Persistent (>6 months) Neuropsychiatric symptoms in a cohort of SARS- CoV-2 PCR positive patients in Cape Town, South Africa

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dc.contributor.advisorPeter, Jonathan
dc.contributor.advisorStein Dan
dc.contributor.authorVan Niekerk, Inette
dc.date.accessioned2025-04-01T08:42:50Z
dc.date.available2025-04-01T08:42:50Z
dc.date.issued2024
dc.date.updated2025-04-01T08:41:00Z
dc.description.abstractBackground : SARS-CoV-2 is a neurotrophic and pro-inflammatory virus, with several acute and more persistent neuropsychiatric sequelae reported. There are limited data from younger African cohorts and few acute illness biomarkers of persistent neuropsychiatric symptoms. Objectives : To determine the prevalence of neuropsychiatric symptoms in a cohort of South African SARS-CoV-2 PCR positive patients at least six months following infection/hospitalization. Second, to examine the association of neuropsychiatric outcomes with clinical illness severity, systemic inflammation, cardiovascular and renin-angiotensin system (RAS) biomarkers. Methodology: SARS-CoV-2 PCR positive patients were recruited prospectively from Cape Town, South Africa, including hospitalized patients from ancestral, beta and delta-dominant COVID-19 waves (pre-vaccine rollout); and asymptomatic/mild SARS-CoV-2 positive patients. Telephonic interviews were conducted at least six months post infection/hospitalization. Validated measures employed were: WHO Self-Report Questionnaire (SRQ-20), Generalized Anxiety Disorder Scale (GAD-7), Chalder Fatigue Scale (CFS-11) and Telephonic Montreal Cognitive Assessment (T-MoCA). The 96-protein O-link inflammation and cardiovascular panels, RAS fingerprinting, and antibody responses were measured in plasma/serum samples collected at peak severity and recovery (>3 months post infection). Results: Ninety-seven participants completed telephonic interviews. The median (IQR) age was 48 (37-59) years, and 54% were female. More than half of this South African COVID19 cohort had one or more persistent neuropsychiatric symptoms >6 months post vaccine-naïve infection. On the T-MoCA, 44% of participants showed evidence of cognitive and/or memory impairments. There were no significant associations between neuropsychiatric outcomes and illness severity, systemic inflammation, cardiovascular and renin-angiotensin-system (RAS) biomarkers. Conclusion : The high prevalence of persistent neuropsychiatric symptoms in this young African cohort supports ongoing attention to long COVID. Persistent neuropsychiatric outcomes post-COVID are not associated with systemic inflammation or altered renin angiotensin physiology. Psychosocial variables affecting individual responses to the virus may explain the lack of association found on the biological front.
dc.identifier.apacitationVan Niekerk, I. (2024). <i>Persistent (>6 months) Neuropsychiatric symptoms in a cohort of SARS- CoV-2 PCR positive patients in Cape Town, South Africa</i>. (). University of Cape Town ,Faculty of Health Sciences ,Department of Psychiatry and Mental Health. Retrieved from http://hdl.handle.net/11427/41313en_ZA
dc.identifier.chicagocitationVan Niekerk, Inette. <i>"Persistent (>6 months) Neuropsychiatric symptoms in a cohort of SARS- CoV-2 PCR positive patients in Cape Town, South Africa."</i> ., University of Cape Town ,Faculty of Health Sciences ,Department of Psychiatry and Mental Health, 2024. http://hdl.handle.net/11427/41313en_ZA
dc.identifier.citationVan Niekerk, I. 2024. Persistent (>6 months) Neuropsychiatric symptoms in a cohort of SARS- CoV-2 PCR positive patients in Cape Town, South Africa. . University of Cape Town ,Faculty of Health Sciences ,Department of Psychiatry and Mental Health. http://hdl.handle.net/11427/41313en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Van Niekerk, Inette AB - Background : SARS-CoV-2 is a neurotrophic and pro-inflammatory virus, with several acute and more persistent neuropsychiatric sequelae reported. There are limited data from younger African cohorts and few acute illness biomarkers of persistent neuropsychiatric symptoms. Objectives : To determine the prevalence of neuropsychiatric symptoms in a cohort of South African SARS-CoV-2 PCR positive patients at least six months following infection/hospitalization. Second, to examine the association of neuropsychiatric outcomes with clinical illness severity, systemic inflammation, cardiovascular and renin-angiotensin system (RAS) biomarkers. Methodology: SARS-CoV-2 PCR positive patients were recruited prospectively from Cape Town, South Africa, including hospitalized patients from ancestral, beta and delta-dominant COVID-19 waves (pre-vaccine rollout); and asymptomatic/mild SARS-CoV-2 positive patients. Telephonic interviews were conducted at least six months post infection/hospitalization. Validated measures employed were: WHO Self-Report Questionnaire (SRQ-20), Generalized Anxiety Disorder Scale (GAD-7), Chalder Fatigue Scale (CFS-11) and Telephonic Montreal Cognitive Assessment (T-MoCA). The 96-protein O-link inflammation and cardiovascular panels, RAS fingerprinting, and antibody responses were measured in plasma/serum samples collected at peak severity and recovery (>3 months post infection). Results: Ninety-seven participants completed telephonic interviews. The median (IQR) age was 48 (37-59) years, and 54% were female. More than half of this South African COVID19 cohort had one or more persistent neuropsychiatric symptoms >6 months post vaccine-naïve infection. On the T-MoCA, 44% of participants showed evidence of cognitive and/or memory impairments. There were no significant associations between neuropsychiatric outcomes and illness severity, systemic inflammation, cardiovascular and renin-angiotensin-system (RAS) biomarkers. Conclusion : The high prevalence of persistent neuropsychiatric symptoms in this young African cohort supports ongoing attention to long COVID. Persistent neuropsychiatric outcomes post-COVID are not associated with systemic inflammation or altered renin angiotensin physiology. Psychosocial variables affecting individual responses to the virus may explain the lack of association found on the biological front. DA - 2024 DB - OpenUCT DP - University of Cape Town KW - Anxiety, biopsychosocial, cognitive impairment LK - https://open.uct.ac.za PB - University of Cape Town PY - 2024 T1 - Persistent (>6 months) Neuropsychiatric symptoms in a cohort of SARS- CoV-2 PCR positive patients in Cape Town, South Africa TI - Persistent (>6 months) Neuropsychiatric symptoms in a cohort of SARS- CoV-2 PCR positive patients in Cape Town, South Africa UR - http://hdl.handle.net/11427/41313 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/41313
dc.identifier.vancouvercitationVan Niekerk I. Persistent (>6 months) Neuropsychiatric symptoms in a cohort of SARS- CoV-2 PCR positive patients in Cape Town, South Africa. []. University of Cape Town ,Faculty of Health Sciences ,Department of Psychiatry and Mental Health, 2024 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/41313en_ZA
dc.language.isoen
dc.language.rfc3066ENG
dc.publisher.departmentDepartment of Psychiatry and Mental Health
dc.publisher.facultyFaculty of Health Sciences
dc.publisher.institutionUniversity of Cape Town
dc.subjectAnxiety, biopsychosocial, cognitive impairment
dc.titlePersistent (>6 months) Neuropsychiatric symptoms in a cohort of SARS- CoV-2 PCR positive patients in Cape Town, South Africa
dc.typeThesis / Dissertation
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMMed
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