Mood Disorders After COVID-19

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Abstract

Introduction. The COVID-19 pandemic has led to a high prevalence of post-COVID-19 syndrome (PCS), with mood disorders being the most common manifestations.

Objective: To study the prevalence of PCS-associated mood disorders and their features.

Materials and methods. We examined patients after COVID-19 (n = 91; age: 24-84 years; median time to recovery: 7 months) using the following tools: the BDI and HADS (screening for anxiety and depression); the Starkstein Apathy Scale; FIS and FSS (fatigue assessment); the MoCA, MMSE, and FAB (cognitive assessment); the FIRST, ESS, PSQI, and ISI (sleep disorders evaluation); the EQ5D (quality of life measurement). We designed a special questionnaire to collect data related to a history of COVID-19 and patients' condition after discharge. In addition, we analyzed electronic medical records and discharge summaries and performed neurological examination.

Results. Of all the examined patients, 65 (71.4%) participants had signs and symptoms of PCS. Mood disorders were observed in 33 (50.8%) cases, with apathy (78.7%), anxiety (66.7%), and fatigue (60.6%) being the most common. Depressive disorders were found in 12 (36.3%) patients. Cognitive functions were impaired in 7 (21.2%) patients; sleep disorders were observed in 16 (48.5%) cases. We found a positive correlation between depressive disorders and fatigue based on the BDI, FIS, and FSS scores (rS = 0.711; rS = 0.453), depressive disorders and anxiety (rS = 0.366), fatigue and apathy (rS = 0.350). Anxiety increased the risk of sleep disorders (rS = 0.683). Quality of life has been shown to decrease in patients with mood disorders due to the negative effect of long-term fatigue and depressive disorders.

Conclusions. There is a close connection between different types of mood disorders that develop after COVID-19 and exacerbate symptoms of each other. Early diagnosis and treatment of these disorders can improve patients' quality of life and preserve their ability to work.

About the authors

Anna G. Mikheeva

Almazov National Medical Research Centre

Author for correspondence.
Email: amikheevag@mail.ru
ORCID iD: 0000-0002-1478-6580

Postgraduate Student, Department of Neurology with the Clinic, Medical Education Institute, Laboratory Assistant-Researcher, Research Laboratory of New Coronavirus Infection and Postcovid Syndrome, Center for Personalized Medicine

Russian Federation, St. Petersburg

Mariya P. Topuzova

Almazov National Medical Research Centre

Email: Topuzova_MP@almazovcentre.ru
ORCID iD: 0000-0002-0175-3085

Cand. Sci. (Med.), Associate Professor, Department of Neurology with the Clinic, Medical Education Institute, Senior Researcher, Research Laboratory of New Coronavirus Infection and Postcovid Syndrome, Center for Personalized Medicine

Russian Federation, St. Petersburg

Valeriya A. Malko

Almazov National Medical Research Centre

Email: Malko_VA@almazovcentre.ru
ORCID iD: 0000-0003-2230-3750

Postgraduate Student, Department of Neurology with the Clinic, Medical Education Institute, Junior Researcher, Research Laboratory of New Coronavirus Infection and Postcovid Syndrome, Center for Personalized Medicine

Russian Federation, St. Petersburg

Ekaterina S. Zhilina

Almazov National Medical Research Centre

Email: Zhilina_ES@almazovcentre.ru
ORCID iD: 0000-0002-9020-3287

Resident, Department of Neurology with the Clinic, Medical Education Institute

Russian Federation, St. Petersburg

Arina A. Mikhailova

Almazov National Medical Research Centre

Email: Mikhailova_AA@almazovcentre.ru
ORCID iD: 0000-0001-6066-3525

Laboratory Research Assistant, Research Laboratory of New Coronavirus Infection and Postcovid Syndrome, Center for Personalized Medicine, Resident, Department of Endocrinology

Russian Federation, St. Petersburg

Daria I. Lagutina

Almazov National Medical Research Centre

Email: Lagutina_DI@almazovcentre.ru
ORCID iD: 0000-0001-6198-5278

Laboratory Research Assistant, Research Laboratory of New Coronavirus Infection and Postcovid Syndrome, Center for Personalized Medicine, Resident, Department of Endocrinology

Russian Federation, St. Petersburg

Tatiana L. Karonova

Almazov National Medical Research Centre

Email: Karonova_TL@almazovcentre.ru
ORCID iD: 0000-0002-1547-0123

D. Sci. (Med.), Head, Research Laboratory of New Coronavirus Infection and Postcovid Syndrome, Center for Personalized Medicine, Chief Researcher, Clinical Endocrinology Laboratory, Professor, Department of Internal Medicine

