A new study published in Lancet Psychiatry reveals that many individuals who were hospitalized with COVID-19 continue to experience cognitive and psychiatric problems up to three years after infection. Conducted by researchers across the UK, led by the University of Oxford and the University of Leicester, the study highlights the persistent and significant nature of these symptoms, as well as the emergence of new symptoms years after the initial infection.
KEY FINDINGS OF THE STUDY
The study involved 475 participants from the PHOSP-COVID study, who completed cognitive tests and reported symptoms of depression, anxiety, fatigue, and subjective memory problems. The researchers found:
- Cognitive Deficits: Participants scored significantly lower in cognitive tests, with an average deficit equivalent to 10 IQ points.
- Psychiatric Symptoms: Approximately 1 in 5 participants reported severe depression, 1 in 8 reported anxiety, 1 in 4 reported fatigue, and 1 in 4 reported subjective memory problems. These symptoms worsened over time.
- Emergence of New Symptoms: Some participants developed new symptoms 2-3 years post-infection, often emerging in individuals who already had symptoms six months post-infection.
- Occupation Changes: More than one in four participants reported changing their occupation, often due to cognitive deficits rather than depression or anxiety.
EARLY SYMPTOMS AS PREDICTORS
The study suggests that early symptoms can predict later, more severe issues, underscoring the importance of timely management. The degree of recovery at six months post-COVID-19 is a strong predictor of longer-term psychiatric and cognitive outcomes.
IMPLICATIONS FOR HEALTH AND EMPLOYMENT
Dr. Maxime Taquet, NIHR Academic Clinical Lecturer at the University of Oxford, emphasized the importance of understanding the burden of long-term brain symptoms for policymakers and clinicians. The study indicates that cognitive deficits rather than lack of energy or interest are driving occupation changes post-COVID-19, affecting people’s ability to meet job demands.
NEED FOR FURTHER RESEARCH AND INTERVENTIONS
Professor Paul Harrison, Professor of Psychiatry at the University of Oxford, and Professor Chris Brightling, Clinical Professor of Respiratory Medicine at the University of Leicester, both stress the need for more research to develop effective interventions. Understanding the biological mechanisms driving these symptoms and identifying therapeutic strategies to promote cognitive recovery or prevent further decline are crucial next steps.
STUDY LIMITATIONS
The study sample consisted of individuals hospitalized during the first wave of the pandemic, who were not vaccinated at the time of infection and only 20% of those invited consented to follow-up assessments. Thus, the findings may not be generalizable to those who were not hospitalized or who were vaccinated.
PHOSP-COVID CONSORTIUM
PHOSP-COVID is a consortium of scientists across the UK researching long-term health outcomes for patients hospitalized with COVID-19. The study was funded by MQ Mental Health Research and the Wolfson Foundation, supported by the NIHR Biomedical Research Centres in Leicester and Oxford Health.
The paper “Cognitive and psychiatric symptom trajectories 2-3 years post-COVID-19 hospitalization: a longitudinal prospective cohort study” is published in Lancet Psychiatry.
This study underscores the significant and persistent cognitive and psychiatric issues faced by individuals hospitalized with COVID-19, highlighting the need for continued research and targeted interventions to improve long-term recovery outcomes.
