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Clinical Consequences of COVID-19: 2nd Edition

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Epidemiology & Public Health".

Deadline for manuscript submissions: 30 January 2025 | Viewed by 13579

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Special Issue Editors

Dr. Francesco Alessandri

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Department of General Surgery and Organ Transplantation Unit, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Interests: intensive care medicine; ECCO2R; delirium; ultrasound; COVID-19; polytrauma
Special Issues, Collections and Topics in MDPI journals

Dr. Francesco Pugliese

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Department of General Surgery and Organ Transplantation Unit, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Interests: intensive care medicine; lung-kidney-liver transplants; ECMO; COVID-19
Special Issues, Collections and Topics in MDPI journals

Dr. Giovanni Giordano

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Department of General Surgery and Organ Transplantation Unit, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
Interests: critical care; intensive care medicine; anesthesiology; ecmo; extracorporeal
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleauges,

In 2019, the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) caused a global pandemic, representing a major public health crisis. SARS-CoV-2 can infect all age groups, regardless of gender, ethnicity, and general health status. Direct contact, as well as aerosol and droplet transmission, are the three main routes of SARS-CoV-2 transmission. Although the pulmonary system is its primary entry site, several non-respiratory clinical symptoms, alongside cumulating anatomical evidence, have demonstrated the virus’s potential to invade multiple organs throughout the body, including the nervous system. There is wide consensus that the COVID-19 pandemic affected not only physical health but also mental health and wellbeing. As COVID-19 was a novel disease, much understanding of its clinical course and possible long-term health consequences remains uncertain.

Given the enormous success of the First Edition of this Special Issue of JCM (https://www.mdpi.com/journal/jcm/special_issues/Clinical_Consequences_COVID), we believe that it is time to launch the Second Edition, collecting additional insights into long COVID-19 and the post-COVID world. The Second Edition is keen to attract a global audience, welcoming contributions on this subject from researchers around the world.

Dr. Francesco Alessandri
Dr. Francesco Pugliese
Dr. Giovanni Giordano
Guest Editors

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Keywords

COVID-19
long COVID-19
SARS-CoV-2
mental health
COVID-19 health consequences

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9 pages, 1402 KiB

Open AccessArticle

Changes in the Epidemiology of Thoracic and Cardiovascular Diseases in Korea During the COVID-19 Pandemic: A Nationwide Analysis

by Jung Ho Park, Hong Kyu Lee, Hyoung Soo Kim, Kunil Kim, Yong Joon Ra and Jeong Wook Kang

J. Clin. Med. 2024, 13(23), 7059; https://doi.org/10.3390/jcm13237059 - 22 Nov 2024

Abstract

Background/Objectives: There is limited evidence regarding the impact of the coronavirus disease 2019 (COVID-19) pandemic on the epidemiology of thoracic and cardiovascular diseases. This study aimed to investigate changes in medical visits for these conditions during the COVID-19 pandemic. Methods: We analyzed the entire Korean population (~50 million) for monthly medical visits for 15 common thoracic and cardiovascular conditions, including pneumothorax, large bullae, lung cancer, esophageal cancer, thymoma, empyema, mediastinitis, esophageal rupture, multiple rib fractures, hemothorax, rib mass, varicose vein, pectus excavatum, aortic dissection, aortic aneurysm, and valve disease from January 2019 to December 2021. Data were obtained from the Korean National Health Insurance Service using the International Classification of Disease (ICD)-10 codes. Variations in the mean monthly medical visits of 15 frequent thoracic and cardiovascular diseases before and during the COVID-19 pandemic were compared using the Mann–Whitney U test, while changes in variance were assessed using Levene’s test. Results: The mean monthly number of medical visits for pneumothorax and large bullae significantly decreased during the COVID-19 pandemic compared to before the pandemic (by 10.1% and 12.8%; both p < 0.001). On the contrary, there was a significant increase in the mean monthly counts of medical visits for lung cancer, esophageal cancer, thymoma, and valve disease diagnosis (by 6.6%, 5.3%, 8.8%, and 5.0%, respectively; all p < 0.05). Conclusions: In Korea, the number of diagnosed cases of pneumothorax significantly decreased during the COVID-19 pandemic compared to before COVID-19, while diagnoses of thoracic cancers and valve disease increased. Full article

(This article belongs to the Special Issue Clinical Consequences of COVID-19: 2nd Edition)

