Several months after contracting COVID-19, hospitalised patients were found to be psychologically “worse off” than those who did not end up in hospital, a study on the long-term impact of the disease has shown.
This has prompted a call for advance action to be taken to tackle the increasing need of mental health support.
The data, collated by Mater Dei Hospital’s Department of Cardiology in collaboration with the Medicine and Pathology Departments, was based on 2,279 people who had the virus between November 2020 and January 2021.
It showed one in four was still suffering from symptoms months later, with about 22 per cent of former patients saying they felt worse since they contracted the virus.
The figure was described as “impressive” by consultant cardiologist Caroline Magri, who had analysed the data.
It also reveals a “major difference in quality of life”, several months later, between COVID patients who were hospitalised and those who were not. Of the former patients contacted pre-immunisation by junior doctors, 5.2 per cent had been hospitalised – a “very high” rate compared to influenza and other conditions, according to Magri.
The research showed hospitalised patients to be “significantly worse statistically” in terms of general well-being, vitality and how worn out they were at the end of the day, mental health, social and physical function and bodily pain.
“It was the beginning of the pandemic, governed by a greater fear of mortality and its long-term effects. Patients did not know what was going to happen,” Magri explained, adding they were affected by physical and emotional problems.
Impact remained, months later
The fact that hospitalised patients continued to exhibit worse mental health compared to non-hospitalised patients was in keeping with similar studies abroad that also found a high incidence of anxiety and depression, especially if they had been in ITU.
While Magri acknowledged it was to be expected that hospitalised patients were more adversely affected, she pointed out that, at the time of the interviews, five months had already elapsed since they were COVID positive.
“Therefore, it would be expected that the impact of hospitalisation would have declined,” she noted.
Although it was known that SARS-CoV-2 could affect the nervous system, this did not fully explain the high incidence of anxiety and depression noted in the long COVID syndrome.
Apart from the social aspect, which included long periods in isolation, fear of dying and of infecting others, as well as associated financial implications, the exact underlying cause was still not clear.
She urged “thinking in advance regarding the increasing need of mental health support and the provision of appropriate assistance to these patients”.
The follow-up hospital study was conducted to provide a general overview of conditions in the Maltese population, how COVID-19 affected them both physically and psychologically, and how they differed from the rest due to their genetic make-up.
Together with other studies, it attempts to shed light on an as yet relatively unknown virus.
Recent University of Malta research, carried out by Rachel Xuereb for her PhD, has also indicated that complaints months later of shortness of breath in COVID-positive patients were “not just in the mind”.
The smaller study has shown that inflammation and cardiac injury markers were still high in patients five months after contracting the virus, although symptoms tended to improve.