In order to understand the long-term effects of severe Covid-19 infection, US researchers have reviewed symptoms in people affected by other forms of coronavirus, notably SARS and MERS.
The meta-analysis of 65 peer-reviewed studies and seven preprints on the observed psychiatric consequences of more than 3,550 severe infections with SARS (2002), MERS (2012) and Covid-19. The study was limited to cases treated in hospital and therefore does not apply to patients who experienced milder symptoms or were asymptomatic.
The results of the analysis suggest that whereas most patients will not suffer immediate mental health effects, certain complications like depression, anxiety, fatigue, and post-traumatic stress disorder (PTSD) could emerge in the months and years that follow hospitalisation.
Two studies that systematically assessed common symptoms in a panel of 129 patients hospitalised with SARS and MERS noted various mental disorders such as confusion (28%), low mood (32%), anxiety (35%), impaired memory (34%) and insomnia (42%).
Twelve studies of patients with Covid-19 painted a similar picture with evidence of delirium in 26 out of 40 intensive-care patients, agitation in 40 out of 58 intensive-care patients and altered consciousness in 17 out of 82 patients who subsequently died.
Six other studies of patients with SARS and MERS also found frequent reports of low mood (11%), insomnia (12%), anxiety (12%), irritability (13%), memory impairment (19%), fatigue (19%) and frequent recall of traumatic memories (30%) over a follow-up period ranging from 6 weeks to 39 months.
“While there is little evidence to suggest that common mental illnesses beyond short-term delirium are a feature of Covid-19 infection, clinicians should monitor for the possibility that common mental disorders such as depression, anxiety, fatigue, and PTSD could arise in the weeks and months following recovery from severe infection, as has been seen with SARS and MERS,” points out Dr Jonathan Rogers, a researcher from University College London, UK and a co-author of the study.