Longitudinal Assessment of Mental Health Sequelae in COVID-19 Survivors: A Cohort Study.

introductionThe long-term consequences of COVID-19, also known as post-acute sequelae of SARS-CoV-2 infection (PASC), remain incompletely understood. Early studies have highlighted persistent multi-system symptoms, including anxiety, but data beyond one year are limited. This study aimed to evaluate the incidence of anxiety symptoms over three years among COVID-19 survivors. This cohort study aimed to investigate the longitudinal outcomes of COVID-19 survivors, with a focus on the persistence and development of sequelae.  Methods: The study enrolled a cohort of 109 subjects who were admitted with real-time polymerase chain reaction (RT-PCR)-confirmed COVID-19 in a tertiary care hospital in south-central India. Due to the retrospective enrollment in 2023, participants were interviewed to recall their anxiety status at discharge (2021) and one year after discharge (2022). This was followed by a prospective assessment of anxiety, two years (2023), and three years (2024) after discharge. The study involved the collection of quantitative data using a standardized questionnaire based on the Hamilton Anxiety Rating Scale (HAM-A), sent to the subjects via non-contact methods such as digital platforms or telephonic conversations. After data gathering, the data were tabulated on a Microsoft Excel spreadsheet and analyzed with the help of the IBM SPSS trial version 21. Statistical analysis included descriptive statistics, chi-square tests, and ordinal logistic regression.

resultsThe mean age of the study subjects was 36.08 ± 15.31 years, with the majority being females. Corresponding to the time of discharge from the hospital, varying levels of anxiety were found among the participants, with most of them having mild anxiety, followed by severe anxiety and mild to moderate anxiety. The major contributors to the severe as well as mild to moderate anxiety were impaired intellectual abilities, insomnia, and depressed mood. The mean baseline HAM-A score at the time of discharge, one year, two years, and three years after discharge were 17.06 ± 10.71, 10.46 ± 8.38, 4.32 ± 5.21, and 1.13 ± 2.58, respectively.

conclusionLongitudinal follow-up showed a notable improvement in anxiety scores over a period of three years, with the mean score falling drastically at each year, suggesting a positive trend in mental health recovery. Findings support the need for integrated long-term mental health support and the need for primary case mental health screening.