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24 pages, 2587 KiB

Open AccessArticle

Demyelination in Patients with POST-COVID Depression

by Marina Khodanovich, Mikhail Svetlik, Daria Kamaeva, Anna Usova, Marina Kudabaeva, Tatyana Anan’ina, Irina Vasserlauf, Valentina Pashkevich, Marina Moshkina, Victoria Obukhovskaya, Nadezhda Kataeva, Anastasia Levina, Yana Tumentceva, Svetlana Vasilieva, Evgeny Schastnyy and Anna Naumova

J. Clin. Med. 2024, 13(16), 4692; https://doi.org/10.3390/jcm13164692 - 9 Aug 2024

Cited by 1 | Viewed by 756

Abstract

Background: Depression is one of the most severe sequelae of COVID-19, with major depressive disorder often characterized by disruption in white matter (WM) connectivity stemming from changes in brain myelination. This study aimed to quantitatively assess brain myelination in clinically diagnosed post-COVID depression (PCD) using the recently proposed MRI method, macromolecular proton fraction (MPF) mapping. Methods: The study involved 63 recovered COVID-19 patients (52 mild, 11 moderate, and 2 severe) at 13.5 ± 10.0 months post-recovery, with matched controls without prior COVID-19 history (n = 19). A post-COVID depression group (PCD, n = 25) was identified based on psychiatric diagnosis, while a comparison group (noPCD, n = 38) included participants with neurological COVID-19 complications, excluding clinical depression. Results: Fast MPF mapping revealed extensive demyelination in PCD patients, particularly in juxtacortical WM (predominantly occipital lobe and medial surface), WM tracts (inferior fronto-occipital fasciculus (IFOF), posterior thalamic radiation, external capsule, sagittal stratum, tapetum), and grey matter (GM) structures (hippocampus, putamen, globus pallidus, and amygdala). The noPCD group also displayed notable demyelination, but with less magnitude and propagation. Multiple regression analysis highlighted IFOF demyelination as the primary predictor of Hamilton scores, PCD presence, and severity. The number of post-COVID symptoms was a significant predictor of PCD presence, while the number of acute symptoms was a significant predictor of PCD severity. Conclusions: This study, for the first time, reveals extensive demyelination in numerous WM and GM structures in PCD, outlining IFOF demyelination as a key biomarker. Full article

(This article belongs to the Special Issue Clinical Consequences of COVID-19: 2nd Edition)

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12 pages, 2668 KiB

Open AccessArticle

Does the Fear of COVID-19 Impact on Menopausal Symptoms in Women? A Research Investigation

by Nurseli Soylu Erener, Salime Mucuk and Fulya Çağlı

J. Clin. Med. 2024, 13(15), 4576; https://doi.org/10.3390/jcm13154576 - 5 Aug 2024

Viewed by 972

Abstract

Objectives: This study aimed to determine the relationship between the fear of COVID-19 and menopausal symptoms in women during the menopausal period. Methods: This study is a descriptive cross-sectional study. This study was completed with a total of 161 women who met the inclusion criteria. Data were collected face-to-face using the Personnel Information Form, Menopause Symptom Assessment Scale, and Coronavirus 19 Phobia Scale. Results: There is a slightly positive relationship between the social subscale of the COVID-19 fear scale and the somatic subscale of the menopause symptoms scale. There is a slightly positive relationship between the economic subscale of the COVID-19 scale and the psychological subscale of the menopausal symptoms scale. There is a slightly positive correlation between the total score of the total COVID-19 phobia scale and the somatic and psychological subscales of the menopause symptoms assessment scale. However, there is no significant relationship between the total score of the COVID-19 phobia scale and the total score and urological subscale of the menopause symptoms assessment scale. Conclusions: It has been determined that fear of COVID-19 is slightly positively associated with somatic and psychological complaints in menopausal women. Full article

(This article belongs to the Special Issue Clinical Consequences of COVID-19: 2nd Edition)

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9 pages, 199 KiB

Open AccessArticle

Impact of the COVID-19 Pandemic on Self-Confidence in Patient Treatment in the Endodontic and Restorative Procedures of Dentistry Students at the University of Novi Sad

by Milica Jeremic Knezevic, Milana Bojinovic, Daniela Djurovic Koprivica, Aleksandra Maletin, Aleksandar Knezevic, Marija Sarac, Tatjana Puskar, Zeljka Nikolasevic and Bojana Ramic

