Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Sep 28, 2022
Date Accepted: Jan 12, 2023
Date Submitted to PubMed: Jan 16, 2023
Association of Acute Signs and Symptoms of COVID-19 and Exacerbation of Depression and Anxiety in Patents with Clinically Mild COVID-19: A Retrospective Observational Study
ABSTRACT
Background:
To date, the association between acute signs and symptoms of COVID-19 and the exacerbation of depression and anxiety in clinically mild COVID-19 patients has not been evaluated.
Objective:
This study was design to assess the correlation between acute signs and symptoms of COVID-19 and the exacerbation of depression and anxiety in clinically mild COVID-19 patients at a residential treatment center in South Korea.
Methods:
This retrospective study assessed 2,671 COVID-19 patients admitted to four residential treatment centers operated by Seoul National University Hospital in South Korea from March 2020 to April 2022. Depression and anxiety were assessed using the 2-item Patient Health Questionnaire (PHQ-2) and 2-item Generalized Anxiety Disorder (GAD-2), respectively. The exacerbation of depression and anxiety symptoms was identified from the differences of PHQ-2 scores and GAD-2 scores between admission and discharge, respectively. The patients’ clinical characteristics, including acute signs and symptoms of COVID-19, were obtained from electronic health records.
Results:
Patients who had experienced sleep disorders appeared to be associated with exacerbated depression (P<.001) and anxiety (P<.001), and those who experienced sore throat appeared to be associated with exacerbated anxiety symptoms (P<.05). Patients with abnormal oxygen saturation during quarantine were more likely to have exacerbated depression (P<.05), and those with abnormal body temperature during quarantine were more likely to experience anxiety (P<.05). As anticipated, patients who experienced psychological symptoms at admission were more likely to experience depression (P<.001) and anxiety (P<.001). Meanwhile, the PHQ-2 and GAD-2 scores measured at admission revealed that the lower the score, the higher the possibility of exacerbating both depression (P<.001) and anxiety (P<.001).
Conclusions:
Results from current analysis suggest the importance of considering further interventions that might mitigate the exacerbation of depression and anxiety in patients with abnormal oxygen saturation, abnormal body temperature, sore throat and sleep disorder symptoms, or initial psychological symptoms. In addition, this study highlights the usability of short and efficient scales such as PHQ-2 and GAD-2 in the assessment of mental health of clinically mild COVID-19 patients quarantined at home during the long COVID era.
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