Research Article
Year 2025,
Volume: 50 Issue: 2, 328 - 340, 30.06.2025
Abstract
Purpose: Following the acute stage of COVID-19, many patients have experienced persistent physical and neuropsychiatric symptoms, regardless of the severity of the illness. Key concerns like fatigue, depressive symptoms, and cognitive impairments have a detrimental effect on psychosocial functioning and quality of life. This study aims to explore cognitive impairments and depression one year after discharge from the hospital for COVID-19, along with implications for quality of life.
Materials and Methods: Patients hospitalized with COVID-19 with mild-moderate disease severity were asked to participate in a 12-month follow-up evaluation. A total of 60 individuals who had recovered from COVID-19 were examined for cognitive functions, depressive symptoms, and quality of life. They were then compared to a healthy comparison group, matched for age and education, who had not been infected with COVID-19.
Results: After 1 year following discharge, cognitive impairment was noted in 21.7% of COVID-19 patients, based on The Montreal Cognitive Assessment, while only 3.3% of the non-COVID-19 control group exhibited the same. Quality of life domains were largely comparable across groups. Depressive symptoms were identified as the main factor affecting quality of life domains in COVID-19 patients.
Conclusion: Despite the potential for cognitive impairment to last for up to a year following hospital discharge, it does not seem to have a negative effect on the quality of life in our group of patients with mild-to-moderate disease severity. However, depressive symptoms were found to be the key indicators of quality of life.
Ethical Statement
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Ethics approval was obtained from the Istanbul University Cerrahpaşa Ethics Committee, with decision number 380358. The study procedure was fully explained, and written consent was obtained from all participants.
References
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- Sasannejad C, Ely EW, Lahiri S. Long-term cognitive impairment after acute respiratory distress syndrome: a review of clinical impact and pathophysiological mechanisms. Crit Care. 2019;23:352.
- Baldini T, Asioli GM, Romoli M, Mazziotti D, Agosta F, Mauro A et al. Cerebral venous thrombosis and severe acute respiratory syndrome coronavirus-2 infection: a systematic review and meta-analysis. Eur J Neurol. 2021;28:3478-90.
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Year 2025,
Volume: 50 Issue: 2, 328 - 340, 30.06.2025
Abstract
Amaç: COVID-19’un akut evresini takiben, hastalığın şiddet düzeyinden bağımsız olarak birçok hastada uzun süreli fiziksel ve nöropsikiyatrik semptomlar ortaya çıkmıştır. Yorgunluk, depresif semptomlar ve bilişsel bozukluklar gibi temel sorunlar, psikososyal işlevsellik ve yaşam kalitesi üzerinde olumsuz etkilere neden olmaktadır. Bu çalışma, COVID-19 nedeniyle hastaneden taburcu edilen bireylerde, bir yıl sonrasında bilişsel bozukluklar ve depresyonun varlığını ve bunların yaşam kalitesi üzerindeki etkilerini araştırmayı amaçlamaktadır.
Gereç ve Yöntem: COVID-19 nedeniyle hafif-orta şiddette hastalık geçiren ve hastanede yatarak tedavi gören hastalardan, taburculuktan 12 ay sonra değerlendirmeye katılmaları istenildi. COVID-19’dan iyileşmiş toplam 60 birey, bilişsel işlevler, depresif semptomlar ve yaşam kalitesi açısından değerlendirilmiş ve yaş ve eğitim düzeyine göre eşleştirilmiş, COVID19 enfeksiyonu geçirmemiş sağlıklı bir kontrol grubu ile karşılaştırılmıştır.
Bulgular: Taburculuktan 1 yıl sonra, Montreal Bilişsel Değerlendirme ölçeğine göre COVID-19 hastalarının %21,7’sinde bilişsel bozukluk tespit edilmiştir, buna karşın kontrol grubunda bu oran yalnızca %3,3’tür. Yaşam kalitesi alanları genel olarak gruplar arasında benzerdir. Depresif semptomlar, COVID-19 hastalarında yaşam kalitesi alanlarını etkileyen ana faktör olarak belirlenmiştir.
Sonuç: Taburculuk sonrası bir yıl boyunca bilişsel bozukluklar devam edebilse de, hafif-orta şiddette hastalık geçiren hasta grubunda yaşam kalitesi üzerinde olumsuz bir etkisi bulunmamıştır. Ancak depresif semptomlar, yaşam kalitesinin temel göstergeleri olarak tespit edilmiştir.
