Post-COVID neuropsychiatric symptoms in India: Prevalence, risk factors, and persistence

Background: The global research has actively investigated the post-COVID neuropsychiatric symptoms (PCNS). There is a paucity of studies from India that explore long-term PCNS. Aim: This study aims to estimate prevalence, types of PCNS, associated factors (sociodemographic factors, life events, COVID-19-related variables, and vaccination status) and persistence of PCNS after two years. Methods: A cross-sectional study was conducted from October 2022 to October 2023 in a tertiary care hospital. A total of 2,281 randomly selected individuals with reverse transcription polymerase chain reaction-positive for COVID-19 were screened for PCNS. Among 927 participants consented to and completed the telephonic screening for PCNS. Structured clinical interviews for DSM-5-Research Version and World Health Organization-Post-COVID Case Report Form were applied. Descriptive statistics and binary logistic regression analysis were used for data analysis. Results: Median age of individuals was 34 years, and 51.3% being female. Only 21.6% had lifetime PCNS, and 7.3% had persistent PCNS at two years of COVID-19. The common lifetime PCNS were persistent fatigue (15.6%), reduced smell (5.9%), reduced taste (4.8%), anxiety (4.3%), insomnia (3.6%), depressed mood (2.6%), cognitive symptoms (2.6%), and persistent muscle pain (2.6%). The logistic regression analysis revealed a positive association of lifetime PCNS with female gender, preexisting medical comorbidities, symptomatic COVID-19, oxygen supplementation, repeated infections, and life events. Full or partially vaccinated against COVID-19 appeared to be protective against PCNS. Conclusion: About one in five individuals developed lifetime PCNS following COVID. Among them, one in three had persistent PCNS after two years of COVID. Female gender, life events, severity of COVID-19, repeated infection, and Vaccine-naïve status were associated with the development of PCNS.