Subjective cognitive, psychiatric, and fatigue symptoms two years after COVID-19: A prospective longitudinal cohort study

Abstract

Introduction: COVID-19 survivors may present with cognitive and psychiatric symptoms long after the acute phase of SARS-CoV-2 infection. Objectives: To determine subjective cognitive, psychiatric, and fatigue symptoms two years after COVID-19, and their change from six months to two years. Methods: We assessed three COVID-19 patient groups of different acute disease severity (ICU-treated, ward-treated, home-isolated) concerning subjective cognitive functioning (AB Neuropsychological Assessment Schedule), anxiety (Generalised Anxiety Disorder 7), depression (Patient Health Questionnaire 9), post-traumatic stress (Impact of Event Scale 6), and fatigue (Multidimensional Fatigue Inventory) with a mailed questionnaire approximately two years after acute COVID-19. We compared the results with those obtained six months after the acute disease. We studied whether any change emerged in the scores of symptomatic patients between six- and 24-month follow-ups. Results: Two years post-COVID-19, 58 ICU-treated, 35 ward-treated, and 28 home-isolated patients responded to the questionnaire. Subjective cognitive symptoms and fatigue emerged as the most common problems occurring in 30.6 and 35.5% of patients, respectively. In patients with clinically significant symptoms at six months, symptom scores for depression, anxiety, and post-traumatic stress decreased at two years. Conclusions: Two years after COVID-19, particularly self-reported cognitive symptoms and fatigue remained clinically significant, but also some recovery was evident in depression, anxiety, and post-traumatic stress.