References
- Huang L, Yao Q, Gu X, Chen H, Wang W, Xu Y et al. 1-year outcomes in hospital survivors with COVID-19: a longitudinal cohort study. Lancet. 2021;398:747-58.
- Venkatesan P. NICE guideline on long COVID. Lancet Respir Med. 2021;9:129.
- Nakamura ZM, Nash RP, Laughon SL, Rosenstein DL. Neuropsychiatric complications of COVID-19. Curr Psychiatry Rep. 2021;23:1-9.
- Schou TM, Joca S, Wegener G, Bay-Richter C. Psychiatric and neuropsychiatric sequelae of COVID-19: a systematic review. Brain Behav Immun. 2021;97:328-48.
- Ceban F, Ling S, Lui LM, Lee Y, Gill H, Teopiz KM et al. Fatigue and cognitive impairment in post-COVID-19 syndrome: a systematic review and meta-analysis. Brain Behav Immun. 2022;101:93-135.
- Miskowiak KW, Johnsen S, Sattler SM, Nielsen S, Kunalan K, Rungby J et al. Cognitive impairments four months after COVID-19 hospital discharge: pattern, severity and association with illness variables. Eur Neuropsychopharmacol. 2021;46:39-48.
- Mendez R, Balanzá-Martínez V, Luperdi SC, Estrada I, Llamas-Velasco S, Martinez-Villalba S et al. Short-term neuropsychiatric outcomes and quality of life in COVID-19 survivors. J Intern Med. 2021;290:621-31.
- Mattioli F, Stampatori C, Righetti F, Sala E, Tomasi C, De Palma G. Neurological and cognitive sequelae of COVID-19: a four month follow-up. J Neurol. 2021;268:4422-8.
- Almeria M, Cejudo JC, Sotoca J, Deus J, Krupinski J. Cognitive profile following COVID-19 infection: clinical predictors leading to neuropsychological impairment. Brain Behav Immun Health. 2020;9:100163.
- Daroische R, Hemminghyth MS, Eilertsen TH, Breitve MH, Chwiszczuk LJ. Cognitive impairment after COVID-19: a review on objective test data. Front Neurol. 2021;12:699582.
- Poletti S, Palladini M, Mazza MG, Rovere-Querini P, Benedetti F, Ciceri F et al. Long-term consequences of COVID-19 on cognitive functioning up to 6 months after discharge: role of depression and impact on quality of life. Eur Arch Psychiatry Clin Neurosci. 2022;272:773-82.
- Miskowiak K, Fugledalen L, Jespersen A, Rungby J, Hansen J, Johnsen S et al. Trajectory of cognitive impairments over 1 year after COVID-19 hospitalisation: pattern, severity and functional implications. Eur Neuropsychopharmacol. 2022;59:82-92.
- Ferrucci R, Dini M, Rosci C, Groppo E, Damiano M, Poletti S et al. One-year cognitive follow-up of COVID-19 hospitalized patients. Eur J Neurol. 2022;29:2006-14.
- Khraisat B, Toubasi A, AlZoubi L, Al-Sayegh T, Mansour A. Meta-analysis of prevalence: the psychological sequelae among COVID-19 survivors. Int J Psychiatry Clin Pract. 2022;26:234-43.
- Deng J, Zhou F, Hou W, Silver Z, Wong A, Li W et al. The prevalence of depression, anxiety and sleep disturbances in COVID-19 patients: a meta-analysis. Ann N Y Acad Sci. 2021;1486:90-101.
- Troyer EA, Kohn JN, Hong S. Are we facing a crashing wave of neuropsychiatric sequelae of COVID-19? Neuropsychiatric symptoms and potential immunologic mechanisms. Brain Behav Immun. 2020;87:34-9.
- Passavanti M, Argentieri A, Barbieri DM, Loureiro A, Fadda P, Pallottino L et al. The psychological impact of COVID-19 and restrictive measures in the world. J Affect Disord. 2021;283:36-51.
- Hawlader MDH, Rashid MU, Khan MAS, Ma P, Feng D, Li J et al. Quality of life of COVID-19 recovered patients: a 1-year follow-up study from Bangladesh. Infect Dis Poverty. 2023;12:79.
