Changes in Neuropsychiatric Symptoms Among COVID-19-Convalescent Patients During Hospitalization at a Tertiary Care Center.

Abstract

Objective: The investigators compared neuropsychiatric symptoms among COVID-19 patients at hospital admission and at discharge.

Methods: Clinical data on neuropsychiatric syndromes were prospectively collected from 103 COVID-19 patients at admission and immediately before discharge. Clinical evaluations and serum biomarkers were analyzed to assess their relationship with neuropsychiatric symptoms and patient survival.

Results: Neuropsychiatric symptoms had improved by the time of hospital discharge (N=81) compared with admission. Depression scores decreased from 5.0 to 3.8 points on the Beck Depression Inventory (t=3.04); anxiety scores decreased from 12.3 to 10.0 points on the Beck Anxiety Inventory (t=2.75); and cognitive scores increased from 21.8 to 23.6 points on the Montreal Cognitive Assessment (t=-4.07). Delirium was present among 24% of patients upon admission but only among 12% before discharge. Markers of inflammation were correlated with neuropsychiatric symptoms. Longer hospital stays significantly predicted depression (R²=0.06), and gender and procalcitonin levels were significantly associated with anxiety (R²=0.05). Cognitive impairment was linked to depression and the need for endotracheal intubation. Both cognitive impairment and endotracheal intubation were associated with lower survival rates (R²=0.10 and 0.18, respectively).

Conclusions: These findings reveal that a significant number of COVID-19 patients continued to exhibit affective symptoms, delirium, and cognitive deficits at discharge, with delirium and cognitive deficits being linked to lower survival rates and inflammation markers being significantly associated with these symptoms. Factors such as gender, hospital stay length, and mechanical ventilation predicted neuropsychiatric symptoms.