Mental health and alcohol use among patients attending a post-COVID-19 follow-up clinic: a cohort study, 2022, Broughan et al.

Dolphin

Dolphin

Senior Member (Voting Rights)
This research has got some coverage in the Irish media

Free:
https://hrbopenresearch.org/articles/5-16/v1

Research Article
Mental health and alcohol use among patients attending a post-COVID-19 follow-up clinic: a cohort study
[version 1; peer review: 1 approved]

John Broughan
https://orcid.org/0000-0002-5084-8507
1, Geoff McCombe
https://orcid.org/0000-0003-4898-3459
1, Brendan O’Kelly1,2, Gordana Avramovic1,2, Ronan Fawsitt3,4, Shannon Glaspy
https://orcid.org/0000-0001-7455-0978
1,2, Mary Higgins1,5, Tina McHugh1,2, Louise Vidal2, James Woo2, John S Lambert
https://orcid.org/0000-0001-5404-2415
1,2, Walter Cullen1
Author details

Abstract
Background: Ongoing mental health problems following COVID-19 infection warrant greater examination. This study aimed to investigate psychiatric symptoms and problematic alcohol use among Long COVID patients.

Methods: The study was conducted at the Mater Misericordiae University Hospital’s post-COVID-19 follow-up clinic in Dublin, Ireland. A prospective cohort study design was used encompassing assessment of patients’ outcomes at 2-4 months following an initial clinic visit (Time 1), and 7–14-month follow-up (Time 2). Outcomes regarding participants’ demographics, acute COVID-19 healthcare use, mental health, and alcohol use were examined.

Results: The baseline sample’s (n = 153) median age = 43.5yrs (females = 105 (68.6%)). Sixty-seven of 153 patients (43.8%) were admitted to hospital with COVID-19, 9/67 (13.4%) were admitted to ICU, and 17/67 (25.4%) were readmitted to hospital following an initial COVID-19 stay. Sixteen of 67 (23.9%) visited a GP within seven days of hospital discharge, and 26/67 (38.8%) did so within 30 days. Seventeen of 153 participants (11.1%) had a pre-existing affective disorder. The prevalence of clinical range depression, anxiety, and PTSD scores at Time 1 and Time 2 (n = 93) ranged from 12.9% (Time 1 anxiety) to 22.6% (Time 1 PTSD). No statistically significant differences were observed between Time 1 and Time 2 depression, anxiety, and PTSD scores. Problematic alcohol use was common at Time 1 (45.5%) and significantly more so at Time 2 (71.8%). Clinical range depression, anxiety, and PTSD scores were significantly more frequent among acute COVID-19 hospital admission and GP attendance (30 days) participants, as well as among participants with lengthy ICU stays, and those with a previous affective disorder diagnosis.

Conclusions: Ongoing psychiatric symptoms and problematic alcohol use in Long COVID populations are a concern and these issues may be more common among individuals with severe acute COVID-19 infection and /or pre-existing mental illness.

Keywords
COVID-19; Long COVID; Mental Health; Alcohol Abuse; Cohort Studies
 
As far as I can tell, a person drinking a glass of wine with dinner twice per week would qualify as having problematic alcohol use in this study (as would someone who was drinking to excess daily). The data is available, so someone could actually do a more detailed analysis.

Is alcohol intolerance common in LC as it is in ME? I wonder if people drinking more after 7-14 months actually correlates with increased alcohol tolerance / recovery.
 
So, obviously, the official treatment for long covid will now be 'stop drinking' as 'research' has shown that people who consume 'problematic' levels of alcohol have long covid.

Ergo - alcohol causes long covid.

(anyone who says they don't consume alcohol is obvious lying, or delusional)

ETA - I suppose i should mention that the above is a 'parody' of the way that medicine, at least in the UK, seems to operate, in many, if not all, areas.
 
LarsSG said:
As far as I can tell, a person drinking a glass of wine with dinner twice per week would qualify as having problematic alcohol use in this study (as would someone who was drinking to excess daily). The data is available, so someone could actually do a more detailed analysis.

Is alcohol intolerance common in LC as it is in ME? I wonder if people drinking more after 7-14 months actually correlates with increased alcohol tolerance / recovery.
Click to expand...
I don't know how common it is but at least on Reddit a decent number of people seem to have it, based on these threads.
 
Also the depression scores went down very slightly and the anxiety scores went down significantly between 3 months and a year post-Covid, while alcohol use went up. So probably not the case that worsening mental health is driving more drinking.
 
LarsSG said:
As far as I can tell, a person drinking a glass of wine with dinner twice per week would qualify as having problematic alcohol use in this study (as would someone who was drinking to excess daily). The data is available, so someone could actually do a more detailed analysis.
Click to expand...

Screen Shot 2022-06-08 at 10.25.12 am.png

Screen Shot 2022-06-08 at 10.28.30 am.png

A score of 3 does seem extraordinarily low as a threshold for problematic alcohol intake.

A major problem with this study is the lumping of people with all sorts of post-Covid issues together.
 
I don't drink (scoring 1, 0, and 1, so 2 - but it could have been 1,1,1 if I was 'socialising', which mostly doesn't happen as I live alone and don't like people much, but if forced to 'socialise' about the only thing that makes it even slightly tolerable, is alcohol).

So, I, who drinks maybe once or twice a year, up to a couple of pints a time, am very nearly a problem drinker, according to these 'people'?
 
