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. 2021 Sep 30;144:129–137. doi: 10.1016/j.jpsychires.2021.09.054

Table 2.

Summaries of included publications.

Study Design Population Age Time of assessment Location Diagnostic Tool Findings
Mazza et al. (2021) Uncontrolled observational study 226 patients (67% hospitalized)
66% male
Mean = 58.5
SD = 12.8
Range: 26-87
Mean of 90 days post discharge or ED evaluation (SD = 13.4), previous assessment at one-month follow-up Milan,
Italy
DSM-5, BDI-13, ZSDS Frequency:
  • 8.9% of patients diagnosed with clinically-significant depression (DSM-5), same result with BDI-13 (≥9).

  • 28% of patients with depressed mood based on ZSDS (≥50).

Factors:
  • Female sex (Wilks' λ = 0.92, F = 5.76, p = 0.003), previous psychiatric history (Wilks' λ = 0.93, F = 5.29, p = 0.006), and psychopathology at one-month follow-up (Wilks' λ = 0.82; F = 15.16; p < 0.001) were predictors of depression at three-month follow-up in a multivariate analysis.

  • No effect of age on self-reported depression scores.

  • Length of hospital stay is inversely correlated with ZSDS (r = −0.23, p = 0.005, q = 0.01) and BDI-13 scores (r = −0.21, p = 0.010, q = 0.015).

  • Baseline systemic immune-inflammation index (SII) (ZSDS: χ2 = 42.417, p < 0.0001; BDI-13: χ2 = 56.536, p < 0.0001) and changes of SII (ZSDS: Wald W2 = 6.881, p = 0.0087; BDI-13: Wald W2 = 14.304, p = 0.0002) were predictors of depression and changes of depression at three-month follow-up.

Other findings:
  • Persistent depressive symptoms from one-month follow-up to three-month follow-up, in contrast with significant decrease of PTSD symptoms, anxiety and insomnia.

  • Depression had a significant effect on neurocognitive functioning and ZSDS scores specifically predicted performance in selective attention and processing speed (Wald = 8.37, p = 0.003).

Mattioli et al. (2021) Prospective cohort study 120 patients with mild-moderate COVID-19 (2% hospitalized), health care workers
30 controls, matched for age, sex and main comorbidities, health care workers
25% male
Mean = 47.9
Range: 26-65
Mean of 126 days from diagnosis (Range: 12–215) Brescia, Italy DASS-21 Frequency:
  • DASS-21 depression scores were significantly higher in COVID-19 subjects than in controls (x̅ = 3 vs. x̅ = 1, p = 0.036).

Other findings:
  • DASS-21 depression scores significantly influenced many neuropsychological test scores: MMSE (β = −0.039, p = 0.007) CVLT immediate recall (β = −0.432, p = 0.016), TEA visual RT (β = 6.298, p = 0.007), TOL (β = −0.149, p = 0.008), Rey figure copy and recall (β = −0.096, p = 0.044).

Rass et al. (2021) Uncontrolled observational study 98 out of 135 patients (23% required ICU care, 53% were admitted to the regular ward, 24% were outpatients)
61% male
Median = 56
IQR: 48-68
Range: 19-87
Median of 102 days from diagnosis (IQR: 91–110) Tyrol, Austria HADS-D Frequency:
  • 11% of patients with depressive symptoms:
    • o 7% with mild depressive symptoms (HADS-D score >7)
    • o 3% with clinically-significant depression (HADS-D score >10)
Factors:
  • Severity of the disease does not significantly influence the frequency of depressive symptoms at 3-month follow-up.

González et al. (2021) Uncontrolled observational study 59 of 62 patients who required ICU admission for ARDS secondary to COVID-19
74.2% male
Mean = 60
Range: 48-65
3 months after hospital discharge Lleida, Spain HADS-D Frequency:
  • 15.2% of patients with depressive symptoms:

o 10.2% with borderline abnormal scores (HADS-D score >7 and ≤ 10)
o 5.0% with clinically-significant depression (HADS-D score >10)
Morin et al. (2021) Uncontrolled observational study 170 out of 177 hospitalized patients (54.8% required ICU care)
62% male
Mean = 56.9
SD = 13.2
Median of 125 days after hospital discharge (IQR: 94–128) Paris region, France BDI-13 Frequency:
  • 20.6% of patients with depressive symptoms (BDI-13 > 7), notably 18.1% of ICU patients.

  • Depressive symptoms observed in 18.0% of intubated patients and in 21.7% of non-intubated patients.

  • 30.8% of patients ≥75 yr with depressive symptoms vs 19.7% of patients <75 yr.

van den Borst et al. (2020) Uncontrolled observational study 124 patients (16.1% with critical disease, 20.9% with severe disease, 41.1% with moderate disease, 21.7% with mild disease)
60% male
Mean = 59
SD = 14
Mean of 13.0 weeks after onset of symptoms (SD = 2.2)
Mean of 9.1 weeks after discharge for hospitalized patients (SD = 1.6)
Nijmegen, Netherlands HADS-D Frequency:
  • 12% of patients with clinically-significant depression (HADS-D > 10), notably 22% of patients with mild disease and 10% of patients with critical disease.

Factors:
  • Severity of the disease does not significantly influence the frequency of depression at 13-week follow-up.

Frontera et al. (2021) Prospective cohort study 136 of 196 patients with neurological complications during hospitalization for COVID-19
143 of 186 COVID-19 controls, matched for age, sex, race/ethnicity, and intubation status
65% male
Median = 68
IQR: 55-77
Median of 6.7 months from neurological symptom onset (or COVID-19 symptom in controls)
(IQR: 6.5–6.8)
New York, USA Neuro-QoL Frequency:
  • 29% of patients with neurological complications scored worse than average on depression section of Neuro-QoL (T score >50)

  • 22% of COVID-19 controls scored worse than average on depression section of Neuro-QoL (T score >50)

Factors:
  • No significant difference between both groups.

Daher et al. (2021) Uncontrolled observational study 18 patients who required ICU admission for ARDS secondary to COVID-19
61% male
Mean = 61
SD = 7
Mean of 197 days after hospital discharge (SD = 15) Aachen, Germany PHQ-9 Frequency:
  • 27% of patients with moderate to severe depressive symptoms (PHQ-9 > 9), all with type L pneumonia (less severe cases than patients with type H pneumonia):
    • o 22% with moderate depressive symptoms (PHQ-9 > 9 and ≤ 14)
    • o 5% with severe depressive symptoms (PHQ-9 > 14)
Factors:
  • No significant difference in depression scores of patients with type H or L pneumonia.

DSM-V, Diagnostic and Statistical Manual of Mental Disorders; BDI-13, 13-items Beck's Depression Inventory; ZSDS, Zung Self-rating Depression Scale; DASS-21, Depression, Anxiety and Stress Scale; HADS-D, Hospital Anxiety and Depression Scale - Depression; Neuro-QoL, Quality of Life in Neurological Disorders; PHQ-9, Patient Health Questionnaire; MMSE, Mini–Mental State Examination; CVLT immediate recall, California Verbal Learning Test immediate recall for verbal memory; TEA visual RT, visual reaction times section of the TEA attention test; TOL, Tower of London test for executive abilities.