This is a plain English summary of an original research article. The views expressed are those of the author(s) and reviewer(s) at the time of publication.
Researchers assessed the long-term mental health and cognitive abilities of people who were hospitalised with COVID-19. Many people, 2 to 3 years after their infection, had:
- thinking problems, equivalent to a loss of 10 IQ points
- depression or anxiety
- fatigue
- shorter working hours or a change of job, usually because of poor health.
The researchers call for more support for people with these problems following hospitalisation for COVID-19.
More information on long COVID can be found on the NHS website.
The issue: can severe COVID-19 infections cause long-term mental health problems?
Up to a year after a COVID-19 infection, people are at increased risk of mental health conditions (including depression and anxiety) and cognitive problems (affecting reasoning, understanding, memory). Risks are greater among people who were hospitalised.
This study investigated whether mental health and cognitive problems persist 2 to 3 years after hospitalisation for COVID-19.
What’s new?
The study included 475 adults who were hospitalised with a COVID-19 infection (between February 2020 and March 2021) and had not been vaccinated. They had all taken part in a previous study exploring the effects of the disease after discharge. Most (60%) were men and their average age was 58 years.
Participants completed online cognitive tests, and reported their symptoms of depression, anxiety and fatigue. They also reported whether they felt they had memory problems, if they had changed job, and why.
The researchers found that 2 – 3 years after being hospitalised with COVID-19:
- participants had worse memory and attention scores than others of similar social, economic and educational background; the average loss (equivalent to 10 IQ points) is likely to make a noticeable difference to their ability to work and interact socially
- most reported at least mild symptoms of depression (75%), anxiety (54%), fatigue (62%), or self-reported memory problems (52%)
- many had severe symptoms of depression (22%), fatigue (25%), or self-reported memory problems (25%)
- many (27%) had changed jobs or reduced their working hours; the most common reason was poor health.
Overall, symptoms of depression, anxiety, and fatigue were more severe at 2–3 years than after 6 or 12 months, and new symptoms appeared. People who had symptoms at 6 months were most likely to report new symptoms at 2–3 years.
Changing jobs was strongly linked with memory and attention problems, whether self-reported or identified by tests.
Why is this important?
Mental health and cognition problems were more severe 2–3 years after hospitalisation for COVID-19, than after 6 months. The researchers suggest that intervening early (after 6 months, for example) might improve long-term mental health and thinking problems in this group.
The researchers suggest that many people may have changed job because they could no longer meet the cognitive demands, rather than because of a lack of energy, interest or confidence. They call for more support for people with cognitive problems following COVID-19.
These findings may not be generalisable to everyone with severe COVID-19. Participants were hospitalised during the first wave of the pandemic and were not vaccinated at the time of the infection. In addition, few (20%) of those invited took part in the study.
What’s next?
The researchers call for further research to develop effective interventions for people with long-term mental health and thinking problems following hospitalisation for COVID-19.
How does this research fit with my current practice?
What else do I need to know?
You may be interested to read
This is a summary of: Taquet M, and others. Cognitive and psychiatric symptom trajectories 2–3 years after hospital admission for COVID-19: a longitudinal, prospective cohort study in the UK. Lancet Psychiatry 2024; 11: 696 – 708.
A podcast about the study on YouTube.
Professional commentary on the study from the Science Media Centre.
Information on taking part in NIHR research on COVID.
Read other NIHR Evidence on long COVID.
Funding: This study was supported by an NIHR/UK Research and Innovation Rapid Response to COVID Initiative grant and the NIHR Oxford Health Biomedical Research Centre.
Conflicts of Interest: Multiple authors have received fees and funding from pharmaceutical companies. See paper for full details.
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