Exploring depressive symptom trajectories in COVID-19 patients with clinically mild condition in South Korea using remote patient monitoring: longitudinal data analysis

• Published in: Frontiers in public health Vol. 12; p. 1265848
• Main Authors: Sung, Sumi, Kim, Su Hwan, Kim, Youlim, Bae, Ye Seul, Chie, Eui Kyu
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 10.04.2024
• Subjects: Adult; Aged; COVID-19; COVID-19 - diagnosis; COVID-19 - psychology; depression; Depression - diagnosis; Female; Humans; LCMM; Longitudinal Studies; Male; Middle Aged; Public Health; Quarantine - psychology; Republic of Korea; SARS-CoV-2; telehealth; Telemedicine; Republic of Korea; COVID-19; telemedicine; depression; LCMM; telehealth
• ISSN: 2296-2565; 2296-2565
• DOI: 10.3389/fpubh.2024.1265848

During the height of the COVID-19 pandemic, the Korean government temporarily allowed full scale telehealth care for safety and usability. However, limited studies have evaluated the impact of telehealth by analyzing the physical and/or mental health data of patients with COVID-19 diagnosis collected through telehealth targeting Korean population. This study aimed to identify subgroup of depressive symptom trajectories in patients with clinically mild COVID-19 using collected longitudinal data from a telehealth-based contactless clinical trial. A total of 199 patients with COVID-19 were accrued for contactless clinical trial using telehealth from March 23 to July 20, 2022. Depressive symptoms were measured using the patient health questionnaire-9 on the start day of quarantine, on the final day of quarantine, and 1 month after release from quarantine. Additionally, acute COVID-19 symptoms were assessed every day during quarantine. This study used a latent class mixed model to differentiate subgroups of depressive symptom trajectories and a logistic regression model with Firth's correction to identify associations between acute COVID-19 symptoms and the subgroups. Two latent classes were identified: class 1 with declining linearity at a slow rate and class 2 with increasing linearity. Among COVID-19 symptoms, fever, chest pain, and brain fog 1 month after release from quarantine showed strong associations with class 2 (fever: OR, 19.43, 95% CI, 2.30-165.42; chest pain: OR, 6.55, 95% CI, 1.15-34.61; brain fog: OR, 7.03, 95% CI 2.57-20.95). Sleeping difficulty and gastrointestinal symptoms were also associated with class 2 (gastrointestinal symptoms: OR, 4.76, 95% CI, 1.71-14.21; sleeping difficulty: OR, 3.12, 95% CI, 1.71-14.21). These findings emphasize the need for the early detection of depressive symptoms in patients in the acute phase of COVID-19 using telemedicine. Active intervention, including digital therapeutics, may help patients with aggravated depressive symptoms.