One in every five Covid-19 survivors are showing symptoms including fatigue, cognitive problems and a range of psychiatric problems, a research review led by Oxford Brookes University has noted. It also painted a gloomy picture for the future, warning that more number of people will be affected by neuropsychiatric and cognitive complications.
The study has come close on the heels of similar observation from the World Health Organization (WHO) officials who recently noted that the ongoing Coronavirus pandemic has caused more “mass trauma” than World War II.
The observation hold importance in the context of India where more number of people with mental health disorder could pose further burden on the already patchy mental health care system. One in seven people or a total of 197.3 million people live with mental illness in India, according to the 2019 Global Burden of Disease Study.
Psychologists at Oxford Brookes University and a psychiatrist from Oxford Health NHS Foundation Trust, had evaluated published research papers in order to understand more about the possible effects of the SARS-COV-2 infection on the brain, and the extent people can expect to experience short and long-term mental health issues.
The study found that in the short-term, a wide range of neuropsychiatric problems were reported. In one examined study, 95 per cent of clinically stable Covid-19 patients had post-traumatic stress disorder (PTSD) and other studies found between 17-42 per cent of patients experienced affective disorders, such as depression.
The main short-term cognitive problems were found to be impaired attention (reported by 45 per cent patients) and impaired memory (between 13-28 per cent of patients) while in the long-term, neuropsychiatric problems were mostly affective disorders and fatigue, as well as impaired attention (reported by 44 per cent of patients) and memory (reported between 28-50 per cent of patients).
Dr Sanjay Kumar, senior lecturer in Psychology at Oxford Brookes University said: “Understanding the neuropsychiatric and cognitive consequences of Covid-19 is important as millions of people have been affected by the virus, and many cases go undetected.
“These conditions affect people’s capacity to work effectively, drive, manage finances, make informed decisions and participate in daily family activities.”If even just a fraction of patients experience neuropsychiatric complications, the impact on public health services could be significant.”
Academics say that there is likely to be an increase in patients with psychiatric and cognitive problems who were otherwise healthy prior to COVID-19 infection.
“Detailed cognitive evaluation and robust monitoring of patients should be considered in order to detect new neurological cases,” Dr Kumar continued adding that “This will also enable health care providers to plan adequate health care and resources, and improve the quality of life for many Covid-19 survivors.
Co-author Dr Tina Malhotra, Consultant Psychiatrist working in Oxford Health NHS Foundation Trust said: “We are already seeing an impact of Covid-19 on mental health. Patients are presenting with Long Covid syndrome which includes fatigue, cognitive problems and a range of psychiatric problems.
“It is estimated that these problems are experienced by 1 in 5 people who have had COVID. Management of such patients in long-Covid clinics should involve a multidisciplinary team including psychiatrists.
“The world has experienced mass trauma because World War II affected many, many lives,” WHO Director-General Tedros Adhanom Ghebreyesus said recently. The WHO chief added that the pandemic-induced mass trauma is “beyond proportion and even bigger than what the world experienced” after the Second World War.
According to a 2017 profile of India by the World Health Organization, per 100,000 people, India has approximately 0.29 psychiatrists, 0.07 clinical psychologists, 0.06 social workers and 0.80 nurses, a poor doctor-patient ratio. The future is not encouraging in the sector.
“Even if we keep the population growth rates and attrition rates of psychiatrists at 0 per cent, we require 2700 new psychiatrists annually to fill in the gap in the next 10 years. However, every year only 700 psychiatrists are trained in PG seats, said Dr Kabir Garg, Dr Prabha S Chandra and Dr C Naveen Kumar Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka in their study ‘Number of psychiatrists in India: Baby steps forward, but a long way to go’ published in Indian Journal of Psychiatry in 2019.