217 - Associations of Health and Demographic Factors with Depression and Anxiety in Patients with Post-Acute Sequelae of COVID-19

Objectives: This study examined the association of patient-reported health status of physical, social, and mental well-being and demographic factors with no-mild vs. moderate-severe symptoms of depression and anxiety in patients with Post-Acute Sequelae of COVID-19 (PASC).

Design: Retrospective electronic health record (EHR) review from June 2020 to October 2022 at a outpatient COVID clinic.
Demographics, Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7), and Patient-Reported Outcomes Measurement Information System (PROMIS-29 v.2.0) (i.e., physical functional, fatigue, sleep disturbance, social roles influence, and pain interference). Data analysis used one-way ANOVA. PHQ-9 and GAD-7 scores were dichotomized into no-mild (< 10) or moderate-severe (>10). All analyses were set at p < 0.05 for the statistical significance level.

Results: Of 1,672 PASC patients (mean age 51.0±14.9 years, 66% women, 65.4% White, 10.5% African American, 12.1% Hispanic or Latino), 49% scored as >10 depression and 29% >10 anxiety. Compared to norms, subjects reported poorer physical functioning and social roles limitation (means 35.7 ± 7.7; 47.5 ± 11.6) and greater fatigue, sleep disturbance and pain interference (means 61.4 ± 10.7; 51.8 ± 3.9; 58.7 ± 11.1). Those with no-mild depression and anxiety had less fatigue and pain but poorer physical function and greater impact on social roles than those of being more depressed/anxious. Women had more severe depression, anxiety, fatigue, and pain, and poorer physical functioning. Older subjects reported less anxiety and fatigue but greater sleep disturbance and higher impact on social roles. African American patients reported poorer physical functioning and Hispanic or Latino patients had higher levels of depression and anxiety.

Conclusions: Symptoms were not always congruent with expectations. The prevalence of self-reported moderate to severe anxiety and depression in patients with PASC is fairly high and should be investigated and addressed. Further research into understanding the pathogenesis and treatment of physical and affective complaints is warranted.