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SLEEP DISORDER IN COVID19 SURVIVORS

N. BOUATTOUR¹, S. ABID², M. TURKI¹, I. EL WHADHANE², A. KOTTI², N. KALLEL² , N.
HALOUANI¹, J. ALOULOU¹, S. MSAAD², W. FEKI², S. KAMMOUN²
DEPARTEMENT OF PSYCHIATRIC B, CHU HÉDICHAKER SFAX-TUNISIA 2 DEPARTEMENT OF
PNEUMO-ALLERGOLOGY, CHU HÉDICHAKER SFAX-TUNISIA

BACKGROUND : A wide spectrum of long-term COVID-19 effects have been reported.
However, much less data are available about how COVID-19 will affect sleep over
time in recovered patients.

Aim studyAssessing the long-term impact of COVID 19 on sleep, and the potential
associated risk factors among SARS-CoV-2-infected patients after hospital discharge.
METHODOLOGY : This is a prospective cohort study including 84 adult Tunisian
COVID 19 inpatients who had been discharged alive from hospital. Each enrolled
patient was asked about the period before SARS COV2 related hospital stay, and the
6-9 month-period after hospital discharge, using several self-reported evaluation
scales (Arabic validated version of the Pittsburgh Sleep Quality Index (PSQI), the
Insomnia Severity Index (ISI), the validated Arabic version of the Epworth Sleepiness
Scale (ESS), the visual analogue scale (VAS) for pain, the validated Arabic version of
the Patient Health Questionnaire (PHQ)-9 and the EuroQol five-dimension five-level
(EQ-5D-5L) questionnaire).

RESULTS : The mean age of patients in the study was 57,59 ± 12,84 years with 46
(54,8%) men and 38 (45,2%) women. As compared with baseline statue of patients, all
assessed outcomes were significantly impaired (VAS pain: 1,71±1,1 Vs 3,8±2,84; PSQI:
3,25±2,4 VS 6,39±4,73; ESS: 1,94±2,44 VS 3,59±4,53; ISI: 1,95±2,76 VS 6,07±5,96, and
PHQ-9: 1,45±2,74 VS 7,47 ± 6,61; p<=0.0001). The percentage of poor sleepers (PSQI
global score > 5) and patients with insomnia had significantly increased from 15,5% to
48,8% and from 1,2 to 11%, respectively (p<=0.0001). The percentage of patients
experiencing depression symptoms has also doubled (25% to 58,3%), while severe
pain was reported by more than one out of five patients against only 1,2% at baseline.
The post-COVID -19 PSQI was significantly correlated with body mass index (r=0,328,
p=0,003); the post-COVID-19 VAS pain (r=0,479, p=0,0001) as well as the post-COVID-
19 PHQ-9 scale (r=0,712, p=0,0001).
CONCLUSIONS : Sleep disturbances, depression symptoms as well as chronic pain
are highly prevalent in long-term follow-up period in hospitalized COVID-19 survivors,
therefore, they should be systematically screened.

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