July 31, 2024

expert reaction to study looking at cognitive and psychiatric symptom trajectories 2–3 years after hospital admission for COVID-19

A study published in the Lancet Psychiatry looks at cognitive and psychiatric symptoms after COVID-19 related hospitalisation.

Prof Dame Til Wykes, Head of School of Mental Health and Psychological Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, said:

“This is a large well conducted study of people who agreed to be re-contacted following a hospitalization for Covid-19.  So these individuals would have been those most severely affected by the disease.  All reported some mental health symptoms and/or cognitive difficulties in the two or three years after their admission with about a fifth reported more severe problems and many reporting increased or new symptoms compared to their reports at 6 and 12 months.

“These results are important, but they refer to those who were the most affected by Covid-19.  New treatments that have been introduced, as well as vaccinations, will reduce the numbers of people needing admission and should decrease these after-effects.  But we do need to know how prevalent these problems are in those not admitted but were treated at home as they too might need further support and intervention.

“Long term consequences, especially for thinking skills, have been noted in several reports and of course by the Covid-19 survivors themselves.  This paper quantifies their concerns and points out that we need better interventions to prevent or treat these long term issues.

“We know cognitive problems are associated with loss of employment in general and these Covid-19 patients also report changing jobs due to thinking difficulties not their mental health symptoms.

“There is a lot of evidence that cognitive remediation therapies improve thinking skills even for those with severe mental health problems, like schizophrenia.  Introducing this psychological therapy early should help people develop successful problem-solving skills and achieve their social and employment goals.  Survivors of Covid-19 clearly deserve further clinical interventions focussing on their key long-term problems, this paper shows that they were not imagining them.”

Prof David Curtis, Honorary Professor, UCL, said:

“I think it’s very difficult to decide what this study tells us about the prevalence of problems after infection with COVID because 2,469 volunteers were invited to participate in the study but only 475 actually did so, fewer than 1 in 5.  It is easy to speculate that those who agreed were those who were more likely to have experienced deterioration of their mental health, cognitive function and/or occupational function, whereas people who were now functioning well post-COVID might have been less motivated.  It may well be that some people do experience long-term problems as a result of COVD infection.  But these symptoms are generally common and non-specific so elucidating any precise relationship remains very challenging.”

‘Cognitive and psychiatric symptom trajectories 2–3 years after hospital admission for COVID-19: a longitudinal, prospective cohort study in the UK’ by Maxime Taquet et al. was published in the Lancet Psychiatry at 23:30 UK time on Wednesday 31 July 2024. 

DOI: PIIS2215-0366(24)00214-1/fulltext

Declared interests

Prof Dame Til Wykes: “Professor Dame Til Wykes is an expert in cognitive remediation and has published randomised controlled trials on its effects”

Prof David Curtis: “I have no conflict of interest.”

This Roundup was accompanied by an SMC Briefing.