Mental well-being of Tunisian COVID-19 survivors: a cohort study

TL;DR

This study shows that Tunisian survivors of COVID-19 experience long-term mental health issues and reduced quality of life months after recovery.

Contribution

The study provides new evidence on the long-term mental health effects of COVID-19 in a Tunisian cohort.

Findings

Depressive symptoms increased 10-fold in survivors six to nine months post-discharge.

Quality of life significantly declined across multiple dimensions after recovery.

Depressive symptoms were strongly correlated with reduced quality of life scores.

Abstract

COVID-19 affected humankind worldwide in different aspects of life. Survivors still report the effects of the pandemic on daily life, physical health, and mental health.

To assess effects of the pandemic on the mood and the quality of life of the survivors.

We conducted a prospective cohort study including 121 Tunisian COVID-19 inpatients who had been discharged alive from hospital. Each enrolled patient was asked about the period before the hospital stay, and the 6-9 month-period after hospital discharge, using several scales: the validated Arabic version of “Patient Health Questionnaire” (PHQ-9) to screen for depressive symptoms, and “EuroQol five-dimension three-level” (EQ-5D-3L) to assess the quality of life.

The median age of participants was 59 years, with extreme values ranging from 18 to 80. Among them, 51.2% were females. As compared with baseline statue of patients, the depressive dimension assessed through PHQ was significantly impaired (7.05 vs 1.12; p<0.001). The different dimensions of the EQ-5D-3L showed significant deterioration in mean scores (mobility:1.09 vs 1.31, p<0.001;  selfcare:1 vs 1.11, p=0.001; daily activities:1.09 vs 1.49, p<0.001; pain and disturbance: 1.17 vs1.49, p<0.0005 and anxiety and depression: 1.07 vs 1.57, p<0.001). Depressive symptoms were 10 times more frequent in post-COVID (57.9% vs 5.7%). The post-COVID PHQ-9 score was correlated with the post-COVID EQ-5D-3L score (p=0.033).

This study points out the long-term impact of the COVID infection. Therefore, the clinician should screen for possible psychological distress even after resolution of the disease, in order to guarantee a better quality of life.

None Declared