Pain, fatigue and psychological sequelae in patients surviving COVID-19: results from a prospective observational controlled study

Abstract

Background: Since the beginning of the COVID-19 pandemic, there has been a growing recognition of its psychiatric implications. Anxiety, stress and sleep disorders are the main issues faced by healthcare professionals but less is known on the general population. We sought to determine the prevalence of neuro-psychiatric disorders, pain and fatigue in COVID-19 patients compared to healthy controls. The secondary outcome was to define the determinants of such disorders.

Methods: This single centre, prospective, observational, cohort study enrolled adult patients referring to the post-COVID-19 outpatient clinic of our University hospital from January 2021 to June 2021. Anthropometrical and functional respiratory data were collected, pain and fatigue were evaluated through a VAS scale while stress, anxiety, quality of sleep and the impact of the event were evaluated through questionnaires: perceived stress scale, ZUNG 1971, Pittsburgh and impact of events scale.

Results: 301 cases and 115 controls were enrolled. The COVID-19 group had a higher prevalence of stress (scale points 18 vs 3, p<0.01), anxiety (ZUNG score 39 vs 21, p<0.01), and poor sleep (68.1% vs 6.1%, p<0.01). Alongside they had a significantly higher VAS pain score (2 vs 0, p<0.001) and VAS fatigue (3 vs 0, p<0.001). Female gender was the only feature that could predict fatigue, pain, anxiety, poor sleep quality and post-traumatic stress disorder syndrome. COVID-19 severity wasn't associated with any psichological sequelae.

Conclusions: In an outpatient setting, stress, anxiety, sleep quality, pain and fatigue should be assessed in the holistic view of post-COVID-19 patients, especially in females