Exploring the Impact of COVID-19 on Mental Health: Key Effects and Insights

Impact of COVID-19 on Mental Health

Overview of COVID-19 Symptoms

A recent analysis explored the immediate and long-term effects of COVID-19 and other severe coronavirus infections on mental health. While the primary symptoms of COVID-19, caused by the SARS-CoV-2 virus, are respiratory issues such as cough, shortness of breath, and fever, there is evidence that SARS-CoV-2 can also impact other body systems, including the nervous system. In acute cases, severe coronavirus infections may directly affect the brain or impair brain function by reducing blood oxygen levels or triggering the immune response. Additionally, the psychological toll of recovering from a potentially fatal illness can have lasting effects on mental health.

Previous Research on Coronaviruses

Prior outbreaks of novel coronaviruses, specifically the severe acute respiratory syndrome (SARS) in 2002 and the Middle East respiratory syndrome (MERS) in 2012, sparked studies examining the viral effects on mental health. Drawing from these reports and initial studies involving COVID-19 patients, researchers from University College London, King’s College London, and the University of Pavia in Italy investigated the immediate and longer-term mental health impacts of COVID-19. Their findings were published in Lancet Psychiatry.

Effects of Severe Coronavirus Infections on Mental Health

Systematic Review Findings

The researchers conducted a systematic review of studies reporting mental health symptoms in patients with suspected or confirmed cases of SARS, MERS, and COVID-19. They identified 72 studies that met their criteria, analyzing data from over 3,550 hospitalized patients.

Two studies focused on common psychiatric symptoms among patients hospitalized with SARS or MERS, revealing that confusion was prevalent (27.9%, 36/129 patients), indicating that delirium often occurs in severe cases. Other frequently reported symptoms included depressed mood (32.6%, 42/129 patients), anxiety (35.7%, 46/129 patients), impaired memory (34.1%, 44/129 patients), and insomnia (41.9%, 54/129 patients).

Recent studies of patients with severe COVID-19 infections reflected a similar trend. One study documented confusion in 26 out of 40 (65%) ICU patients and agitation in 40 out of 58 (69%) ICU patients. Another study noted altered consciousness in 17 out of 82 (21%) COVID-19 patients who later succumbed to the illness.

Long-Term Mental Health Consequences

Six studies examining recovered SARS and MERS patients reported frequent instances of low mood (10.5%, 35/332 patients), insomnia (12.1%, 34/280 patients), anxiety (12.3%, 21/171 patients), irritability (12.8%, 28/218 patients), memory impairment (19.3%, 44/233 patients), and fatigue (19.3%, 61/316 patients). One study highlighted that 30% (55/181 patients) recalled traumatic memories, while sleep disturbances were noted in 100% (14/14 patients).

Researchers estimated the prevalence of post-traumatic stress disorder (PTSD) among SARS and MERS survivors at 32.2% (121/402 cases across four studies). Rates of depression and anxiety disorders were estimated at 14.9% (77/517 cases from five studies) and 14.8% (42/284 cases from three studies), respectively. The authors cautioned that these figures might be overestimates due to inadequate comparison groups and a lack of assessment regarding patients’ prior mental health histories, complicating the determination of coronavirus effects.

Need for Further Research

Conclusions and Recommendations

The researchers concluded that most individuals with severe COVID-19 are likely to recover without developing mental illness, assuming the infection follows patterns observed in earlier coronavirus outbreaks. However, delirium may be common among hospitalized patients, and there is a potential long-term risk for depression, anxiety, fatigue, and PTSD.

The authors emphasized that a significant portion of the studies reviewed (68 out of 72) were of low to medium quality and primarily focused on SARS and MERS patients. Dr. Jonathan Rogers from University College London, a lead author of the study, stated, “With few data yet for COVID-19, high-quality, peer-reviewed research into psychiatric symptoms of patients infected with SARS-CoV-2, as well as investigations to mitigate these outcomes, is needed. Monitoring for the development of symptoms should be a routine part of the care we provide.”

In a related comment, Dr. Iris Sommer from the University of Groningen, who was not involved in the study, remarked that while findings from previous coronavirus outbreaks are informative, they may not accurately predict the prevalence of psychiatric complications in COVID-19 patients. She highlighted the importance of preparing to treat a significant number of COVID-19 patients who may develop delirium, PTSD, anxiety, and depression, a crucial message for the psychiatric community.

References

1. Rogers JP, Chesney E, Oliver D, et al. Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic. Lancet Psychiatry Published Online, May 18, 2020. https://doi.org/10.1016/S2215-0366(20)30203-0.
2. The Lancet, Press release 18 May 2020. “The Lancet Psychiatry: Study finds few immediate mental health effects of COVID-19, but longer-term impact must be considered.” https://www.eurekalert.org/pub_releases/2020-05/tl-pss051820.php.
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