Persistent Somatic Symptoms Are Key to Individual Illness Perception at One Year After COVID-19 in a Cross-sectional Analysis of a Prospective Cohort Study

Overview

Journal J Psychosom Res

Specialty Psychiatry

Date 2023 Mar 25

PMID 36965396

Authors

Katharina Hufner

Piotr Tymoszuk

Sabina Sahanic

Anna Luger

Anna Boehm

Alex Pizzini

Christoph Schwabl

Sabine Koppelstatter

Katharina Kurz

Malte Asshoff

Birgit Mosheimer-Feistritzer

Bernhard Pfeifer

Verena Rass

Andrea Schroll

Sarah Iglseder

Alexander Egger

Ewald Woll

Gunter Weiss

Raimund Helbok

Gerlig Widmann

Thomas Sonnweber

Ivan Tancevski

Barbara Sperner-Unterweger

Judith Loffler-Ragg

Affiliations

Soon will be listed here.

Abstract

Objective: Subjective illness perception (IP) can differ from physician's clinical assessment results. Herein, we explored patient's IP during coronavirus disease 2019 (COVID-19) recovery.

Methods: Participants of the prospective observation CovILD study (ClinicalTrials.gov: NCT04416100) with persistent somatic symptoms or cardiopulmonary findings one year after COVID-19 were analyzed (n = 74). Explanatory variables included demographic and comorbidity, COVID-19 course and one-year follow-up data of persistent somatic symptoms, physical performance, lung function testing, chest computed tomography and trans-thoracic echocardiography. Factors affecting IP (Brief Illness Perception Questionnaire) one year after COVID-19 were identified by regularized modeling and unsupervised clustering.

Results: In modeling, 33% of overall IP variance (R) was attributed to fatigue intensity, reduced physical performance and persistent somatic symptom count. Overall IP was largely independent of lung and heart findings revealed by imaging and function testing. In clustering, persistent somatic symptom count (Kruskal-Wallis test: η = 0.31, p < .001), fatigue (η = 0.34, p < .001), diminished physical performance (χ test, Cramer V effect size statistic: V = 0.51, p < .001), dyspnea (V = 0.37, p = .006), hair loss (V = 0.57, p < .001) and sleep problems (V = 0.36, p = .008) were strongly associated with the concern, emotional representation, complaints, disease timeline and consequences IP dimensions.

Conclusion: Persistent somatic symptoms rather than abnormalities in cardiopulmonary testing influence IP one year after COVID-19. Modifying IP represents a promising innovative approach to treatment of post-COVID-19 condition. Besides COVID-19 severity, individual IP should guide rehabilitation and psychological therapy decisions.

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