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

Front Public Health. 2024 Apr 10:12:1265848. doi: 10.3389/fpubh.2024.1265848. eCollection 2024.

Abstract

Background: 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.

Objective: 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.

Methods: 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.

Results: 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).

Conclusion: 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.

Keywords: COVID-19; LCMM; depression; telehealth; telemedicine.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • COVID-19* / diagnosis
  • COVID-19* / psychology
  • Depression* / diagnosis
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Quarantine / psychology
  • Republic of Korea
  • SARS-CoV-2
  • Telemedicine*

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by an Institute of Information & Communications Technology Planning & Evaluation (IITP) grant funded by the Korean government (MSIT) (No. 2021–0-00312, Development of Non-Face-to-face Patient Infection Activity Prediction and Protection Management SW Technology at Home and Community Treatment Centers for Effective Response to Infectious Disease).