The Prevalence and Predictors of Post-Stroke Depression and Anxiety During COVID-19 Pandemic

Abstract

Introduction: Stroke is associated with a rise in post-stroke depression (PSD) and anxiety (PSA). In this study, we evaluated the impact of COVID-19 pandemic on the rates of PSD and PSA.

Methods: All stroke admissions to two hospitals in Saudi Arabia during two months were prospectively evaluated for PSD and PSA. NIHSS and serum TSH assessed on admission. PSD and PSA were evaluated using Hospital Anxiety and Depression Scale (HADS). Post-stroke disability was assessed by mRS, while social support assessed by Multidimensional Scale of Perceived Social Support (MSPSS).

Results: Among 50 participants (28 males), clinically significant PSD was found in 36%, while PSA in 32%. PSD associated with higher NIHSS (P < 0.001); lower MSPSS (P = 0.003); higher mRS (P = 0.001); and discontinuation of rehabilitation (P = 0.02). PSA was associated with higher TSH (P = 0.01); lower MSPSS (P = 0.03); while discontinuation of rehabilitation was related to less PSA (P = 0.034). Multivariate analysis showed that NIHSS (OR: 1.58, 95% CI: 742-3.37; P = 0.01); and MSPSS score (OR: 0.66, 95% CI: 0.47-0.94; P = 0.002) were associated with PSD; while PSA was related to TSH level (OR: 8.32, 95% CI:1.42-47.23; P = 0.02), and discontinuation of rehabilitation (OR: -0.96, 95% CI: -1.90-0.02; P = 0.04).

Conclusions: Our research shows that the rise in PSD is related to stroke severity and this has not changed significantly during the pandemic; however, PSA showed a noticeable peak. Social deprivation and the lacking levels of rehabilitation related significantly to both.

Keywords: Anxiety; COVID-19; Depression; Ischemic stroke; Social support.