Neuropsychiatric symptoms may worsen over time in COVID-19 survivors

Scientists are learning more about the long-term neuropsychiatric symptoms associated with SARS-CoV-2 infection. New findings from researchers at Columbia University provide preliminary evidence that depression, insomnia, and trauma-related symptoms might grow worse over time.

Previous research, which examined the electronic health records of 236,379 patients, had found that one in three COVID-19 survivors were diagnosed with a neurological or psychiatric condition within six months of infection, with anxiety and mood disorders being the most common.

In the new longitudinal research, published in Brain, Behavior, & Immunity – Health, scientists examined how neuropsychiatric symptoms evolved over time within a small cohort of COVID-19 survivors.

“Research continues to show that many survivors of COVID-19 experience lasting neuropsychiatric symptoms,” explained lead researcher Evan J. Kyzar, a resident physician in psychiatry and Leon Levy Fellow in Neuroscience at Columbia University and the New York State Psychiatric Institute.

“We were interested determining which specific psychiatric symptoms might persist after COVID-19 at long-term follow-up, which in our study ranged from about 6 months to over a year in some participants. Collecting data of this type might allow for providers to screen COVID-19 survivors for lasting symptoms and provide more focused follow-up care.”

The researchers recruited participants from the greater New York City area between April 15th, 2020, and February 23rd, 2021. The participants completed medical and psychiatric questionnaires online, and also visited a laboratory for physical examinations. They completed follow-up surveys at 24 to 60 weeks after initial enrollment. The analysis included 52 people who had a confirmed COVID-19 infection and filled out both baseline and follow-up surveys.

“We found relatively high rates of insomnia, depressive-like symptoms, and trauma-related symptoms at long-term follow-up (at least 24 weeks after initial infection) in COVID-19 survivors recruited from our medical center,” Kyzar told PsyPost. “Interestingly, questionnaire scores at follow-up showed that trauma- and PTSD-related symptoms appear to be getting worse when compared to when participants were initially enrolled in our study.”

The new study lacked a control group and did not control for some important socioeconomic factors, leaving it unclear whether the observed changes in symptoms were the result of COVID-19. But the findings are in line with a similar study, which examined trauma-related symptoms in COVID-19 survivors in Wuhan, China, and included a control group.

“While our studies should be considered preliminary, there is converging evidence from other research groups that PTSD-related symptoms are prominent in COVID-19 survivors,” Kyzar said. “Determining what risk factors may contribute to lasting neuropsychiatric symptoms after COVID-19 infection, as well as probing the neurobiological mechanisms that might be involved, are critical questions for further research.”

The study, “Anxiety, depression, insomnia, and trauma-related symptoms following COVID-19 infection at long-term follow-up“, was authored by Evan J. Kyzar, Lawrence J. Purpura, Jayesh Shah, Anyelina Cantos, Anna S. Nordvig, and Michael T. Yin.