Do Anxiety and Depression Predict Persistent Physical Symptoms After a Severe COVID-19 Episode? A Prospective Study

Hugo Bottemanne; Clément Gouraud; Jean-Sébastien Hulot; Anne Blanchard; Brigitte Ranque; Khadija Lahlou-Laforêt; Frédéric Limosin; Sven Günther; David Lebeaux; Cédric Lemogne

doi:10.3389/fpsyt.2021.757685

Do Anxiety and Depression Predict Persistent Physical Symptoms After a Severe COVID-19 Episode? A Prospective Study

Front Psychiatry. 2021 Nov 10:12:757685. doi: 10.3389/fpsyt.2021.757685. eCollection 2021.

Authors

Affiliations

¹ Paris Brain Institute - Institut du Cerveau et de la Moelle Épiniére, UMR 7225, UMR_S 1127, CNRS, INSERM, Sorbonne University, Service de Psychiatrie de l'Adulte, Hôpital de la Pitié-Salpêtriére, DMU Neurosciences, Assistance Publique-Hôpitaux De Paris, Paris, France.
² Service de Psychiatrie de l'Adulte, DMU Psychiatrie et Addictologie, Hôpital Hôtel-Dieu, Université de Paris, Assistance Publique-Hopitaux de Paris, Paris, Paris, France.
³ CIC 1418 and DMU CARTE, Assistance Publique Hopitaux De Paris, Hôpital Européen Georges-Pompidou, Paris, France.
⁴ Service de Néphrologie, Assistance Publique Hopitaux De Paris, Hôpital Européen-Georges Pompidou, Université de Paris, Paris, France.
⁵ Service de Médecine Interne, Assistance Publique Hopitaux De Paris, Hôpital Européen-Georges Pompidou, Université de Paris, Paris, France.
⁶ DMU Psychiatrie et Addictologie, Service de Psychiatrie de l'Adulte, Assistance Publique Hopitaux De Paris, Hôpital Européen-Georges Pompidou, Université de Paris, Paris, France.
⁷ DMU Psychiatrie et Addictologie, Service de Psychiatrie de l'Adulte, Assistance Publique Hopitaux De Paris, Hôpital Corentin Celton, Université de Paris, Paris, France.
⁸ Innovative Therapies in Haemostasis, INSERM, Université de Paris, Paris, France.
⁹ Service de Physiologie, Assistance Publique Hopitaux De Paris, Georges Pompidou European Hospital, Paris, France.
¹⁰ Service de Microbiologie, Unité Mobile d'Infectiologie, Assistance Publique Hopitaux De Paris, Hôpital Européen Georges Pompidou, Université de Paris, Paris, France.
¹¹ Service de Psychiatrie de l'Adulte, Hôpital Hôtel-Dieu, DMU Psychiatrie et Addictologie, Assistance Publique Hopitaux De Paris, INSERM, Institut de Psychiatrie et Neurosciences de Paris, UMR_S1266, Université de Paris, Paris, France.

Abstract

Background: Persistent physical symptoms are common after a coronavirus disease 2019 (COVID-19) episode, but their pathophysiological mechanisms remain poorly understood. In this study, we aimed to explore the association between anxiety and depression at 1-month after acute infection and the presence of fatigue, dyspnea, and pain complaints at 3-month follow-up. Methods: We conducted a prospective study in patients previously hospitalized for COVID-19 followed up for 3 months. The Hospital Anxiety and Depression Scale (HAD-S) was administered by physicians at 1-month follow-up, and the presence of fatigue, dyspnea, and pain complaints was assessed at both 1 month and 3 months. Multivariable logistic regressions explored the association between anxiety and depression subscores and the persistence of each of the physical symptom at 3 months. Results: A total of 84 patients were included in this study (Median age: 60 years, interquartile range: 50.5-67.5 years, 23 women). We did not find any significant interaction between anxiety and the presence of fatigue, dyspnea, or pain complaints at 1 month in predicting the persistence of these symptoms at 3 months (all p ≥ 0.36). In contrast, depression significantly interacted with the presence of pain at 1 month in predicting the persistence of pain at 3 months (OR: 1.60, 95% CI: 1.02-2.51, p = 0.039), with a similar trend for dyspnea (OR: 1.51, 95% CI: 0.99-2.28, p = 0.052). Discussion and Conclusion: Contrary to anxiety, depression after an acute COVID-19 episode may be associated with and increased risk of some persistent physical symptoms, including pain and dyspnea.

Keywords: COVID-19; anxiety; depression; fatigue pain; long Covid; post-acute COVID-19 syndrome; post-covid condition; somatoform disorders.