COVID-19 Infection and Psychosocial Symptoms in First Year Post-Stroke Patients

Abstract

Background: Annually 12.2 million adults worldwide suffer a stroke, this can result in physical and psychosocial issues like depression, anxiety, and fatigue. These symptoms are very similar to those in individuals from the general population during the COVID-19 pandemic. Psychosocial symptoms are known to have a negative impact on the recovery of stroke survivors. However, little is known about the impact of a COVID infection post-stroke on psychosocial outcomes.

Aim: This study aimed to investigate a relationship between COVID-19 infection and depression, anxiety, and fatigue symptoms in first year stroke survivors with and without a COVID-19 infection post-stroke.

Method: Retrospective study using cross-sectional data from the UPACT study. Patients with a stroke in the last year in one of five Dutch hospitals participated. The primary outcomes of the current study consisted of depression, anxiety, and fatigue. This information was analyzed for secondary analysis using Quantile regression for two study groups: the COVID group and non-COVID group.

Results: 572 stroke survivors were included, 126 experienced a COVID infection. There was significant influence of COVID infection on anxiety, not on depression or fatigue. Daily functioning capability and time since stroke were associated with improved psychosocial symptoms. Previous depression or anxiety, cerebral infarction, sex, or age were associated with an increase in (some of the) psychosocial symptoms.

Conclusion: COVID infection had a significant influence on anxiety. Influential factors on psychosocial scores varied greatly between study groups, leading to cautionary interpretation of the current findings. Further research is necessary to consider if tailored rehabilitation programs could benefit stroke survivors.

Practical implications: Even though the COVID pandemic is no longer present, post-stroke COVID-infections can still occur. If COVID infections rise or a pandemic occurs again in the future, stroke rehabilitation may need adjustment, particularly around anxiety.