Seventeen of 153 participants (11.1%) had a pre-existing affective disorder. The prevalence of clinical range depression, anxiety, and PTSD scores at Time 1 and Time 2 (n = 93) ranged from 12.9% (Time 1 anxiety) to 22.6% (Time 1 PTSD). No statistically significant differences were observed between Time 1 and Time 2 depression, anxiety, and PTSD scores.
Click to expand...

With a different mindset, the headline on this study could have been 'Pre-existing mood disorders not related to the onset of post-Covid symptoms'.

Only 11.1% of the participants had 'a pre-existing affective disorder'. That's probably not remarkable given prevailing rates in the population
The Health at a Glance Report reported that Ireland has one of the highest rates (3/36 countries) of mental health illness in Europe with 18.5% of the Irish population recorded as having a mental health illness such as anxiety, bipolar disorder, depression, or alcohol/drug use in 2016.
Click to expand...
I don't think there is evidence here for a pre-existing affective disorder being a risk factor for post-Covid symptoms.


There's actually quite a low prevalence of depression after Covid-19 in this sample - around 50% had no signs of depression and another nearly 30% had only mild signs, as measured by the PHQ. These percentages look to be consistent with the scores found in the general population Anxiety and depression in the Republic of Ireland during the COVID-19 pandemic using the same survey tools:
Anxiety and depression in the ROI duding the Covid-19 pandemic said:
Background: The COVID-19 pandemic in Ireland resulted in a nationwide quarantine on March 27, 2020. This study represents the first assessment of rates of anxiety and depression in the general population of Ireland during the pandemic.

Aims: Our first aim was to estimate the probable prevalence rates of generalized anxiety disorder (GAD) and depression and to identify sociodemographic risk factors associated with screening positive for GAD or depression. Our second aim was to determine if COVID-19 related anxiety was highest amongst those in society at greatest risk of morality from COVID-19.

Method: Self-report data were collected from a nationally representative Irish sample (N = 1041) online between March 31 and April 5; the first week of the nationwide quarantine measures. Recognized cut-off scores on the GAD-7 and PHQ-9 were used to estimate rates of GAD and depression. Correlates of screening positive for GAD or depression were assessed using logistic regression analysis.

Results: GAD (20.0%), depression (22.8%) and GAD or depression (27.7%) was common.
Click to expand...
 
Last edited:
this paper said:
Conclusions: Ongoing psychiatric symptoms and problematic alcohol use in Long COVID populations are a concern and these issues may be more common among individuals with severe acute COVID-19 infection and /or pre-existing mental illness.
Click to expand...
Given the foregoing, the conclusion of this paper seems to unfairly characterise people turning up at the post-Covid clinics (some of whom have symptoms consistent withME/CFS, and some of whom will have other health and psychological issues (PTSD from the experience of being very ill may be a valid problem).

Of course, concern is warranted about psychiatric symptoms and problematic alcohol use in anyone, but this paper does not seem to provide good evidence for being more concerned about depression and anxiety and alcohol use in Long Covid populations as a whole.
 
Last edited:
I downloaded their data and had a look at some of the details and the drinking data definitely doesn't add up. I don't think we can trust any of their alcohol conclusions and I'd want to look very carefully at the other data as well before believing it (but I've gone past my limit for this kind of mental effort).



[Edit: Corrected tweet and reposted.]
 
Last edited:
Hutan said:
There's actually quite a low prevalence of depression after Covid-19 in this sample - around 50% had no signs of depression and another early 30% had only mild signs, as measured by the PHQ.
Click to expand...

It is very easy to score mild or moderate on the PHQ-9 if you have Long Covid without being depressed at all. Being tired and having some brain fog puts you in the mild category, add in some difficulty sleeping and a little moving slowly and you're moderate.
 
If you have a glass of wine 4 days a week you score 4 then having 6 drinks every Christmas day gives you another point to be classed as a problematic drinker. The question then is what a control group would score. It may be that people with longcovid drink much less than the normal population and maybe they have cut back drastically on their previous levels.
 
AUDIT-C has been around since 1989 - AUDIT-C for Alcohol Use and is the basis for the current NHS Primary Care questionnaire: Alcohol Questionnaire - NHS

AUDIT-C limitations:

  • "AUDIT-C is a 3-item alcohol screen that can help identify persons who are hazardous drinkers or have active alcohol use disorders.
  • The AUDIT-C is a modified, shortened version of the 10-question AUDIT instrument. Its briefer design makes it more practical for incorporation into routine patient interviews or health history questionnaires in a primary care setting.
  • AUDIT-C is a screening tool. An abnormal or positive screening result may thus “raise suspicion” about the presence of an alcohol use problem, while a normal or negative result should suggest a low probability of an alcohol use problem. Assessment for purposes of diagnosis occurs in subsequent stages of evaluation."
my bolding.

UK Chief Medical Officers' advice is that no one should drink more than 14 units of alcohol in a week, but it seems improbable that amount could fit with the non problematic levels as defined by AUDIT-C so there's clearly a mismatch between AUDIT-C and and official advice on alcohol, at least in the UK.
 
I can imagine that this "research" was supported by government and insurance companies so that they can claim anyone with Long Covid is a drunk, secret or otherwise. If it becomes common knowledge then sufferers saying that they have Long Covid are at risk of being accused of being mad drunks.
 
You must log in or register to reply here.
Back
Top Bottom