The Association of Acute Signs and Symptoms of COVID-19 and Exacerbation of Depression and Anxiety in Patients With Clinically Mild COVID-19: Retrospective Observational Study
BackgroundTo date, the association between acute signs and symptoms of COVID-19 and the exacerbation of depression and anxiety in patients with clinically mild COVID-19 has not been evaluated. ObjectiveThis study was designed to assess the correlation between acut...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2023-01-01
|
| Series: | JMIR Public Health and Surveillance |
| Online Access: | https://publichealth.jmir.org/2023/1/e43003 |
| _version_ | 1827857621917368320 |
|---|---|
| author | Sumi Sung Su Hwan Kim Changwoo Lee Youlim Kim Ye Seul Bae Eui Kyu Chie |
| author_facet | Sumi Sung Su Hwan Kim Changwoo Lee Youlim Kim Ye Seul Bae Eui Kyu Chie |
| author_sort | Sumi Sung |
| collection | DOAJ |
| description |
BackgroundTo date, the association between acute signs and symptoms of COVID-19 and the exacerbation of depression and anxiety in patients with clinically mild COVID-19 has not been evaluated.
ObjectiveThis study was designed to assess the correlation between acute signs and symptoms of COVID-19 and the exacerbation of depression and anxiety in patients with clinically mild COVID-19 at a residential treatment center in South Korea.
MethodsThis retrospective study assessed 2671 patients with COVID-19 admitted to 4 residential treatment centers operated by Seoul National University Hospital, 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) scale, respectively. The exacerbation of depression and anxiety symptoms was identified from the differences in PHQ-2 and GAD-2 scores between admission and discharge, respectively. The patients’ clinical characteristics, including acute signs and symptoms of COVID-19, GAD-2 and PHQ-2 scores, were obtained from electronic health records. Demographic characteristics, a summary of vital signs, and COVID-19 symptoms were analyzed and compared between the patient groups with and those without exacerbated PHQ-2 and GAD-2 scores using the chi-square test. We applied logistic regression to identify the association between acute signs and symptoms of COVID-19 and the exacerbation of depression and anxiety.
ResultsSleep disorders were associated with exacerbated depression (odds ratio [OR] 1.09, 95% CI 1.05-1.13) and anxiety (OR 1.1, 95% CI 1.06-1.14), and the sore throat symptom was associated with exacerbated anxiety symptoms (OR 1.03, 95% CI 1.00-1.07). Patients with abnormal oxygen saturation during quarantine were more likely to have exacerbated depression (OR 1.27, 95% CI 1.00-1.62), and those with an abnormal body temperature during quarantine were more likely to experience anxiety (OR 1.08, 95% CI 1.01-1.16). As anticipated, patients who experienced psychological symptoms at admission were more likely to experience depression (OR 1.91, 95% CI 1.52-2.41) and anxiety (OR 1.98, 95% CI 1.54-2.53). Meanwhile, the PHQ-2 and GAD-2 scores measured at admission revealed that lower the score, higher the possibility of exacerbation of both depression (OR 0.15, 95% CI 0.11-0.22) and anxiety (OR 0.13, 95% CI 0.10-0.19).
ConclusionsResults from this study suggest the importance of further interventions for patients with abnormal oxygen saturation, abnormal body temperatures, sore throat, and sleep disorder symptoms or initial psychological symptoms to mitigate the exacerbation of depression and anxiety. In addition, this study highlights the usability of short and efficient scales such as the PHQ-2 and GAD-2 in the assessment of the mental health of patients with clinically mild COVID-19 symptoms who were quarantined at home during the pandemic era. |
| first_indexed | 2024-03-12T12:44:19Z |
| format | Article |
| id | doaj.art-3f89567cb9a64de78682dc9c1ed954dd |
| institution | Directory Open Access Journal |
| issn | 2369-2960 |
| language | English |
| last_indexed | 2024-03-12T12:44:19Z |
| publishDate | 2023-01-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Public Health and Surveillance |
| spelling | doaj.art-3f89567cb9a64de78682dc9c1ed954dd2023-08-28T23:31:40ZengJMIR PublicationsJMIR Public Health and Surveillance2369-29602023-01-019e4300310.2196/43003The Association of Acute Signs and Symptoms of COVID-19 and Exacerbation of Depression and Anxiety in Patients With Clinically Mild COVID-19: Retrospective Observational StudySumi Sunghttps://orcid.org/0000-0003-3897-4698Su Hwan Kimhttps://orcid.org/0000-0002-8465-3564Changwoo Leehttps://orcid.org/0000-0002-0028-5478Youlim Kimhttps://orcid.org/0000-0001-7600-1200Ye Seul Baehttps://orcid.org/0000-0003-0763-5458Eui Kyu Chiehttps://orcid.org/0000-0003-2027-7472 BackgroundTo date, the association between acute signs and symptoms of COVID-19 and the exacerbation of depression and anxiety in patients with clinically mild COVID-19 has not been evaluated. ObjectiveThis study was designed to assess the correlation between acute signs and symptoms of COVID-19 and the exacerbation of depression and anxiety in patients with clinically mild COVID-19 at a residential treatment center in South Korea. MethodsThis retrospective study assessed 2671 patients with COVID-19 admitted to 4 residential treatment centers operated by Seoul National University Hospital, 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) scale, respectively. The exacerbation of depression and anxiety symptoms was identified from the differences in PHQ-2 and GAD-2 scores between admission and