Dynamics of Anxiety, Depression, and Sleep Quality Following COVID-19 Hospitalization in Romania

COVID-19 has been associated with neurological and psychiatric manifestations, both at disease onset and post-infectious sequelae, most commonly anxiety, depression, and sleep disturbances. Previous pandemics suggest potential for long-term neuropsychiatric consequences. We conducted a prospective study in patients hospitalized with non-critical COVID-19, evaluating symptoms using validated psychometric instruments at discharge, after 3–6 and 12 months post-infection. Additionally, a four-year follow-up was performed through telephone interviews, to document newly diagnosed psychiatric disorders and mortality. At baseline, 22% of patients reported anxiety, 8% depression, and 16% poor sleep. Most symptoms improved within the first year, particularly during the first 3–6 months. At four-year follow-up, mortality reached 5%, while clinician-diagnosed psychiatric disorders increased to 6% for anxiety, 11% for depression, and 3% for mixed disorders. Anxiety and poor sleep—but not depression—were associated with the severity of the acute episode. Overall, post-COVID-19 anxiety, depression, and sleep disturbances were more prevalent than in the general population, though rates were lower than reported in other studies. Most symptoms resolved within the first year. However, new-onset cases of depression and other psychiatric disorders emerged during long-term follow-up, suggesting distinct trajectories of post-COVID psychiatric morbidity.