Assessment of Anxiety and Depression in Hospitalized Patients with Severe Covid-19 Pneumonia

ABSTRACT

Anxiety and depression are highly prevalent psychiatric disorders among patients admitted for organic causes. To determine whether patients hospitalized with severe COVID-19 pneumonia present symptoms of anxiety and/or depression that are directly proportional to their clinical course. A longitudinal, prospective, observational study was conducted in the High Specialty and Advanced Medicine Building of the UANL University Hospital. Spanish-speaking patients of both sexes, aged 18 and over, diagnosed with severe COVID-19 pneumonia, were surveyed from September 2020 to January 2021. Sociodemographic data were obtained, including age, sex, comorbidities, occupation, education, marital status, national origin and religion, length of stay, and oxygen requirements. These data were collected directly from the patient or the most recent information from the patient's medical record. Anxiety and depression symptoms were assessed on the day of admission using the Hospital Anxiety and Depression Scale (HADS). Results: 57 patients hospitalized with COVID-19 pneumonia were followed during their hospital stay, until discharge, or until the patient required invasive mechanical ventilation. The mean age of the patients was 57.8 years. Upon admission, 29.8% of the patients presented symptoms suggestive of anxiety, and 7% presented clinically significant anxiety morbidity. In comparison, 8.8% of the patients presented symptoms suggestive of depression and 3.5% clinically indicative of comorbid depression. At the last evaluation in our study of patients, up to 12% presented anxiety symptoms (2% clinically morbid) and 2% significant depression morbidity. The trend toward depression and anxiety decreased over time and was highest in the first days of hospitalization. We found no association between these symptoms and having been intubated at any point during their stay. The median length of stay was 7 (4-10) days, and most were admitted with low-flow oxygen therapy (78.9%). Furthermore, we found a low to very low correlation between length of hospital stay, oxygen saturation, and oxygen volume with HADS scores for anxiety and depression. The prevalence of comorbid depression and anxiety was higher in the first days of hospital stay and was not related to patient clinical data, hospital stay, or receipt of invasive mechanical ventilation during their stay.

Keywords: COVID-19, Anxiety, Depression, Hospital Care