COVID-19 enfeksiyonu geçiren bireylerde altı ay içinde görülen ruhsal bozukluklar

Year 2023, Volume: 48 Issue: 3, 759 - 771, 30.09.2023

Cana Aksoy Poyraz , Ömer Faruk Demirel , Burç Çağrı Poyraz , Şenol Turan Ersel Bulu , Sadige Osmanlı Shirolu Yasin Kavla , Elif Burcu Ersungur Rıdvan Karaali

https://doi.org/10.17826/cumj.1242481

Cited By: 1

Abstract

Amaç: Bir hastanın Covid-19 semptomları gösterdiği sürenin uzaması ruhsal bozukluklarla yakından ilişkilidir. Bununla birlikte, hastalığın erken evrelerinde kimde belirtilerin uzun süreceğini öngörmenin mümkün olup olmadığı hakkında çok az şey biliniyor. Bu çalışmada Covid-19 sonrası psikiyatrik semptomların zamanla nasıl geliştiğini, bu semptomları etkileyen değişkenleri anlamayı amaçladık.
Gereç ve Yöntem: Covid-19 hastaları hastanede yatarken ve taburcu olduktan sonraki altı ay içinde gösterdikleri kaygı, depresyon, akut stres ve uyku bozuklukları açısından uzun dönemli olarak değerlendirildi. Yakın zamanda Covid-19 ile yoğun bakım dışındaki birimlere kabul edilen yetişkin hastalar çalışma kapsamına alındı. Ruhsal durumları, Hastane Kaygı ve Depresyon Ölçeği, Ulusal Ölçekte Stresli Olaylar Anketi, Akut Stres Bozukluğu Ölçeği Kısa Formu, Pittsburgh Uyku Kalitesi Endeksi kullanılarak değerlendirildi. Hastaların klinik verileri hastane kayıtlarından derlendi. Taburcu olduktan altı ay sonra hastalara aynı soru formu ve dirençli fiziksel semptomların değerlendirilmesi için de bir semptomlar listesi WhatsApp aracılığıyla gönderildi.
Bulgular: Çalışmaya dahil edilen 143 katılımcıdan 47'si çalışmayı tamamladı. Sonuçlar hastaların depresyon, anksiyete ve uykusuzluğunun takip sırasında önemli ölçüde azaldığını gösterdi. Ancak akut stres semptomları bildiren hasta sayısında artış oldu. Akut enfeksiyon sırasındaki en yüksek C-reaktif protein seviyesi (OR=1.09), takip sırasındaki depresyonu öngörmüştür. Hastanede yatış sırasında daha fazla enfeksiyöz semptom yaşamanın, altı ay sonra daha fazla sayıda uzamış semptom öngördüğü saptandı (OR=1.5).
Sonuç: Akut Covid-19 enfeksiyonu sırasındaki sistemik iltihaplanmanın şiddeti depresyon belirtilerinin direnmesine yol açabilir. Buna göre, akut enfeksiyon sırasında daha çok sayıda semptom gösteren hastalar uzamış Covid-19 hastalığı geçirme tehlikesi altında olabilirler.

Keywords

Anksiyete, depresyon, travma sonrası stres, uzun süreli semptomlar, COVID-19, inflamasyon

Six-month psychiatric outcomes among survivors of COVID-19

Abstract

Purpose: Long-lasting COVID-19 symptoms are closely associated with psychiatric sequelae. However, little is known about whether it is possible to predict a protracted course early in the disease. In this study, we aimed to understand how post-COVID-19 psychiatric symptomatology evolves over time and the variables that affect these symptoms.
Materials and Methods: Anxiety, depression, acute stress, and sleep disorders among patients with COVID-19 were prospectively evaluated during hospitalization and six months after discharge. Adult patients recently admitted to non-intensive care units with COVID-19 were eligible. Their psychiatric status was assessed using the Hospital Anxiety and Depression Scale, National Stressful Events Survey Acute Stress Disorder Short Scale, Pittsburgh Sleep Quality Index. The patients’ clinical data were gathered from hospital records. Six months after they were discharged, the same questionnaire and a checklist to assess ongoing physical symptoms were distributed to the patients via WhatsApp.
Results: 143 participants were enrolled, 47 of whom completed the study. The results showed that patients’ depression, anxiety, and insomnia significantly decreased during the follow-up. However, there was an increase in the number of patients who reported acute stress symptoms. The highest C-reactive protein level during acute infection (OR=1.09) predicted depression during the follow-up. Experiencing a higher number of infectious symptoms during hospitalization predicted a higher number of protracted symptoms six months later (OR=1.5).
Conclusion: This indicates that the severity of systemic inflammation during acute COVID-19 infection may predispose patients to persistent depression. Patients with a higher number of symptoms during acute infection may be at risk of developing long-term COVID-19.

Keywords

anxiety, depression, post-traumatic stress, protracted symptoms, COVID-19, inflammation

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