MEDICAL PRACTITIONERS WORLDWIDE should monitor Covid-19 patients for the development of psychiatric symptoms, according to a new study.

The Lancet Psychiatry study – conducted by University College London and King’s College London – examined the mental health effects on 3,500 hospitalised Coronavirus patients, including people with SARS, MERS and Covid-19. 

Since the global pandemic emerged, the full impact of the virus on an infected person’s mental state has yet to be determined. On a wider scale, the impact that Covid-19 restrictions are having on populations at large remains unclear. 

According to the Lancet study, SARS and MERS survivors may be at risk of mental illness including depression, anxiety, fatigue and post-traumatic stress disorder (PTSD).

The medical community should, therefore, be aware of potential impacts Covid-19 may have on a patient’s mental health after treatment. 

Data gathered from two studies of SARS and MERS patients who were hospitalised found that confusion occurred in 28% of patients. 

Low mood was reported in 42% of patients, anxiety in 46% of patients, impaired memory in 34% and insomnia in 12%. 

Looking at Covid-19 patients, 12 studies found evidence of delirium in serious cases. 

Confusion was recorded in 26 out of 40 ICU patients, agitation in 40 out of 58 ICU patients and altered consciousness in 17 out of 82 patients who subsequently died.

The study’s findings suggest that delirium - a mental state characterised by changes in consciousness, behavioural disturbance, and sometimes hallucinations - may be common in hospitalised patients in the acute stages of SARS, MERS and Covid-19. 

The authors have cautioned, however, against drawing definitive conclusions given limitations in methodology and small sample sizes of studies recorded. 

• Our colleagues at Noteworthy are hoping to investigate the measures being taken to tackle a pandemic-induced mental health crisis in Ireland. You can help fund them here. 

If patterns observed in SARS and MERS patients follow a similar course in Covid-19 patients, the study concludes, most Covid-19 patients should recover without experiencing mental illness. 

The 3,500 cases studied suggest that most people won’t suffer from mental health issues, Dr Jonathan Rogers from University College London, UK, who co-led the research said. 

There is little evidence to suggest that common mental illnesses beyond short-term delirium are a feature of Covid-19 infection, Dr Rogers added. 

However, “clinicians should monitor for the possibility that common mental disorders such as depression, anxiety, fatigue, and PTSD could arise in the weeks and months following recovery from severe infection, as has been seen with SARS and MERS,” he said. 

‘Exercise’ 

Aside from medical and immune responses leading to psychiatric issues in Covid-19 patients, the Lancet study also suggests that a wider social impact of Covid-19 – including social isolation and stigma – may lead to mental health problems. 

Separately, researchers in Ireland are trying to pin down the barriers which may be preventing people from exercising more during Covid-19. 

An ongoing survey conducted at Trinity College Dublin shows that 50% of people are exercising more than they used to during Covid-19. 

Data was gathered by Trinity researchers from 1,500 people across Ireland. Most responses came after Government restrictions eased slightly on the 5 of May, enabling people to exercise within a 5 km radius of their homes.

“People haven’t let the closure of gyms, classes or the 5 km distance restriction limit their ability to exercise and are finding new ways to be active,” said Dr Emer Barrett, Assistant Professor in Physiotherapy at Trinity College Dublin. 

“It is very encouraging to see that there is a strong awareness of how physical activity can positively impact mental and physical health particularly at this time of crisis,” Dr Barrett added. 

“We need to understand the factors that have facilitated or motivated this increase in activity with a view to maintaining them once restrictions are lifted,” she said. 

The Trinity study found that 46% of people surveyed felt they were exercising more since Covid-19 restrictions with 28% of people reporting the opposite. 

According to the survey, 54% of people surveyed are now meeting the daily amount of physical exercise recommended in Ireland - 30 minutes moderate intensity physical activity five days per week. 

Of the 1,500 surveyed by Trinity, almost 90% of people reported walking in the last seven days, 50% have found new ways to be active since Covid-19 restrictions and over 90% also said they were physically active because it benefited their mental and physical health.

The main barrier to exercise, according to the survey, was a person’s usual means of working out being unavailable to them, with 20% of people saying being unable to meet friends was key. 

Dr Barrett and her colleague Dr Cuisle Forde say that, following the survey closing on Wednesday, their research will focus on the barriers which have prevented people from exercising more. 

“Our research will allow us to identify whether the decline in their activity is as a result of cocooning, work commitments, or caring for children or dependant others,” said Dr Forde. 

Dr Barrett and Dr Forde said that they hope that over the coming days more men and older people will submit answers to their survey to get a better picture from these two cohorts.