Russian Federation, St. Petersburg

Tatyana M. Alekseeva

Almazov National Medical Research Centre

Email: Alekseeva_TM@almazovcentre.ru
ORCID iD: 0000-0002-4441-1165

D. Sci. (Med.), Head, Department of Neurology with the Clinic, Medical Education Institute

Russian Federation, St. Petersburg

References

  1. Szekanecz Z., Vályi-Nagy I. Post-acute COVID-19 syndrome. Orv. Hetil. 2021;162(27):1067–1078. doi: 10.1556/650.2021.32282
  2. Dixit N.M., Churchill A., Nsair A., Hsu J.J. Post-acute COVID-19 syndrome and the cardiovascular system: what is known? Am. Heart J. Plus. 2021;5:100025. doi: 10.1016/j.ahjo.2021.100025
  3. Carod-Artal F.J. Post-COVID-19 syndrome: epidemiology, diagnostic criteria and pathogenic mechanisms involved. Rev. Neurol. 2021;72(11):384–396. doi: 10.33588/rn.7211.2021230
  4. Pavli A., Theodoridou M., Maltezou H.C. Post-COVID syndrome: incidence, clinical spectrum, and challenges for primary healthcare professionals. Arch. Med. Res. 2021;52(6):575–581. doi: 10.1016/j.arcmed.2021.03.010
  5. Liotta E.M., Batra A., Clark J.R. et al. Frequent neurologic manifestations and encephalopathy-associated morbidity in COVID-19 patients. Ann. Clin. Transl. Neurol. 2020;7(11):2221–2230. doi: 10.1002/acn3.51210
  6. Moghimi N., Di Napoli M., Biller J. et al. The neurological manifestations of post-acute sequelae of SARS-CoV-2 infection. Curr. Neurol. Neurosci. Rep. 2021;21(9):44. doi: 10.1007/s11910-021-01130-1
  7. Anaya J.M., Rojas M., Salinas M.L. et al. Post-COVID syndrome. A case series and comprehensive review. Autoimmun. Rev. 2021;20(11):102947. doi: 10.1016/j.autrev.2021.102947
  8. Nalbandian A., Sehgal K., Gupta A. et al. Post-acute COVID-19 syndrome. Nat. Med. 2021;27(4):601–615. doi: 10.1038/s41591-021-01283-z
  9. Schilling C., Meyer-Lindenberg A., Schweiger J.I. Cognitive disorders and sleep disturbances in long COVID. Nervenarzt. 2022;16:1–8. doi: 10.1007/s00115-022-01297-z
  10. Sperling S., Fløe A., Leth S. et al. Fatigue is a major symptom at COVID-19 hospitalization follow-up. J. Clin. Med. 2022;11(9):2411. doi: 10.3390/jcm11092411
  11. Camargo-Martínez W., Lozada-Martínez I., Escobar-Collazos A. et al. Post-COVID-19 neurological syndrome: implications for sequelae’s treatment. J. Clin. Neurosci. 2021;88:219-225. doi: 10.1016/j.jocn.2021.04.001
  12. Mao L., Jin H., Wang M. et al. Neurologic manifestations of hospitali- zed patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol. 2020;77(6):683–690. doi: 10.1001/jamaneurol.2020.1127
  13. Siegler J.E., Cardona P., Arenillas J.F. et al. Cerebrovascular events and outcomes in hospitalized patients with COVID-19: the SVIN COVID-19 Multinational Registry. Int. J. Stroke. 2021;16(4):437–447. doi: 10.1177/1747493020959216
  14. Harapan B.N., Yoo H.J. Neurological symptoms, manifestations, and complications associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 19 (COVID-19). J. Neurol. 2021;268(9):3059–3071. doi: 10.1007/s00415-021-10406-y
  15. Román G.C., Spencer P.S., Reis J. et al. The neurology of COVID-19 revisited: a proposal from the Environmental Neurology Specialty Group of the World Federation of Neurology to implement international neurological registries. J. Neurol. Sci. 2020;414:116884. doi: 10.1016/j.jns.2020.116884
  16. Ortelli P., Ferrazzoli D., Sebastianelli L. et al. Neuropsychological and neurophysiological correlates of fatigue in post-acute patients with neurological manifestations of COVID-19: Insights into a challenging symptom. J. Neurol. Sci. 2021;420:117271. doi: 10.1016/j.jns.2020.117271
  17. Alpert O., Begun L., Garren P., Solhkhah R. Cytokine storm induced new onset depression in patients with COVID-19. A new look into the association between depression and cytokines -two case reports. Brain Behav. Immun. Health. 2020;9:100173. doi: 10.1016/j.bbih.2020.100173
  18. Ciesielska N., Sokołowski R., Mazur E. et al. Is the Montreal Cognitive Assessment (MoCA) test better suited than the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI) detection among people aged over 60? Meta-analysis. Psychiatr. Pol. 2016;50(5):1039–1052. doi: 10.12740/PP/45368
  19. Hurtado-Pomares M., Carmen Terol-Cantero M., Sánchez-Pérez A. et al. The frontal assessment battery in clinical practice: a systematic review. Int. J. Geriatr. Psychiatry. 2018;33(2):237–251. doi: 10.1002/gps.4751