J. Clin. Med. 2024, 13(14), 4030; https://doi.org/10.3390/jcm13144030 - 10 Jul 2024

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Abstract

(1) Background: The COVID-19 pandemic has brought about a change in the concept of teaching with the introduction of online lectures and “distance learning.” The aim of this study was to determine the impact of the COVID-19 pandemic on the confidence and both theoretical and practical knowledge of dental students regarding the courses in conservative dentistry and endodontics. (2) Methods: The study was conducted using an originally created online questionnaire consisting of 30 questions that the students used to make a subjective assessment of their confidence in performing both endodontic and conservative procedures using numerical scales. They were divided into two groups, a non-COVID group of students, who attended classes before the outbreak of the pandemic, and a COVID group, whose classes were suspended due to the lockdown. The data were processed in the SPSS statistic 25 program, with statistical significance p < 0.05. (3) Results: The comparison of the self-assessment of 96 students from the COVID group and 91 students from the non-COVID group revealed significant results. Compared with the COVID group, the non-COVID students felt more confident in the application of anesthesia in both the maxilla and mandible, in the initial treatment of patients in pain, as well as in all the steps of the endodontic treatment. Both groups felt equally confident in diagnostic and conservative procedures, and the level of theoretical knowledge acquired in the courses. (4) Conclusions: Changes in teaching due to the COVID-19 pandemic had an unfavorable effect on students’ self-confidence in performing routine dental interventions, especially in the endodontic field. The lack of confidence in the COVID group regarding the anesthetic and endodontic procedures appears due to their inability to do any of these procedures during the COVID period; we organized summer practical school under the supervision of teachers, and they gained the necessary knowledge and self-confidence for these procedures. Full article

(This article belongs to the Special Issue Clinical Consequences of COVID-19: 2nd Edition)

13 pages, 1098 KiB

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Changes in Working Situations of Employed Long COVID Patients: Retrospective Study in Japanese Outpatient Clinic

by Yui Matsuda, Yasue Sakurada, Yuki Otsuka, Kazuki Tokumasu, Yasuhiro Nakano, Naruhiko Sunada, Hiroyuki Honda, Toru Hasegawa, Ryosuke Takase, Daisuke Omura, Keigo Ueda and Fumio Otsuka

J. Clin. Med. 2024, 13(13), 3809; https://doi.org/10.3390/jcm13133809 - 28 Jun 2024

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Abstract

Purpose: The present study aimed to uncover the impact of long COVID on the working situations of Japanese patients. Methods: Changes in the working situations of the patients who visited our long COVID clinic were evaluated from medical records for the aspects of physical status, quality of life (QOL), and mental conditions. Results: Of 846 long COVID patients who visited our clinic from February 2021 to December 2023, 545 employed patients aged between 18 and 65 years were included in this study. A total of 295 patients (54.1%) with long COVID (median age: 43 years, female: 55.6%) experienced changes in their working status. Those patients included 220 patients (40.4%) who took a leave of absence, 53 patients (9.7%) who retired, and 22 patients (4%) with reduced working hours. Most of the patients (93.2%) with changes in working conditions had mild disease severity in the acute phase of COVID-19. The majority of those patients with mild disease severity (58.8%) were infected in the Omicron-variant phase and included 65.3% of the female patients. The major symptoms in long COVID patients who had changes in their working situations were fatigue, insomnia, headache, and dyspnea. Scores indicating fatigue and QOL were worsened in long COVID patients who had changes in their working situations. In addition, 63.7% of the long COVID patients with changes in their working situations had decreases in their incomes. Conclusions: Changes in the working situation of long COVID patients who were employed had a negative impact on the maintenance of their QOL. Full article

(This article belongs to the Special Issue Clinical Consequences of COVID-19: 2nd Edition)

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11 pages, 623 KiB

Open AccessArticle

Impact of COVID-19 Pandemic on Health and Life Emergencies Resulting from Illness Cases and Injuries—A Preliminary Study

by Krzysztof Marek Mitura, Daniel Celiński, Jadwiga Snarska and Sławomir Dariusz Szajda

