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Persistent (>6 months) Neuropsychiatric symptoms in a cohort of SARS- CoV-2 PCR positive patients in Cape Town, South Africa
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...
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| Format: | Thesis |
| Language: | English ENG |
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Department of Psychiatry and Mental Health
2025
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| _version_ | 1867613336929042432 |
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| access_status_str | Open Access |
| author | Van Niekerk, Inette |
| author2 | Peter, Jonathan |
| author_browse | Peter, Jonathan Van Niekerk, Inette |
| author_facet | Peter, Jonathan Van Niekerk, Inette |
| author_sort | Van Niekerk, Inette |
| collection | Thesis |
| description | 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. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/41313 |
| institution | University of Cape Town (South Africa) |
| language | English ENG |
| last_indexed | 2026-06-10T12:34:32.198Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2025 |
| publishDateRange | 2025 |
| publishDateSort | 2025 |
| publisher | Department of Psychiatry and Mental Health |
| publisherStr | Department of Psychiatry and Mental Health |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/41313 Persistent (>6 months) Neuropsychiatric symptoms in a cohort of SARS- CoV-2 PCR positive patients in Cape Town, South Africa Van Niekerk, Inette Peter, Jonathan Stein Dan Anxiety, biopsychosocial, cognitive impairment 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. 2025-04-01T08:42:50Z 2025-04-01T08:42:50Z 2024 2025-04-01T08:41:00Z Thesis / Dissertation Masters MMed http://hdl.handle.net/11427/41313 en ENG application/pdf Department of Psychiatry and Mental Health Faculty of Health Sciences University of Cape Town |
| spellingShingle | Anxiety, biopsychosocial, cognitive impairment Van Niekerk, Inette Persistent (>6 months) Neuropsychiatric symptoms in a cohort of SARS- CoV-2 PCR positive patients in Cape Town, South Africa |
| thesis_degree_str | Master's |
| title | Persistent (>6 months) Neuropsychiatric symptoms in a cohort of SARS- CoV-2 PCR positive patients in Cape Town, South Africa |
| title_full | Persistent (>6 months) Neuropsychiatric symptoms in a cohort of SARS- CoV-2 PCR positive patients in Cape Town, South Africa |
| title_fullStr | Persistent (>6 months) Neuropsychiatric symptoms in a cohort of SARS- CoV-2 PCR positive patients in Cape Town, South Africa |
| title_full_unstemmed | Persistent (>6 months) Neuropsychiatric symptoms in a cohort of SARS- CoV-2 PCR positive patients in Cape Town, South Africa |
| title_short | Persistent (>6 months) Neuropsychiatric symptoms in a cohort of SARS- CoV-2 PCR positive patients in Cape Town, South Africa |
| title_sort | persistent 6 months neuropsychiatric symptoms in a cohort of sars cov 2 pcr positive patients in cape town south africa |
| topic | Anxiety, biopsychosocial, cognitive impairment |
| url | http://hdl.handle.net/11427/41313 |
| work_keys_str_mv | AT vanniekerkinette persistent6monthsneuropsychiatricsymptomsinacohortofsarscov2pcrpositivepatientsincapetownsouthafrica |