COVID-19: coronavirus infections may lead to delirium and potentially PTSD

  • Rogers JP, et al
  • Lancet Psychiatry
  • 18 May 2020

  • curated by Priscilla Lynch
  • UK Medical News
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Coronavirus patients may experience psychiatric problems while hospitalised and potentially after they recover, suggests an analysis of past research led by UK researchers.

The systematic review paper, published in The Lancet Psychiatry, compiled results from short- and long-term studies of people hospitalised by recent coronaviruses, namely Severe Acute Respiratory Syndrome (SARS) in 2002-2004, Middle East Respiratory Syndrome (MERS) in 2012, and COVID-19 this year.

A total of 65 peer-reviewed studies and seven preprints met inclusion criteria, with cohort sizes ranging from one to 997 (n=3559). Studies were from China, Hong Kong, South Korea, Canada, Saudi Arabia, France, Japan, Singapore, the UK and the USA. Follow-up time for the post-illness studies varied between 60 days and 12 years.

The systematic review revealed that during the acute illness, common symptoms among patients hospitalised for SARS or MERS included confusion (36 [27.9%; 95% CI, 20.5-36.0] of 129 patients), depressed mood (42 [32.6%; 24.7-40.9] of 129 patients), anxiety (46 [35.7%; 27.6-44.2] of 129 patients), impaired memory (44 [34.1%; 26.2-42.5] of 129 patients) and insomnia (54 [41.9%; 22.5-50.5] of 129 patients).

Almost one in three people (32.2%) hospitalised with SARS or MERS went on to develop post-traumatic stress disorder (PTSD), at an average follow-up time of almost three years, especially if they had ongoing physical health problems.

Rates of depression and anxiety were also high, at roughly 15 per cent one year or longer after the illness, with a further 15 per cent also experiencing some symptoms of depression and anxiety without a clinical diagnosis. More than 15 per cent also experienced chronic fatigue, mood swings, sleep disorder or impaired concentration and memory.

In patients with COVID-19, there was evidence for delirium (confusion in 26 [65%] of 40 intensive care unit (ICU) patients and agitation in 40 [69%] of 58 ICU patients in one study and altered consciousness in 17 [21%] of 82 patients who subsequently died in another study).