J. Clin. Med. 2024, 13(12), 3552; https://doi.org/10.3390/jcm13123552 - 18 Jun 2024

Viewed by 1049

Abstract

Background: Despite organised efforts, the COVID-19 pandemic had a significant impact on the health status of the population and health services including the emergency medical system. The objective of the study was to investigate, based on the Emergency Medical Teams’ (EMT) interventions, the impact of the COVID-19 pandemic on health and life emergencies resulting from illness cases and injuries of Polish females and males. Material and Methods: The data under analysis concern EMT interventions carried out in central and eastern Poland from 1 January 2017 to 31 December 2022 (n = 226,038). The study used descriptive statistics, the Mann–Whitney U Test, and the Chi-square test. Results: A significant increase was observed in the proportion of EMT interventions (p < 0.001) to patients with illness cases (80.30% vs. 83.17%) and a decrease in interventions to patients with injuries (19.70% vs. 16.83%) during the pandemic as compared to the pre-pandemic period. As for illness cases, the patients’ ages during both periods were similar (Me = 66.00 vs. 66.00, p = 0.071). On the other hand, during the pandemic, injuries mainly affected elderly patients as compared to the pre-pandemic period (Me = 50.00 vs. 47.00, p < 0.001). The increase in the proportion of EMT interventions to patients with illness cases and the decrease in patients with injuries during the pandemic, as compared to the pre-pandemic period, concerned the area of intervention, patient’s sex, and age. During the pandemic period, a significantly lower proportion of patients transported to the hospital (p < 0.001) and an increase in the proportion of patients left at the place of call (p < 0.001) were noted. Conclusions: The restrictions aimed at preventing the spread of the SARS-CoV-2 virus contributed to a reduced number of injuries without, however, reducing the number of illness cases. During the pandemic, the elderly were affected by injuries. The study indicates the need for further in-depth analyses to prepare the pre-hospital care system in Poland for the occurrence of other or similar emergencies. Full article

(This article belongs to the Special Issue Clinical Consequences of COVID-19: 2nd Edition)

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11 pages, 1146 KiB

Open AccessArticle

Fatigue, Internet Addiction and Symptoms of Long COVID—A Cross-Sectional Study of Polish Students

by Anna Zalewska and Monika Gałczyk

J. Clin. Med. 2024, 13(12), 3383; https://doi.org/10.3390/jcm13123383 - 9 Jun 2024

Viewed by 1011

Abstract

Introduction: Fatigue is the most persistent symptom in patients with long COVID. Moreover, Internet addiction itself has become a pandemic long-term effect. The aim of this study was to investigate the degree of fatigue and Internet addiction in a group of students with COVID-19 and to determine the relationship between fatigue and addiction in students with and without long COVID symptoms. Material and methods: A cross-sectional study was conducted among 402 Polish students aged 19–26. The 183 students who had COVID-19 signaled the presence of long COVID symptoms, which corresponded to 45.5% of the surveyed group. The Modified Fatigue Impact Scale was used to assess the level of fatigue, and the Kimberly Young questionnaire was used to assess the level of Internet addiction. Results: 19.7% (95% c.i.: 15.9–23.9%) of the students surveyed had a moderate level of Internet dependence (Internet addiction measure value of 50 points or more). Most of them did not complain of high levels of fatigue. Higher levels of dependence and fatigue were observed in subjects with long COVID symptoms (MFIS mean value was 26.5 in this group vs. 17.7 in the others; p = 0.0000 ***). The higher the respondents’ level of dependence, the more they tended to feel tired (correlations were stronger in those with long COVID symptoms: r_S = 0.23; p = 0.0017 **). Conclusions: In view of the results obtained, the study presented here has the potential to contribute to the international debate on the long-term health consequences of the COVID-19 pandemic and strategies to address them. The study provides data that may be useful in the development of educational and health policies that target the psychophysical well-being of patients with long COVID symptoms. This process should be considered as a long-term endeavor. Full article

(This article belongs to the Special Issue Clinical Consequences of COVID-19: 2nd Edition)

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18 pages, 326 KiB

Open AccessArticle

The Influence of the COVID-19 Pandemic on the Sexual Lives of Polish Young Adults

by Helena Perenc, Karolina Pasieka, Kamil Juruś, Karolina Bierć, Rafał Bieś, Marek Krzystanek and Anna Warchala

