The Perfect Enemy | Meta-analysis reveals wide range of persistent long-COVID psychiatric symptoms
February 16, 2024

Meta-analysis reveals wide range of persistent long-COVID psychiatric symptoms

The top three conditions were anxiety, depression, and post-traumatic stress disorder.

A meta-analysis of 23 studies reveals that the psychiatric symptoms of long COVID were, from most to least prevalent, anxiety, depression, post-traumatic stress disorder (PTSD), poor sleep, hyperfocus on symptoms (somatic disorder), impaired cognition, and obsessive-compulsive disorder (OCD). Women and those with a history of psychiatric diagnoses were at greater risk for these symptoms.

The investigation was published late last week in PLoS One.

Padjadjaran University researchers in Indonesia analyzed the results of 23 studies published from January 2020 to October 2021 involving adult COVID-19 patients with psychiatric symptoms lasting more than 4 weeks after infection. Of the 23 studies, 15 were cohort, 5 were cross-sectional, and 3 were case-control. They were conducted in 13 countries in Europe, Asia, and North and South America.

Physical, mental symptoms may be bidirectional

Nineteen studies reported anxiety prevalence rates of 6.8% to 47.8%, 17 studies identified depression rates of 4.4% to 35.9%, 7 found PTSD rates of 13.0% to 42.8%, and 13 showed rates of poor sleep, sleep disturbances, and insomnia in 4.4% to 50.0%. One article found a 35.2% cognitive-deficit rate, one showed a 73.2% rate of impaired cognition, and one identified an OCD rate of 26.0%.

The researchers said the physical and psychiatric symptoms may have a reciprocal relationship. “Mental health issues in Long COVID patients were known to be associated with persistent physical symptoms, such as myalgia and shortness of breath,” the researchers wrote. “This may be bidirectional. The physical symptoms could result in psychiatric symptoms and the psychiatric symptoms may show as physical symptoms.”

These COVID-related psychiatric complications could become a long-term public health burden, the authors said. “This condition should be regarded as the potential cause of a delayed pandemic in the medium to long term,” they wrote. “Therefore, it is recommended to closely monitor people experiencing Long COVID in the long term.”

Most studies included in the meta-analysis relied on self-report questionnaires, and the authors noted the heterogeneous nature of study designs and outcomes, both of which they said may complicate interpretation of the results.