Persistent Psychological Distress and Its Associated Determinants Among Iranian COVID Survivors: A Cross-Sectional Study

Background: The COVID-19 pandemic has resulted in widespread physical and psychological challenges, including persistent psychological distress (PD). Research suggests that while some COVID survivors maintain satisfactory psychological functioning, others may experience long-term, severe PD. Addressing these challenges, along with associated sociodemographic determinants, requires a comprehensive, community-based approach. Objectives: This study aims to determine the prevalence of PD, including depression, anxiety, and stress, among Iranian COVID survivors by analyzing various regional, temporal, and sociodemographic determinants. Methods: The study, conducted between July 2021 and February 2022, aimed to determine persistent PD among Iranian COVID survivors. Ethical approval and other necessary permits were obtained. The final sample size consisted of 300 participants selected from an initial pool of 11,337 medical records. Participants received questionnaires electronically, including the “Socio-Demographic Clinical Questionnaire (SDCQ)” and the “Depression, Anxiety, and Stress Scale 21 (DASS21).” The study used SPSS 26 for statistical analysis, calculating means, standard deviations, and frequencies. Relationships between determinants were examined using ANOVA and chi-square tests. Bayesian regression analysis was employed to explore correlations and predictive power between COVID-19, PD, and the various determinants. Results: The prevalence of depression, anxiety, and stress, considered collectively as PD among participants, was 49%, 53%, and 61%, respectively, with mean severity scores of 10.68 ± 2.16 for depression, 9.18 ± 1.84 for anxiety, and 15.93 ± 2.79 for stress. More severe manifestations of PD were observed in participants from Hospital III (P > 0.05, r ≈ 0.17) and during the temporal period of 12 - 24 weeks post-infection (P < 0.05, r ≈ -0.12). Additionally, significant correlations between PD and determinants such as sex, Intensive Care Unit (ICU) admissions, and intubation were noted (P < 0.05). Bayesian analysis further highlighted cross-correlations between PD and other determinants among Iranian COVID survivors (P < 0.05, BF < 0.1). Conclusions: In conclusion, the study found that Iranian COVID survivors experienced mild levels of depression, anxiety, and stress, with prevalence rates ranging from 49% to 61%. The highest severity of PD was observed in participants from Hospital III and during the period of 12 - 24 weeks post-infection. Additionally, a network of cross-correlations was identified between PD and various other determinants among Iranian COVID survivors.