J. Clin. Med. 2024, 13(12), 3370; https://doi.org/10.3390/jcm13123370 - 7 Jun 2024

Viewed by 919

Abstract

Background: The COVID-19 pandemic brought significant changes to daily life in Poland, with restrictions affecting various sectors, including entertainment, education, and travel. The pandemic’s impact extended to intimate aspects of life. This study aimed to compare the sexual functioning of young adults in Poland before and during the pandemic, using the Changes in Sexual Functioning Questionnaire (CSFQ-14). Methods: The research involved an online survey with demographic questions, the CSFQ-14 for pre-pandemic sexual functioning, and modified CSFQ-14 questions for the pandemic period. Sexual dysfunction was determined using predefined cutoff scores. Results: Overall, the study found no significant difference in the sexual functioning of young Poles during the COVID-19 pandemic compared to before. However, there were gender-specific trends. Women reported enhanced pleasure, satisfaction, and orgasm during lockdown, while men faced challenges with erection and ejaculation. A higher proportion of women experienced overall sexual dysfunction compared to men, both before and during the pandemic. This research provides insights into the impact of the COVID-19 pandemic on the sexual lives of young Poles. While overall sexual functioning remained relatively stable, specific aspects varied by gender. Conclusions: The study emphasizes the need to consider demographic factors, such as age and gender, when assessing the effects of external stressors like a pandemic on sexual health. Further research is essential to fully grasp these complexities and their potential long-term consequences. Full article

(This article belongs to the Special Issue Clinical Consequences of COVID-19: 2nd Edition)

14 pages, 467 KiB

Open AccessArticle

Positive Orientation and Feelings of Loneliness among Polish Students during the COVID-19 Pandemic

by Ewa Kupcewicz, Kamila Rachubińska, Anna Maria Cybulska, Paweł Jastrzębski, Aleksandra Bentkowska and Elżbieta Grochans

J. Clin. Med. 2024, 13(11), 3192; https://doi.org/10.3390/jcm13113192 - 29 May 2024

Viewed by 916

Abstract

Background/Objectives: The COVID-19 pandemic was a time of limited direct contact with other people. The aim of this study was to determine the role of positive orientation and sociodemographic variables in the feelings of global, social and emotional loneliness and to seek predictors for loneliness among students during the COVID-19 pandemic. Methods: The study was conducted on a group of 798 students at the University of Warmia and Mazury in Olsztyn (Poland) between January and March 2022. The empirical data were gathered with the following research tools: the Positive Orientation Scale and the De Jong Gierveld Loneliness Scale—DJGLS. Results: The study found a correlation (r = −0.370; p < 0.001) between positive orientation and emotional loneliness. The level of loneliness was significantly higher in students who greatly reduced their social contact, compared to those who reduced them moderately (p < 0.001). The intensity of social loneliness among women was lower (p < 0.001) than among men. Those who lived with their families or with a close companion felt less intense emotional loneliness (p < 0.001) than those who lived alone. Conclusions: A positive orientation, which manifests itself in a favourable opinion about oneself and in attaching weight to positive aspects of life, was found to be the main determinant of the feelings of global and emotional loneliness. However, it did not prove to be a predictor of social loneliness in the group of students under study. Full article

(This article belongs to the Special Issue Clinical Consequences of COVID-19: 2nd Edition)

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13 pages, 1626 KiB

Open AccessArticle

Assessment of the Impact of SARS-CoV-2 Infection on the Sexual Function of Women, Levels of Oxytocin and Prolactin: A Prospective Cohort Study

by Klaudia Żak, Ernest Starek, Agnieszka Korga-Plewko, Karolina Rasoul-Pelińska, Monika Abramiuk, Mariola Michalczuk, Alicja Rajtak, Jan Kotarski, Karolina Frankowska, Liliana Bis, Marta Ostrowska-Leśko and Marcin Bobiński

J. Clin. Med. 2024, 13(8), 2230; https://doi.org/10.3390/jcm13082230 - 12 Apr 2024

Cited by 1 | Viewed by 1570

Abstract

(1) Background: There is a lack of direct evidence on whether SARS-CoV-2 affects women’s sexual function through a biological-organic mechanism. Existing studies on the topic are few and have produced contradictory results. This study aims to explore the possible relationship between sex hormones and sexual function in patients who have been infected with SARS-CoV-2. Moreover, we aimed to determine whether these changes are related to the clinical course of COVID-19 and whether they are temporary or long-lasting. (2) Methods: A study was conducted on 104 women, including 64 women infected with COVID-19 and a control group of 40 healthy women, between January 2021 and August 2022. Blood samples were collected to measure prolactin and oxytocin levels, and a clinical assessment was performed 3 and 6 months later. Sexual function self-assessment was captured based on the FSFI scale. (3) Results: Our study found that patients with severe COVID-19 had better sexual satisfaction scores one month after recovery but no discernible difference after six months. High levels of serum prolactin were observed in patients with active COVID-19 but became similar to a control group after one month and remained stable over time. Higher prolactin levels were significantly associated with increased arousal and hydration. Individuals with severe COVID-19 had notably low levels of plasma oxytocin, but there was no correlation between oxytocin levels and sexual satisfaction. (4) Conclusions: The gynecologic symptoms, as well as disturbances in oxytocin and prolactin levels, might be observed in a short time after infection. However, SARS-CoV-2 infection has no lasting effect on sexual function, oxytocin, and prolactin levels among women. Full article

