Depression, but Not Fatigue, Improves as Part of Multimodal Post-COVID Rehabilitation

INTRODUCTION: Post-COVID syndrome (PCS) can lead to severe restrictions in the ability to work and participate in society and can lead to the development of depressive symptoms. The aim of this study was to investigate how many PCS patients suffer from clinically relevant depressive symptoms and to what extent PCS rehabilitation can modulate psychological symptoms as well as limitations in functional health. METHODS: Prospective multicenter cohort study PoCoRe (N = 1,028). Assessment of depressiveness (PHQ-9, PHQ-2), fatigue (FSMC) and functional health and disability (WHO-DAS2.0). Frequency analyses, mean comparisons. RESULTS: At the start of rehabilitation, 71.4% (n = 734) fulfilled the core symptoms of depressive disorders in general in the PHQ-2. In the screening-positive patients, the PHQ-9 total score was on average M = 23.74 (standard deviation = 4.43). As expected the depressive symptom burden was reduced more in depressed PCS patients (d = 0.50) than in nondepressed PCS patients (d = 0.32). Fatigue symptoms did not change. Functional health (WHO-DAS) improved above all in coping with everyday life (d = 0.71, or 1.04), and in the nondepressed patients also in mobility (d = 0.27). In the sociomedical assessment, 24.7% of the total samples were assessed as having an impaired capacity for the reference occupation and 19.5% as having an impaired capacity for the general labor market. Depressive patients had the worse sociomedical outcome. CONCLUSION: Depressiveness is common and can be well influenced by PCS rehabilitation. Fatigue is less easily influenced, which indicates that they are independent symptoms. Patients with persistent depression and fatigue have a poorer sociomedical prognosis.