ABSTRACT
BACKGROUND: Psychiatric disorders are associated with a more severe course of COVID-19. COVID-19 can also lead to psychiatric symptoms. AIM: To gain insight into vulnerabilities and protective factors for the course of COVID-19 in a Dutch (neuro)psychiatric population. METHOD: Patients were divided into three groups: patients with pre-existent mental disorders without and with new (neuro)psychiatric symptoms (NPS) during COVID-19 and patients without pre-existent mental disorders who developed de novo NPS during COVID-19. We summarize the characteristics of each group and compare the subgroups with inferential statistics. RESULTS: 186 patients were included in the case register. Patients with NPS showed a more severe course of COVID-19. Mortality in patients with NPS was higher in patients with pre-existent mental disorders compared to patients without pre-existent mental disorders. The most frequently reported de novo psychiatric symptoms during COVID-19 were delirium (46-70%), anxiety (53-54%) and insomnia (18-42%). CONCLUSION: NPS might be an expression of a more severe COVID-19 episode. In patients who developed NPS during COVID-19 we found evidence for a higher mortality risk in patients with pre-existent mental disorders. Extra vigilance for neuropsychiatric symptoms during COVID-19 is warranted.
ABSTRACT
BACKGROUND: Since the end of 2019, COVID-19 and its consequences are present everywhere. Dutch professionals are concerned about the mental consequences, and in particular that during and after hospitalization little attention is paid to psychological problems. AIM: To monitor the short-term course and severity of (neuro)psychiatric symptoms after hospitalization for COVID-19. To make a recommendation regarding whether or not to follow-up these patients psychiatrically to optimize care. METHOD: In an observational cohort-study screening questions and additional questionnaires were used during two follow-up contacts to monitor cognition (MoCA), affective symptoms (HADS and IES) and overall functioning. RESULTS: More than half of the 29 included patients showed (neuro)psychiatric problems at both follow-up moments. Two weeks after discharge, we mainly saw symptoms related to anxiety and depression. Except for complaints related to the traumatic experience of the COVID-19, these seemed to have a favorable natural course. A negative time effect was seen for complaints consistent with post-traumatic stress disorder. Two months after discharge limitations in cognition and overall functioning appeared to be the main complaints after COVID-19. CONCLUSION: (Neuro)psychiatric symptoms after a COVID-19 are common. The natural course for affective complaints is more favorable than for cognitive functions. Specialist follow-up of patients with post-COVID psychological problems is recommended.
ABSTRACT
Course of covid-19 infections and impact on mental health;setting up a national case register.