discharge, respectively. The patients’ clinical characteristics, including acute signs and symptoms of COVID-19, GAD-2 and PHQ-2 scores, were obtained from electronic health records. Demographic characteristics, a summary of vital signs, and COVID-19 symptoms were analyzed and compared between the patient groups with and those without exacerbated PHQ-2 and GAD-2 scores using the chi-square test. We applied logistic regression to identify the association between acute signs and symptoms of COVID-19 and the exacerbation of depression and anxiety. ResultsSleep disorders were associated with exacerbated depression (odds ratio [OR] 1.09, 95% CI 1.05-1.13) and anxiety (OR 1.1, 95% CI 1.06-1.14), and the sore throat symptom was associated with exacerbated anxiety symptoms (OR 1.03, 95% CI 1.00-1.07). Patients with abnormal oxygen saturation during quarantine were more likely to have exacerbated depression (OR 1.27, 95% CI 1.00-1.62), and those with an abnormal body temperature during quarantine were more likely to experience anxiety (OR 1.08, 95% CI 1.01-1.16). As anticipated, patients who experienced psychological symptoms at admission were more likely to experience depression (OR 1.91, 95% CI 1.52-2.41) and anxiety (OR 1.98, 95% CI 1.54-2.53). Meanwhile, the PHQ-2 and GAD-2 scores measured at admission revealed that lower the score, higher the possibility of exacerbation of both depression (OR 0.15, 95% CI 0.11-0.22) and anxiety (OR 0.13, 95% CI 0.10-0.19). ConclusionsResults from this study suggest the importance of further interventions for patients with abnormal oxygen saturation, abnormal body temperatures, sore throat, and sleep disorder symptoms or initial psychological symptoms to mitigate the exacerbation of depression and anxiety. In addition, this study highlights the usability of short and efficient scales such as the PHQ-2 and GAD-2 in the assessment of the mental health of patients with clinically mild COVID-19 symptoms who were quarantined at home during the pandemic era.https://publichealth.jmir.org/2023/1/e43003 |
| spellingShingle | Sumi Sung Su Hwan Kim Changwoo Lee Youlim Kim Ye Seul Bae Eui Kyu Chie The Association of Acute Signs and Symptoms of COVID-19 and Exacerbation of Depression and Anxiety in Patients With Clinically Mild COVID-19: Retrospective Observational Study JMIR Public Health and Surveillance |
| title | The Association of Acute Signs and Symptoms of COVID-19 and Exacerbation of Depression and Anxiety in Patients With Clinically Mild COVID-19: Retrospective Observational Study |
| title_full | The Association of Acute Signs and Symptoms of COVID-19 and Exacerbation of Depression and Anxiety in Patients With Clinically Mild COVID-19: Retrospective Observational Study |
| title_fullStr | The Association of Acute Signs and Symptoms of COVID-19 and Exacerbation of Depression and Anxiety in Patients With Clinically Mild COVID-19: Retrospective Observational Study |
| title_full_unstemmed | The Association of Acute Signs and Symptoms of COVID-19 and Exacerbation of Depression and Anxiety in Patients With Clinically Mild COVID-19: Retrospective Observational Study |
| title_short | The Association of Acute Signs and Symptoms of COVID-19 and Exacerbation of Depression and Anxiety in Patients With Clinically Mild COVID-19: Retrospective Observational Study |
| title_sort | association of acute signs and symptoms of covid 19 and exacerbation of depression and anxiety in patients with clinically mild covid 19 retrospective observational study |
| url | https://publichealth.jmir.org/2023/1/e43003 |
| work_keys_str_mv | AT sumisung theassociationofacutesignsandsymptomsofcovid19andexacerbationofdepressionandanxietyinpatientswithclinicallymildcovid19retrospectiveobservationalstudy AT suhwankim theassociationofacutesignsandsymptomsofcovid19andexacerbationofdepressionandanxietyinpatientswithclinicallymildcovid19retrospectiveobservationalstudy AT changwoolee theassociationofacutesignsandsymptomsofcovid19andexacerbationofdepressionandanxietyinpatientswithclinicallymildcovid19retrospectiveobservationalstudy AT youlimkim theassociationofacutesignsandsymptomsofcovid19andexacerbationofdepressionandanxietyinpatientswithclinicallymildcovid19retrospectiveobservationalstudy AT yeseulbae theassociationofacutesignsandsymptomsofcovid19andexacerbationofdepressionandanxietyinpatientswithclinicallymildcovid19retrospectiveobservationalstudy AT euikyuchie theassociationofacutesignsandsymptomsofcovid19andexacerbationofdepressionandanxietyinpatientswithclinicallymildcovid19retrospectiveobservationalstudy AT sumisung associationofacutesignsandsymptomsofcovid19andexacerbationofdepressionandanxietyinpatientswithclinicallymildcovid19retrospectiveobservationalstudy AT suhwankim associationofacutesignsandsymptomsofcovid19andexacerbationofdepressionandanxietyinpatientswithclinicallymildcovid19retrospectiveobservationalstudy AT changwoolee associationofacutesignsandsymptomsofcovid19andexacerbationofdepressionandanxietyinpatientswithclinicallymildcovid19retrospectiveobservationalstudy AT youlimkim associationofacutesignsandsymptomsofcovid19andexacerbationofdepressionandanxietyinpatientswithclinicallymildcovid19retrospectiveobservationalstudy AT yeseulbae associationofacutesignsandsymptomsofcovid19andexacerbationofdepressionandanxietyinpatientswithclinicallymildcovid19retrospectiveobservationalstudy AT euikyuchie associationofacutesignsandsymptomsofcovid19andexacerbationofdepressionandanxietyinpatientswithclinicallymildcovid19retrospectiveobservationalstudy |