(This article belongs to the Special Issue Clinical Consequences of COVID-19: 2nd Edition)

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12 pages, 445 KiB

Open AccessArticle

Long COVID Symptoms vs. Back Pain and Physical Activity among Students in Poland—Cross-Sectional Study

by Monika Gałczyk and Anna Zalewska

J. Clin. Med. 2024, 13(4), 1038; https://doi.org/10.3390/jcm13041038 - 11 Feb 2024

Viewed by 1480

Abstract

Background: Back pain (BP) is a common condition that affects people of all ages. Moderate- and vigorous-intensity physical activity (PA) is a key element in maintaining health. The purpose of this research was to determine the level of physical activity and back pain (BP) in students with long COVID symptoms and to determine the relationship between the level of PA and BP in students with and without long COVID. Methods: A survey was carried out among 402 students from Poland. The inclusion criteria were as follows: student status, age of over 18 years, history of COVID-19, and consent to participate in the study. The International Physical Activity Questionnaire (IPAQ) was used to determine the level of PA. The Oswestry Disability Index (ODI) and the Neck Disability Index (NDI) were used to assess BP. Results: We found that at least half of the students surveyed did not experience any lumbosacral or cervical spine pain. The authors found no association between the level of PA in women and a history of long COVID symptoms, while there were statistically significant differences in intense PA in men (p = 0.0263), with those who did not report long COVID symptoms being more active. With regard to cervical and lumbar spine pain complaints, in our study, these were statistically significantly stronger in students who were observed to have long COVID symptoms. The difference was not significant only for lumbosacral complaints among men. No strong correlations were found between PA level and the severity of BP. Conclusion: Additional investigation is required to comprehend the complex interaction between long COVID symptoms and levels of PA and BP. Special attention should be paid to the prevention of back pain mainly in the COVID-19 group of students. Full article

(This article belongs to the Special Issue Clinical Consequences of COVID-19: 2nd Edition)

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30 pages, 835 KiB

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Evaluating Mental Health Outcomes in COVID-19 ICU Survivors: A Scoping Review of Measurement Tools

by Kimberly T’ng, Justin Kenardy and Andree Hartanto

J. Clin. Med. 2024, 13(11), 3191; https://doi.org/10.3390/jcm13113191 - 29 May 2024

Viewed by 1229

Abstract

Objective: The objective of this scoping review was to map the range of measurement tools used to study the prevalence of common mental health conditions in COVID-19 ICU survivors. Introduction: Increased rates of admission to and survivorship from intensive care units (ICUs) have been observed in recent years, particularly during the global pandemic. ICU patients are at a higher risk of developing depressive, anxiety, and PTSD symptoms. Due to the high burden of disease, an accurate understanding of long-term mental health challenges for this population is key. Unfortunately, there is significant variability in reported prevalence rates. Heterogeneity in measurement tools potentially contribute to this. Inclusion criteria: Studies were eligible if they (a) reported mental health outcomes of adult patients diagnosed with COVID-19 and admitted to an ICU, (b) used standardised mental health outcome measures, and (3) were peer-reviewed. Methods: Searches were conducted in PubMed, PsycInfo, and Scopus. The initial search retrieved 1234 publications. After de-duplication and title and abstract screening, 72 full-text articles were examined for eligibility and 44 articles were excluded, leaving 28 eligible studies. Reference lists of the eligible studies were screened, and four other studies were added. 32 studies were ultimately included in this review. Results: Significant heterogeneity of measurement tools and clinical thresholds were observed. Only 6.25% of the studies compared changes in mental health outcomes to baseline measurements. Between five and nine unique measurement tools were used to study depression, anxiety, and PTSD, respectively. Studies were also observed to use up to 19 different thresholds to establish the prevalence of PTSD. Conclusions: The heterogeneity of measurement tools and thresholds continues to confound prevalence rate estimations of mental health complications post-ICU admission. Future research will benefit from consistency in the use of recommended outcome measures and the use of psychometrically comparable cut-off points between key measures. Full article

(This article belongs to the Special Issue Clinical Consequences of COVID-19: 2nd Edition)

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