A review of existing studies of recovered COVID-19 patients, and data on SARS and MERS patients, show that two-thirds of infected patients should survive without symptoms like "confusion," "agitation" or "low mood."
COVID-19 is caused by the new coronavirus, SARS-CoV-2. Both SARS, sudden acute respiratory syndrome, which caused an outbreak in 2002, and MERS, Middle East Respiratory Syndrome, which caused an outbreak in 2012, are also caused by coronaviruses.
Despite the analysis, the researchers emphasize that more studies are needed to assess the true effects of COVID-19 on the mental health of those infected.
"Our analysis ... suggests that most people will not suffer from mental health problems following coronavirus infection," lead author Jonathan Rogers, of University College London, said in a press release.
"While there is little evidence to suggest that common mental illnesses beyond short-term delirium are a feature of COVID-19 infection, clinicians should monitor for the possibility that common mental disorders such as depression, anxiety, fatigue and PTSD could arise in the weeks and months following recovery from severe infection, as has been seen with SARS and MERS," he added.
Nearly 4.8 million people worldwide have been infected with COVID-19, including nearly 1.5 million in the United States, according to the latest figures from Johns Hopkins University.
While the majority of patients will recover, the stress of being affected by the disease can lead to lingering mental health issuse, particularly in those who were seriously ill and required hospital care. Among the potential disorders are depression, anxiety, fatigue and post-traumatic stress disorder, researchers say.
For the analysis, Rogers and his colleagues reviewed data from 65 peer-reviewed studies and seven articles in press that focused on mental health issues associated with SARS, MERS and COVID-19.
Data from two studies that assessed common symptoms of patients admitted to hospital with SARS and MERS collectively found that 28 percent experienced confusion, while 33 percent reported low mood, 36 percent had anxiety, 34 percent suffered from impaired memory and 12 percent reported insomnia, they noted.
Six other studies looking at SARS and MERS patients following initial infection taken together observed that 11 percent reported low mood, 12 percent reported insomnia, 12 percent had anxiety and 19 percent had memory impairment, the authors said. In addition, 30 percent of patients in these studies reported frequent recall of "traumatic memories" for anywhere from six weeks to 39 months after their initial infection.
Meanwhile, 12 studies to date focusing on COVID-19, with data on 3,550 patients, painted a similar picture. Roughly 65 percent of patients in intensive care units experienced confusion, 69 percent displayed agitation and 21 percent had "altered consciousness" -- or awake, but not fully alert -- while acutely ill.
The researchers emphasize, however, that the studies done so far are of "low to moderate quality" and have no data on how patients are faring after recovery.
Based on these findings, the authors of The Lancet Psychiatry paper estimate the prevalence of PTSD among SARS and MERS survivors was 33 percent at an average of 34 months after the acute stage of illness. Rates of depression and anxiety disorders were around 15 percent up to two years after the acute stage.
Because of the similarities in patient mental health with these three coronaviruses, the researchers expect similar levels of PTSD, depression and anxiety among those who recover from COVID-19.
"With few data yet for COVID-19, high quality, peer-reviewed research into psychiatric symptoms of patients infected with SARS-CoV-2 as well as investigations to mitigate these outcomes is needed," Rogers said. "Monitoring for the development of symptoms should be a routine part of the care we provide."