- O’Brien K, Townsend L, Dowds J, O’Kelly B, Conlon N, Smyth E et al. One-year quality of life and health outcomes in patients hospitalised with COVID-19: a longitudinal cohort study. Respir Res. 2022;23:115.
- Gesser AF, Campos ML, Artismo RS, Karloh M, Matte DL, Souza HCD et al. Impact of COVID-19 critical illness on functional status, fatigue symptoms and health-related quality of life one year after hospital discharge: a systematic review and meta-analysis. Disabil Rehabil. 2023;45:1-12.
- Rosa RG, Cavalcanti AB, Azevedo LCP, Lisboa TC, Damiani LP, Machado FR et al. Association between acute disease severity and one-year quality of life among post-hospitalisation COVID-19 patients: coalition VII prospective cohort study. Intensive Care Med. 2023;49:166-77.
- World Health Organization. WHO guidelines on the use of chest imaging in COVID-19. Geneva, World Health Organization, 2022. https://www.who.int/publications/i/item/9789240055704 (accessed May 2021).
- Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53:695-9.
- Ozdilek B, Kenangil G. Validation of the Turkish version of the Montreal Cognitive Assessment Scale (MoCA-TR) in patients with Parkinson’s disease. Clin Neuropsychol. 2014;28:333-43.
- Skevington SM, Lotfy M, O’Connell KA. The World Health Organization’s WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group. Qual Life Res. 2004;13:299-310.
- Eser E, Fidaner H, Fidaner C, Psychometric properties of the WHOQOL-100 and WHOQOL-BREF. J Psychiatry Psychol Psychopharmacol. 1999;7:23-40.
- Buysse DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28:193-213.
- Ağargün MY, Validity and reliability of Turkish version of Pittsburgh Sleep Quality Index. Turk Psikiyatri Derg. 1996;7:107.
- Beck AT, Steer RA. Internal consistencies of the original and revised Beck Depression Inventory. J Clin Psychol. 1984;40:1365-7.
- Hisli N, A study on the validity of the Beck Depression Inventory. Turk Psychol J. 1998;6:118-23.
- Beck AT, Steer RA, Carbin MG, Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation. Clin Psychol Rev. 1988;8:77-100.
- Broadbent DE, Cooper PF, FitzGerald P, Parkes KR. The Cognitive Failures Questionnaire (CFQ) and its correlates. Br J Clin Psychol. 1982;21:1-16.
- Eser HY, Inan MY, Kucuker MU, Development, validity and reliability of the 4-point Likert Turkish version of the Cognitive Failures Questionnaire. Ann Med Res. 2020;27:837.
- World Health Organization. COVID-19 therapeutic trial synopsis. https://www.who.int/blueprint/priority-diseases/key-action/COVID-19_Treatment_Trial_Design_Master_Protocol_synopsis_Final_18022020.pdf (accessed May 2021).
- Méndez R, Balanzá-Martínez V, Luperdi SC, Estrada I, Llamas-Velasco S, Martinez-Villalba S et al. Long-term neuropsychiatric outcomes in COVID-19 survivors: a one-year longitudinal study. J Intern Med. 2022;291:247.
- Cavaco S, Sousa G, Gonçalves A, Almeida J, Monteiro E, Reis D et al. Predictors of cognitive dysfunction one year post COVID-19. Neuropsychology. 2023;37:849-58.
- Rass V, Beer R, Schiefecker AJ, Kofler M, Lindner A, Asenbaum P et al. Neurological outcomes one year after COVID-19 diagnosis: a prospective longitudinal cohort study. Eur J Neurol. 2022;29:1685-96.
- Godoy-González M, Navarra-Ventura G, Gomà G, Subirà C, Bertran MJ, Masclans JR et al. Objective and subjective cognition in survivors of COVID-19 one year after ICU discharge: the role of demographic, clinical and emotional factors. Crit Care. 2023;27:188.
- Sasannejad C, Ely EW, Lahiri S. Long-term cognitive impairment after acute respiratory distress syndrome: a review of clinical impact and pathophysiological mechanisms. Crit Care. 2019;23:352.
