{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T23:31:42Z","timestamp":1789601502326,"version":"build-2803163510"},"reference-count":55,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T00:00:00Z","timestamp":1693526400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behavioral Sciences"],"abstract":"<jats:p>We aimed to investigate depression, anxiety, stress, and PTSD symptoms and their relationship with disease severity in acutely ill hospitalized Coronavirus disease 2019 (COVID-19) patients. A single-center cross-sectional observational survey study screening for psychiatric symptoms using the Depression, Anxiety and Stress Scale\u201421 Items (DASS-21) and the Impact of Events Scale-Revised (IES-R) questionnaires was performed including a total of 169 acutely ill COVID-19 patients. All patients were adults and of white race and developed respiratory insufficiency during hospitalization. Demographic, clinical and laboratory data were evaluated as predictors of psychiatric symptoms. We hypothesized that higher intensity of COVID-19 symptoms and higher oxygen requirement would be associated with occurrence of depression, anxiety, stress, and PTSD symptoms. Depressive symptoms were absent in 29%, mild in 16%, moderate in 27.8%, severe in 10.7% and extremely severe in 16.6% patients. Anxiety symptoms were absent in 43.8%, mild in 6.5%, moderate in 17.2%, severe in 5.3% and extremely severe in 27.2% patients. Stress symptoms were absent in 78.7%, mild in 4.7%, moderate in 7.1%, severe in 7.7%, and extremely severe in 1.8% patients. A total of 60.9% patients had no PTSD symptoms, 16% had undiagnosed symptoms, and 23.1% met the criteria for a PTSD diagnosis. All psychiatric symptoms were more pronounced in female patients, depression and anxiety symptoms were associated with prior chronic obstructive pulmonary disease. Only depressive symptoms were significantly associated with higher intensity of COVID-19 symptoms and higher oxygen requirement. Acutely ill hospitalized COVID-19 patients presented a high prevalence of emergent psychiatric sequelae, especially in females, and more severe COVID-19 influenced mostly the severity of depressive symptoms.<\/jats:p>","DOI":"10.3390\/bs13090734","type":"journal-article","created":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T02:59:55Z","timestamp":1693796395000},"page":"734","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Relationship of Anxiety, Depression, Stress, and Post-Traumatic Stress Disorder Symptoms with Disease Severity in Acutely Ill Hospitalized COVID-19 Patients"],"prefix":"10.3390","volume":"13","author":[{"given":"Dijana","family":"Lucijanic","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Referral Centre for Stress-Related Disorders of the Ministry of Health, Centre University Hospital Dubrava, Avenija Gojka \u0160u\u0161ka 6, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3742-0757","authenticated-orcid":false,"given":"Alma","family":"Mihaljevic Peles","sequence":"additional","affiliation":[{"name":"Clinical Hospital Centre Zagreb,  Psychiatric Clinic, Kispaticeva 12, 10000 Zagreb, Croatia"},{"name":"Department for Chemistry and Biochemistry, School of Medicine, Salata 3, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5377-0269","authenticated-orcid":false,"given":"Nevenka","family":"Piskac Zivkovic","sequence":"additional","affiliation":[{"name":"Special Hospital Radiochirurgia, Ulica dr. Franje Tu\u0111mana 4, 10431 Sveta Nedjelja, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1372-2040","authenticated-orcid":false,"given":"Marko","family":"Lucijanic","sequence":"additional","affiliation":[{"name":"Hematology Department, University Hospital Dubrava, Av. Gojka Suska 6, 10000 Zagreb, Croatia"},{"name":"School of Medicine, University of Zagreb, Salata 3, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matija","family":"Kranjcevic","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Referral Centre for Stress-Related Disorders of the Ministry of Health, Centre University Hospital Dubrava, Avenija Gojka \u0160u\u0161ka 6, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lana","family":"Muzinic Marinic","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Referral Centre for Stress-Related Disorders of the Ministry of Health, Centre University Hospital Dubrava, Avenija Gojka \u0160u\u0161ka 6, 10000 Zagreb, Croatia"},{"name":"University of Applied Health Sciences in Zagreb, Mlinarska Street 38, 10000 Zagreb, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.euroneuro.2021.10.864","article-title":"The impact of the prolonged COVID-19 pandemic on stress resilience and mental health: A critical review across waves","volume":"55","author":"Manchia","year":"2022","journal-title":"Eur. 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