Emerging evidence underlines psychological impact of Covid-19

Patients recovering from Covid-19 can suffer from depression, anxiety, reduced sleep quality and post-traumatic stress disorder (PTSD), according to emerging evidence on the psychological impact of the virus. 

A HSE evidence summary titled What is the psychological impact of Covid-19 on patients recovering from the disease who need rehabilitation? recommends that a “high prevalence of depression, anxiety and PTSD symptoms” should be anticipated by healthcare professionals as patients recover from the virus.

“Particular consideration is required for those with pre-morbid psychiatric illness, healthcare workers, and those who have been treated in intensive care.”

While noting the limited data available on the psychological impact of the disease, it outlined evidence from a recent multi-centre Chinese study in which 96 per cent of recovered Covid-19 patients self-reported PTSD symptoms. 

Data from the severe acute respiratory syndrome (SARS) outbreak shows that stress and other psychiatric symptoms persisted long-term, the document adds. 

According to the World Health Organisation (WHO), “anxiety and depressive symptoms may constitute common reactions for people in the context of Covid-19 diagnosis”. 

People diagnosed with Covid-19 are at higher risk of sleep problems due to “acute stress responses, as well as additional reasons for those who are hospitalised such as environmental factors, invasive medical procedures (eg, mechanical ventilation) and the frequent combination of multiple medications possibly disrupting sleep patterns.

“Stressors particular to Covid-19 include: fear of falling ill and dying, fear of being socially excluded/placed in quarantine, loss of livelihood and loss of loved ones, and feelings of helplessness, boredom and loneliness due to being isolated. 

“These stressors may trigger new symptoms or exacerbate underlying mental or neurological conditions. Patients with preexisting mental health conditions and substance abuse disorders may also be adversely impacted.”

A study from China found that most clinically stable Covid-19 patients suffered from “significant post-traumatic stress symptoms” prior to discharge. 

Given the high level of post-traumatic stress symptoms among patients, it recommended “appropriate crisis psychological interventions and long-term follow-up assessments should be urgently initiated for Covid-19 survivors.”