ABSTRACT
Declaration de liens d'interets: Brugmann Foundation.Copyright © 2023
ABSTRACT
Introduction: Several surveys report that post-COVID-19 patients (pts) could be at risk of persistent emotional distress, fatigue and impaired neurocognitive function (NCF). Objective(s): The aim was to assess emotional distress, fatigue and NCF in order to provide adequate care. Method(s): Patients with persistent physical or mental symptoms, at least 8 weeks post-COVID-19, were eligible for this ongoing prospective longitudinal single center trial. Data on depression, anxiety, cognition, post-traumatic stress symptoms (PTSS) and fatigue were collected using 4 validated questionnaires at study entry (T0) and at 6 months (T1). Result(s): Ninety-three pts were recruited between November 2020- March 2021. Test results from 64 eligible pts (15 male pts) were analyzed at T0;63 pts (98%) were treated in outpatient settings. Median age was 47 years [range 27-75]). Median time since COVID-19 was 29 weeks [range 8-53]. Twenty-two pts (34%) had a history of psychiatric disorders. According to the Hospital Anxiety Depression Scale (HADS), 44 pts (73%) reported anxiety symptoms and 26 pts (41%) reported depressive symptoms;48 pts (69%) reported cognitive complaints according to the Cognitive Failure Questionnaire and 29 pts (45%) suffered from PTSS, according to the Post-Traumatic Stress Disorder Checklist-Civilian Version (PCL-C). Fifty-five pts (86%) had an elevated score on the Fatigue Severity Scale, indicating severe fatigue. Twenty-seven pts (42%) were still on sick leaf. Diminished social support and psychiatric history were predictive factors for neurocognitive dysfunction and PTSS. Conclusion(s): A majority of patients who recovered physically from COVID-19, are at risk for suffering from persistent anxiety, PTSS and neurocognitive dysfunction.
ABSTRACT
Objectives: Exploring anxiety, depression, and insomnia as a network of symptoms and their intensities among hospital workers after the first wave of COVID19. Method(s): 907 hospital workers have completed the survey including 442 Frontline Workers and 465 Hospital Workers. Online surveys were performed in two hospitals from June 6, 2020, and August 8, 2020, in Belgium. Anxiety, depression and insomnia was assessed by the GAD-7, PHQ-9 and ISI, respectively. We estimated a Directed Acyclic Graph for the items of these questionnaires and networks were compared and described in terms of true positive (connection between two nodes present in both networks), falls positive (connection between two nodes present among Frontline network) and falls negative (connection between two nodes present among Hospital Workers network). Finally, intensity of symptoms was calculated using the total mean score and severity frequency of the three questionnaires. Result(s): For both groups, the anxiety, depression, and insomnia items are independent: The three symptomatologies form clusters and do not seem to interact with each other, in both groups. Network comparison revealed 9 true positives, 11 false positives, and 9 false negative. Most of the different connections are found within the symptoms of insomnia. The insomnia symptom network in the Hospital group is characterized by "Difficulty maintaining sleep" as the initiating symptom that results to "Worry". In the Frontline group, "Interference" seems be the initiating symptom, which leads to the Early morning awakening. About intensity of symptoms, Frontline showed a significant higher intensity than Hospital Workers for anxiety, depression, and insomnia. Moreover, there were significantly more workers with moderate symptoms among Frontline than Hospital workers in comparison with "no symptoms" for our three scales. Conclusion(s): The network of anxiety and depression are similar between Frontline and Hospital, but not the insomnia network characterized by different initiating symptoms and leading to a different final symptom. In addition, Frontline have significantly higher complaints of anxiety, depression, and insomnia than Hospital workers, which is consistent with the plethora of studies on this topic. These differences in networks should be considered to developing specific treatment of insomnia in these two populations.