Health care social workers are reporting an uptick in patients complaining of persistent symptoms after recovering from a bout with COVID-19. Social media has already named these unconfirmed diagnoses Long Covid, and the public is beginning to take their own pulse and check fitness stats on their iPhones and Fitbits. Social workers tell us it is too early to scientifically ascertain whether these reported symptoms are an unexpected permanent consequence of the SARS-CoV-2 infection or if the symptoms are a variety of the immediate consequences of COVID-19.

A Preliminary Observational Study

A comprehensive assessment of the mental health manifestations in people with COVID-19 at one year has not yet been undertaken. However, preliminary studies indicate that COVID-19 is associated with an increased risk of mental health disorders, including anxiety, depression, substance use, and sleep disorders, up to one year after initial infection. 

Social workers used data from the VA national health care databases to estimate the risks of mental health outcomes in people who survived at least 30 days after a positive polymerase chain reaction test result between March 2020 and January 2021. They identified data for 153,848 individuals and matched them to two control groups without COVID-19: 5,637,840 contemporary controls and 5,859,251 historical controls who predated the pandemic.

• Compared with the non-infected control group, people with COVID-19 showed a 60% higher risk of any mental health diagnosis or prescription at one year (equivalent to an additional 64 per 1,000 people). 
• COVID-19 was associated with an additional 24 per 1,000 people with sleep disorders at one year.
• 15 per 1,000 with depressive disorders.
• 11 per 1,000 with neurocognitive decline.
• 4 per 1,000 with any (non-opioid) substance use disorders. 

British Medical Journal Reports

At the same time U.S. researchers were looking into reports of Long COVID, British researchers conducted a longitudinal population-based study. They summarized their findings like this: "Symptoms of anxiety and depression were marked but often transient, increasing during lockdowns and subsiding afterwards to pre-pandemic levels. Nevertheless, around 10% of the population experienced persistent distress, with women, 18–30-year-olds, people with pre-existing mental or physical health problems, those living in deprived areas, and ethnic minority communities most affected. What have we learnt? Time, money, and scarce research expertise have been devoted to showing, again and on a societal scale, that threat makes people anxious but diminishes for most people when the danger passes."

Research Conclusion

What do these studies tell us?

• Both report significant and consistent but modest associations between SARS-CoV-2 infection and increased rates of psychiatric disorders. 
• Although some symptoms seem to persist for at least 12 months, the absolute risk of experiencing a psychiatric disorder decreases sharply after the first month.
• We do not yet know the true incidence and consequences of long covid, and we are still witnessing the unfolding toll of the pandemic on healthcare staff.
• We do not have an effective response to the devastating disruption to health, social care, and voluntary sector services on the lives of people with serious mental illness.  

The Bottom Line So Far

Social workers say their findings suggest that people who survive the acute phase of COVID-19 are at increased risk of an array of incident mental health disorders and that tackling mental health disorders among survivors of COVID-19 should be a priority. "If you're experiencing any of the following symptoms, come in and see a Healthcare social worker and have your case evaluated for a more complete diagnosis," a healthcare social worker we interviewed suggested.

Neurological symptoms:

• Difficulty thinking or concentrating (sometimes referred to as “brain fog”)
• Headache
• Sleep problems
• Dizziness when you stand up (lightheadedness)
• Pins-and-needles feelings
• Change in smell or taste
• Depression or anxiety

"Our understanding of the long-term health implications of COVID-19 infection is still in the preliminary stage. As time passes and more cases are evaluated, we will be able to more accurately assess the long-term impact and offer therapeutic guidance. It is much too early to panic."

What others are reading on the FAMCare Blog:

Where Have All the Flowers Gone...

The Art and Science of Social Work

Veterans Still Serving