- Baldini T, Asioli GM, Romoli M, Mazziotti D, Agosta F, Mauro A et al. Cerebral venous thrombosis and severe acute respiratory syndrome coronavirus-2 infection: a systematic review and meta-analysis. Eur J Neurol. 2021;28:3478-90.
- Mazza MG, Palladini M, De Lorenzo R, Bravi B, Poletti S, Furlan R et al. Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: effect of inflammatory biomarkers at three-month follow-up. Brain Behav Immun. 2021;94:138-47.
- Cristillo V, Pilotto A, Piccinelli SC, Gipponi S, Bonzi G, Padovani A et al. Predictors of “brain fog” one year after COVID-19 disease. Neurol Sci. 2022;43:5795-7.
- Seeßle J, Waterboer T, Hippchen T, Schnitzler P, Götzinger F, Kräusslich HG et al. Persistent symptoms in adult patients one year after coronavirus disease 2019 (COVID-19): a prospective cohort study. Clin Infect Dis. 2022;74:1191-8.
- Yang T, Yan MZ, Li X, Lau EH. Sequelae of COVID-19 among previously hospitalized patients up to one year after discharge: a systematic review and meta-analysis. Infection. 2022;50:1067-79.
- Evans RA, Leavy OC, Richardson M, Tunnicliffe EM, Elneima O, Brightling CE et al. Clinical characteristics with inflammation profiling of long COVID and association with one-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med. 2022;10:761-75.
- Huang L, Li X, Gu X, Zhang H, Ren L, Gong T et al. Health outcomes in people two years after surviving hospitalisation with COVID-19: a longitudinal cohort study. Lancet Respir Med. 2022;10:863-76.
- Zhang H, Huang C, Gu X, Li X, Hu Y, Ren L et al. Three-year outcomes of discharged survivors of COVID-19 following the SARS-CoV-2 Omicron (B.1.1.529) wave in 2022 in China: a longitudinal cohort study. Lancet Respir Med. 2024;12:55-66.
- Todt BC, Szlejf C, Duim E, Linhares AO, Kogiso D, Fonseca RP et al. Clinical outcomes and quality of life of COVID-19 survivors: a follow-up of three months post hospital discharge. Respir Med. 2021;184:106453.
- Menges D, Ballouz T, Anagnostopoulos A, Aschmann HE, Domenghino A, Frei A et al. Burden of post-COVID-19 syndrome and implications for healthcare service planning: a population-based cohort study. PLoS One. 2021;16:e0254523.
- Sonnweber T, Sahanic S, Pizzini A, Luger A, Schwabl C, Tymoszuk P et al. Cardiopulmonary recovery after COVID-19: an observational prospective multicentre trial. Eur Respir J. 2021;57:2003481.
- Evans RA, McAuley H, Harrison EM, Shikotra A, Singapuri A, Sereno M et al. Physical, cognitive and mental health impacts of COVID-19 after hospitalisation (PHOSP-COVID): a UK multicentre, prospective cohort study. Lancet Respir Med. 2021;9:1275-87.
- Taboada M, Moreno E, Cariñena A, Rey T, Pita-Romero R, Leal S et al. Quality of life, functional status and persistent symptoms after intensive care of COVID-19 patients. Br J Anaesth. 2021;126:e110-3.
- Calabria M, García-Sánchez C, Grunden N, Pueyo R, López-Cano M, Lleó A et al. Post-COVID-19 fatigue: the contribution of cognitive and neuropsychiatric symptoms. J Neurol. 2022;269:3990-9.
- Hendrickson RC, Slevin RA, Hoerster KD, Pelley TJ, Gilchrist KH, Lipscomb J et al. The impact of the COVID-19 pandemic on mental health, occupational functioning and professional retention among health care workers and first responders. J Gen Intern Med. 2022;37:397-408.
- Mazza MG, Palladini M, Poletti S, Benedetti F. Post-COVID-19 depressive symptoms: epidemiology, pathophysiology and pharmacological treatment. CNS Drugs. 2022;36:681-702.
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Details
| Primary Language | English |
|---|---|
| Subjects | Psychiatry |
| Journal Section | Research |
| Authors | |
| Publication Date | June 30, 2025 |
| Submission Date | January 15, 2025 |
| Acceptance Date | May 15, 2025 |
| Published in Issue | Year 2025 Volume: 50 Issue: 2 |
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