الفهرس 
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Abstract
This prospective cohort study aimed to evaluate and follow up the psychological outcomes of post covide-19 patients from baseline to 9 months. Also, to identify risk factors of outcomes of post covid-19 patients after nine months. This study enrolled patients with COVID-19 infection who attended the emergency room, isolation unit, and chest outpatient clinic at Assiut university Hospital from September 2021 till September 2022. We evaluated and followed up with participants at their baseline (when sought medical advice), six, and nine months, except for PTSD as measured after one, six, and nine months. The study populations were recruited by convention sampling method after written consent. It included 137 participants 58 males and 79 females who were categorized into four groups. group 1: mild (n=16) group 2: moderate group (n=60) group 3: severe group (n= 21) group 4: critical group (n=40).
Patients were subjected to a full psychiatric and medical assessment at the beginning of the study. A semi structured form was prepared by researchers to detect socio-demographic and clinical variables of the patients, and the medical history of the patients were reviewed. Also the psychological impact of COVID-19 infection was assessed using some scores including Symptom Checklist 90 (SCL-90), The Pittsburgh Sleep Quality Index (PSQI) and Posttraumatic Stress Disorder Checklist (PCL-5).
We found that the most affected people by COVID-19 infection were old females with mean age 63.13 ± 17.4 mostly unemployed (74.5%) married (62.8%) with secondary education which was the highest percentage (36.5%) among other education levels. Most common associated comorbidities were hypertension (45.3%), chest disease (15.3%) and renal disease (12.4%). There was a high prevalence of smoking among patients (32.8%). Most common symptoms were Dyspnea (86.1%), fever (66.4%), cough (57.7%), Diarrhea (2.9%) and sore throat (1.5%). In laboratory investigations we found leukocytosis, thrombocytopenia, lymphocytopenia (84.7%), impaired liver enzyme and renal function and higher serum ferritin (84.7%), CRP with mean level of 111.76 ± 88.79 and higher d-dimer (86.9%) levels. In the current study, most CT chest of COVID-19 patients was CO-RAD 5. We found that all patients in all groups needed oxygen supply (89.8%) in different forms except mild group. Critical and sever groups required non-invasive (55%) and mechanical ventilation (45%). In the current study, about 22.6% of total participants, in addition, more than half of critical group died while only third of sever group died. Regarding to poor quality of sleep, there was significant decrease of percentage in the second follow up than other measures (baseline and first follow up). In this study, there was a statistically significant difference in reaction time of PCL at moderate group and critical group. At the baseline, most of patient in all groups except mild were probably PTSD. In the follow up, moderate group was significant improved than other groups.
Regarding SCL 90 and its subscales, significant difference in reaction time of somatization, obsessive compulsive, interpersonal sensitivity, depression, anxiety, aggression, phobic-anxiety, psychoticism, and paranoid ideation at four groups. Abnormal response of subscales of SCL-90 had decrease of percentage in the second follow up than another measure (baseline and first follow up). In current study, we reported that after 9 months of COVID-19 infection, somatization (17%), anxiety (17%), aggression (5.7%) phobic anxiety (4.7%), psychoticism (1.9%), and paranoid (3.8%) and obsessive-compulsive (9.4%) as well as depression and interpersonal sensitivity.