Risk factors of PTSD, depression and anxiety in patients with previous COVID-19 infection: A systematic review and meta-analysis
Ira Maria Ma M. Aquino | Regina Ira Antonette M. Geli | Lindsley L. Go | Jose Ronilo G. Juangco
Abstract:
Introduction Studies showed that those who tested positive for COVID-19 have a 65% risk for a psychiatric
disorder, while those undergoing isolation or quarantine are put at risk for anxiety and depression. The
objective of this study was to appraise studies that determine the risk factors for psychiatric disorder
post-COVID-19 infection.
Methods All cross-sectional and cohort studies from 2019 onwards that had COVID-19 survivors that
developed anxiety, depression and/or post-traumatic stress disorder (PTSD), were included. Medline,
Cochrane Library and ClinicalKey were searched using MeSH terms including “COVID-19”, “depression”,
“anxiety”, “post-traumatic stress disorder”, and “risk factor”. The risk of bias was assessed using the
Newcastle-Ottawa scale. The data extracted from the studies were characteristics of the participants,
risk factors, outcome measures and outcomes.
Results Four cohort and four cross-sectional studies involving 1438 COVID-19 survivors who developed
depression, anxiety and/or depression were included. The risk factors that were statistically significant
were 1) female sex (RR = 1.86; 95% CI 1.06, 2.04; Z = 2.32; p = 0.02) for depression, 2) having family
members infected with COVID-19 (RR = 1.56; 95% CI 1.32, 1.85; Z= 5.17; p = <0.01) for depression,
3) steroid administration during hospital admission (RR = 1.62; 95% CI 1.07, 2.47; Z = 2.26; p = 0.02)
for anxiety and 4) female sex (RR = 2.13; 95% CI 1.16, 3.91; Z = 2.45, p = 0.01) for PTSD.
Conclusion Female sex increases the risk of depression and PTSD. A family history of COVID-19 increases
the risk of depression. Steroid administration is a risk factor for anxiety.
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