spearman tests for correlations.

Anxiety symptoms were more severe in ICU patients (median score 12 [0-19]) compared to the home group (median score 9 [0-21]; p=0.012). Similarly, the severity of physical fatigue was higher in the patients treated in ICU (median score 16 [2-21]) compared to home treatment (median score 13 [0-21]; p=0.004). However, the depression severity (p=0.1), PHQ-9 scores (p=0.06), mental fatigue (p=0.06) and daytime sleepiness scores (p=0.6) were similar among the three groups. Overall, there were positive correlations between sleepiness and both mental (r=0.33, p<0.001) and physical fatigue (r=0.44, p<0.001). The PHQ-9 scores positively correlated with sleepiness (r=0.36, p<0.001), mental fatigue (r=0.63, p<0.001) and physical fatigue (r=0.73, p<0.001). Interestingly, these correlations were present for the three groups, even after splitting according to treatment.

We confirmed persistent symptoms of fatigue, daytime sleepiness, anxiety and depression in a large group of recovered individuals after six months from the acute infection. Surprisingly, patients with mild infection presented equivalent intensity of mental fatigue, somnolence and depression, compared to those who required hospitalization.