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Health Services Research & Development

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Mental health outcomes of adults hospitalized for COVID-19: A living rapid review

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Prepared by:
Evidence Synthesis Program (ESP) Coordinating Center
Portland VA Health Care System
Portland, OR
Mark Helfand, MD, MPH, MS, Director

Recommended Citation:
Veazie S, LaFavor B, Vela K, Young S, Sayer N. A, Carlson K, O'Neil M. Evidence Brief: Mental Health Outcomes of Adults Hospitalized for COVID-19. Washington, DC: Evidence Synthesis Program, Health Services Research and Development Service, Office of Research and Development, Department of Veterans Affairs. VA ESP Project #09-199; Jul 2021.


Download PDF: Rapid review, Supplemental Materials, Evidence Snapshot

Takeaway

In this rapid review, investigators conclude that while many patients experience mental health (MH) symptoms such as depression, anxiety, and insomnia during and 3 months after hospitalization for COVID-19, patients infrequently receive a new MH disorder diagnosis 6 months after hospitalization. These conclusions are based on the best available evidence: 17 mostly fair-quality studies (2 prospective cohort, 2 retrospective cohort, and 13 cross-sectional) that enrolled > 200 participants.

Context

People who have been hospitalized for COVID-19 may be at high risk of mental health issues due to the stress of being hospitalized for a serious, highly transmissible illness during a pandemic. This rapid review compares the prevalence of mental health disorders among adults who have been hospitalized for COVID-19 to relevant comparison groups, assesses whether the prevalence varies by patient and disease characteristics, and ascertains patients' mental health care and resource needs.

Key Findings

The best available evidence indicates a high proportion of patients with COVID-19 experience MH symptoms during and 3 months after hospitalization (30-39% may experience anxiety symptoms, 24-40% insomnia symptoms, 20-26% obsessive-compulsive symptoms, and 10-15% PTSD symptoms). Estimates of depression prevalence vary widely across studies (9-66%) due to differences in symptom measurement and reporting methods. By contrast, a low proportion of COVID-19 survivors receive new MH disorder diagnoses in the 6 months after hospitalization (5% of patients will likely be diagnosed with a new mood disorder, 7% anxiety disorder, 3% insomnia, 2% substance use disorder, and 1% psychotic disorder). Some patients, such as women and those with severe COVID-19, may be at higher risk of poor MH outcomes than men or people with mild to moderate COVID-19. Future research should compare patients hospitalized for COVID-19 to those hospitalized for other reasons and evaluate mental health treatment utilization and resource needs following hospitalization.


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