  20. Jackson-Koku G. Beck depression inventory. Occup. Med. (Lond). 2016;66(2):174–175. doi: 10.1093/occmed/kqv087
  21. Тарабрина Н.В. Опросник депрессивности Бека (Beck Depression Inventory — BDI). В кн.: Тарабрина Н.В. «Практикум по психологии посттравматического стресса». СПб.; 2001:182–183. Tarabrina N.V. Beck Depression Inventory — BDI. In: Tarabrina N.V. Handbook on psychology of post-traumatic stress. St. Petersburg; 2001:182–183.
  22. Snaith R.P. The Hospital Anxiety and Depression Scale. Health Qual. Life Outcomes. 2003;1:29. doi: 10.1186/1477-7525-1-29
  23. Garofalo E., Iavarone A., Chieffi S. et al. Italian version of the Starkstein Apathy Scale (SAS-I) and a shortened version (SAS-6) to assess “pure apathy” symptoms: normative study on 392 individuals. Neurol. Sci. 2021;42(3): 1065–1072. doi: 10.1007/s10072-020-04631-y
  24. Lundgren-Nilsson Å., Tennant A., Jakobsson S. et al. Validation of Fatigue Impact Scale with various item sets — a Rasch analysis. Disabil. Rehabil. 2019;41(7):840–846. doi: 10.1080/09638288.2017.1411983
  25. Ozyemisci-Taskiran O., Batur E.B., Yuksel S. et al. Validity and reliability of fatigue severity scale in stroke. Top Stroke Rehabil. 2019;26(2):122–127. doi: 10.1080/10749357.2018.1550957
  26. Gelaye B., Zhong Q.Y., Barrios Y.V. et al. Psychometric evaluation of the Ford Insomnia Response to Stress Test (FIRST) in early pregnancy. J. Clin. Sleep Med. 2016;12(4):579–587. doi: 10.5664/jcsm.5696
  27. Lee J.L., Chung Y., Waters E., Vedam H. The Epworth sleepiness scale: reliably unreliable in a sleep clinic population. J. Sleep Res. 2020;29(5):e13019. doi: 10.1111/jsr.13019
  28. Morin C.M., Belleville G., Bélanger L., Ivers H. The Insomnia Severity Index: psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep. 2011;34(5):601–608. doi: 10.1093/sleep/34.5.601
  29. Liu T.H., Ho A.D., Hsu Y.T., Hsu C.C. Validation of the EQ-5D in Taiwan using item response theory. BMC Public Health. 2021;21(1):2305. doi: 10.1186/s12889-021-12334-y
  30. Huang C., Huang L., Wang Y. et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet. 2021;397(10270): 220–232. doi: 10.1016/S0140-6736(20)32656-8
  31. Chen Y., Huang X., Zhang C. et al. Prevalence and predictors of posttraumatic stress disorder, depression and anxiety among hospitalized patients with coronavirus disease 2019 in China. BMC Psychiatry. 2021;21(1):80. doi: 10.1186/s12888-021-03076-7
  32. Абрамов В.Г., Гайгольник Т.В., Фетисов А.О. и соавт. COVID-19: Внелёгочные проявления у пациентов (собственные данные инфекционного госпиталя ФГБУ ФСНКЦ ФМБА России). Медицина экстремальных ситуаций. 2020;(3):19–25. Abramov V.G., Gaygolnik T.V., Fetisov A.O. et al. COVID-19: extrapulmonary impairments (own data of infection hospital of FSBI FSSCC FMBA of Russia) and experience of use different profile specialists to working in hospitals. Medicine of extreme situations. 2020;3(22):19–25. doi: 10.47183/mes.2020.013
  33. Calabria M., García-Sánchez C., Grunden N. et al. Post-COVID-19 fatigue: the contribution of cognitive and neuropsychiatric symptoms. J. Neurol. 2022;269(8):3990–3999. doi: 10.1007/s00415-022-11141-8
  34. Huang X., Liu L., Eli B. et al. Mental health of COVID-19 survivors at 6 and 12 months postdiagnosis: a cohort study. Front. Psychiatry. 2022;13:863698. doi: 10.3389/fpsyt.2022.863698

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2. Fig. 1. Correlation of the impact of overall fatigue on quality of life (FIS overall score) and the depression severity (BDI).

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3. Fig. 2. Correlation of the fatigue severity (FSS score) and the depression severity (BDI score).

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4. Fig. 3. Correlation of the impact of overall fatigue on quality of life and the apathy severity.

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5. Fig. 4. Correlation of the depression and anxiety severity.

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6. Fig. 5. Relationship between the likelihood of sleep disturbances and anxiety.

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Copyright (c) 2023 Mikheeva A.G., Topuzova M.P., Malko V.A., Zhilina E.S., Mikhailova A.A., Lagutina D.I., Karonova T.L., Alekseeva T.M.

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This work is licensed under a Creative Commons Attribution 4.0 International License.

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