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World J Psychiatr. Oct 19, 2021; 11(10): 821-829
Published online Oct 19, 2021. doi: 10.5498/wjp.v11.i10.821
Psychiatric sequelae in COVID-19 survivors: A narrative review
Cynthia Putri, Jessie Arisa, Joshua Edward Hananto, Timotius Ivan Hariyanto, Andree Kurniawan
Cynthia Putri, Jessie Arisa, Joshua Edward Hananto, Timotius Ivan Hariyanto, Faculty of Medicine, Pelita Harapan University, Tangerang 15811, Indonesia
Andree Kurniawan, Department of Internal Medicine, Faculty of Medicine, Pelita Harapan University, Tangerang 15811, Indonesia
Author contributions: All authors contributed to the concept of this study; Putri C, Arisa J, and Hananto JE designed the study; Hariyanto TI and Kurniawan A analyzed the data and wrote the manuscript; Putri C, Arisa J, and Hananto JE approved the final manuscript; All authors reviewed and approved the final draft.
Conflict-of-interest statement: The authors declare that they have no competing interests to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Andree Kurniawan, MD, PhD, FINASIM, Assistant Professor, Vice Dean, Teacher, Department of Internal Medicine, Faculty of Medicine, Pelita Harapan University, Boulevard Jendral Sudirman Street, Karawaci, Tangerang 15811, Indonesia. andree.kurniawan@uph.edu
Received: February 26, 2021
Peer-review started: February 26, 2021
First decision: May 5, 2021
Revised: May 13, 2021
Accepted: August 18, 2021
Article in press: August 18, 2021
Published online: October 19, 2021
Abstract

In December 2019, a novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was initially reported in Wuhan, China. Previous epidemics including SARS and middle east respiratory syndrome raises concern that COVID-19 infection may pose a significant threat to the mental health of affected individuals. Studies and reviews have shown the acute psychiatric manifestations in COVID-19 patients, although long term psychiatric sequelae are predicted, there are only few review studies about the long term psychiatry outcome in COVID-19 survivors. Clinically significant post-traumatic stress disorder, anxiety, and/or depression among COVID-19 survivors during 14-90 d were observed following the diagnosis. Risk of anxiety or depression were higher in patients with more severe illness at 6 mo follow-up, early convalescence, and at 1 mo follow-up. Diagnosis of COVID-19 Led to more first diagnoses and relapses of psychiatric illness during the first 14-90 d after COVID-19 diagnosis. The possible underlying mechanisms of psychiatric sequelae in COVID-19 infection are neurotropism, immune response to SARS-CoV-2, hypothalamo-pituitary-adrenal axis hyperactivity, disrupted neuronal circuits in several brain regions, increased stress levels, neuroinflammation, and neuronal death. This study will review the psychiatric sequelae in previous coronavirus pandemics, current studies, risk factors, and thorough explanation on pathophysiology of the psychiatric sequalae in COVID-19 survivors.

Keywords: Psychiatrics sequelae, Mental disorders, COVID-19, SARS-CoV-2

Core Tip: Studies and reviews have shown the acute psychiatric manifestations in coronavirus disease 2019 (COVID-19) patients, and although long term psychiatric sequelae are predicted, there are only few review studies about the long-term psychiatry outcome in COVID-19 survivors. Clinically significant post-traumatic stress disorder, anxiety, and/or depression among COVID-19 survivors during 14-90 d following the diagnosis. Risk of anxiety or depression were higher in patients with more severe illness at 6 mo follow-up, early convalescence, and at 1 mo follow-up. Diagnosis of COVID-19 Led to more first diagnoses and relapses of psychiatric illness during the first 14-90 d after COVID-19 diagnosis.