A biopsychosocial analysis of risk factors for persistent physical, cognitive, and psychological symptoms among previously hospitalized post-COVID-19 patients

Abstract

A significant number of COVID-19 survivors continue to experience persistent physical, cognitive, and psychological symptoms up to one year after discharge. This study aimed to examine the frequency, severity, and progression of and risk factors for these symptoms. This single-centre retrospective cohort study included 126 COVID-19 patients admitted to the VieCuri Medical Centre between 2020 and 2022. Follow-up assessments were conducted at 3 and 12 months postdischarge, including pulmonary function tests, CT scans, bioimpedance analysis, and questionnaires on physical, cognitive, and psychological symptoms. At both follow-up assessments, 31-32% of patients reported moderate to severe physical symptoms, 26-27% reported multiple cognitive symptoms, and 14-18% experienced depressive or posttraumatic stress symptoms (PTSSs). Only anxiety symptoms significantly decreased between the 3-month follow-up and the 12-month follow-up (from 22 to 12%; p = .014). The persistence of symptoms at 12 months was significantly associated with premorbid conditions (chronic respiratory disease, multiple comorbidities), illness severity (infection during the third wave), physical factors (COVID-19-related pulmonary abnormalities, lower total lung capacity, and dyspnoea), and cognitive and psychological factors (cognitive symptoms, anxiety, depression, and PTSS) (p < .05). These findings suggest that a significant proportion of COVID-19 survivors continue to experience persistent symptoms due to biopsychosocial factors, thus emphasizing the need for a biopsychosocial approach in early screening and treatment.

Keywords: Anxiety; Cognitive dysfunction; Dyspnoea; Lung diseases; Models, biopsychosocial; Post-acute COVID-19 syndrome.

Fig. 1

Flowchart of the (included) study population.