Cognitive and mental health changes and their vulnerability factors related to COVID-19 lockdown in Italy

The Predictive Power and Dominance of Variables of Purpose and Social Support for Depression, Anxiety, and Fear of COVID-19 in Paraguay

The advent of the COVID-19 pandemic forces us to investigate new emotional phenomena, as well as the validity of psychological variables associated with well-being and mental health. In this cross-sectional study with a correlative-predictive scope, there were 265 participants, adults residing in the Republic of Paraguay. The objectives of this research were to determine the predictive power and dominance of the social support and purpose variables for depression, anxiety, and fear of COVID-19. Both social support and purpose presented a significant negative prediction level for depression. In contrast, only social support presented a negative prediction for anxiety and fear of COVID-19, while purpose even presented a positive relationship with respect to the variable. When evaluating the relationship between the variables of social support and purpose, the perception of meaning presented dominance and negative predictive power for depression, while a positive link between destiny-freedom, depression, anxiety, and fear of COVID-19 was obtained. The probable causes of the results are explained; new research is suggested, and it is concluded on the need to review salutogenic psychological concepts in light of the new pandemic context.

The Blursday database as a resource to study subjective temporalities during COVID-19

The COVID-19 pandemic and associated lockdowns triggered worldwide changes in the daily routines of human experience. The Blursday database provides repeated measures of subjective time and related processes from participants in nine countries tested on 14 questionnaires and 15 behavioural tasks during the COVID-19 pandemic. A total of 2,840 participants completed at least one task, and 439 participants completed all tasks in the first session. The database and all data collection tools are accessible to researchers for studying the effects of social isolation on temporal information processing, time perspective, decision-making, sleep, metacognition, attention, memory, self-perception and mindfulness. Blursday includes quantitative statistics such as sleep patterns, personality traits, psychological well-being and lockdown indices. The database provides quantitative insights on the effects of lockdown (stringency and mobility) and subjective confinement on time perception (duration, passage of time and temporal distances). Perceived isolation affects time perception, and we report an inter-individual central tendency effect in retrospective duration estimation.

Perceptions of societal ageism and declines in subjective memory during the COVID-19 pandemic: Longitudinal evidence from US adults aged ≥55 years

The cognitive health of older adults since the COVID-19 pandemic onset is unclear, as is the potential impact of pandemic-associated societal ageism on perceived cognition. We investigated associations between perceptions of societal ageism and changes in subjective memory over a 10-month period during the COVID-19 pandemic. We collected longitudinal data from monthly online questionnaires in the nationwide COVID-19 Coping Study of US adults aged ≥55 from April 2020 to January 2021 (N = 4444). We analyzed the data using multivariable longitudinal multilevel models. We identified an overall decline in subjective memory, especially in the initial months of the pandemic. Adults who perceived that societal respect for older adults decreased during the pandemic experienced more rapid declines in their subjective memory. These findings suggest that aging adults perceived a decline in their memory, especially during the initial months of the COVID-19 pandemic. Societal interventions to combat ageism may help improve subjective memory and could decrease risk for cognitive decline among middle-aged and older adults.

Remote auditory assessment using Portable Automated Rapid Testing (PART) and participant-owned devices

Remote testing of auditory function can be transformative to both basic research and hearing healthcare; however, historically, many obstacles have limited remote collection of reliable and valid auditory psychometric data. Here, we report performance on a battery of auditory processing tests using a remotely administered system, Portable Automatic Rapid Testing. We compare a previously reported dataset collected in a laboratory setting with the same measures using uncalibrated, participant-owned devices in remote settings (experiment 1, n = 40) remote with and without calibrated hardware (experiment 2, n = 36) and laboratory with and without calibrated hardware (experiment 3, n = 58). Results were well-matched across datasets and had similar reliability, but overall performance was slightly worse than published norms. Analyses of potential nuisance factors such as environmental noise, distraction, or lack of calibration failed to provide reliable evidence that these factors contributed to the observed variance in performance. These data indicate feasibility of remote testing of suprathreshold auditory processing using participants' own devices. Although the current investigation was limited to young participants without hearing difficulties, its outcomes demonstrate the potential for large-scale, remote hearing testing of more hearing-diverse populations both to advance basic science and to establish the clinical viability of auditory remote testing.

Mental Health Consequences of COVID-19 Pandemic Period in the European Population: An Institutional Challenge

The worldwide spread of SARS-CoV-2 has been responsible for an infectious pandemic, with repercussions on socio-economic aspects and on the physical and mental health of the general population. The present systematic review aimed to evaluate the data belonging to the European framework, analyzing the population by age group. Original articles and reviews on the state of mental health of the general European population have been researched starting from 2021. Initially, a total of 1764 studies were found, among which a total of 75 were selected. Youth were the age group most affected by pandemic consequences on mental health, with emotional and behavioral alterations observed from a third to more than a half of children and adolescents examined. Among both adolescents and adults, the female gender had a higher prevalence of psychopathological symptoms. The main risk factors were poor social support, economic difficulties, and, in particular, unemployment or job changes. Additional individual risk factors were the perception of loneliness, the presence of pre-pandemic mental illness/distress, and some personality traits, such as neuroticism, impulsiveness, and the use of maladaptive coping strategies. Unexpectedly, the elderly maintained good resilience towards change, even if a stress factor was represented by the feeling of loneliness and poor social contact. As regards suicidal behaviors, among adolescents, there was an increase in attempts of 25%, with a greater risk for the female gender. This risk increased also among adults, in association with symptoms of anxiety and depression, and poor socio-environmental conditions. In conclusion, some population groups were found to be at greater risk of psychological burden during pandemic waves, thus representing priority targets for socio-health interventions.

Overexposure to COVID-19 information amplifies emotional distress: a latent moderated mediation model

An infodemic has accompanied the COVID-19 pandemic. This study explores whether overexposure to COVID-19-related information amplifies emotional distress. A cross-sectional online survey was conducted in China during the outbreak and after the peak of the pandemic (N = 1313). A latent moderated mediation model was built to analyze this relationship. COVID-19 information exposure was found to relate positively with emotional distress, and risk perception mediated the association between them. Additionally, psychological resilience moderated the mediating effects of risk perception. However, five factors of resilience differed in their moderating effects. This study offers theoretical and practical implications apropos clinical intervention and public health management.

One-year into COVID-19 pandemic: Decision-making and mental-health outcomes and their risk factors

BACKGROUND

The COVID-19 pandemic represents an unprecedented worldwide crisis with serious socioeconomic, physical and mental health consequences. However, its long-lasting effects on both mental health and decision-making difficulties remain unexplored. This study aimed to determine the prevalence and severity of psychological disorders in Italy's populace one-year after the outbreak; further, we investigated potential risks impacting mental health and decision-making.

METHODS

In March 2021, 586 individuals (18-73 years) completed an online-survey plus a computerized delay discounting task for hypothetical money rewards.

RESULTS

Psychological symptoms prevalence exceeded the Italy's lockdown rates, with about one-third reporting moderate-to-extremely severe depression, another third anxiety, and the rest stress; mirrored by an increase of symptoms at clinically significant severity levels. One year into the pandemic, half of our sample presented at least one psychological problem, and one-third was at risk of developing a more clinically severe psychological outcome. Fear of job loss, loneliness and intolerance of uncertainty were among the major risk factors to mental health. Plus, social-relationships and financial uncertainty were key determinants of depression, while fear of COVID-19 infection predicted anxiety symptoms. For decision-making tendencies, elevated delay discounting rates, implying less future-oriented behaviors, were mostly predicted by increased job loss fear and older age (>35 years).

LIMITATIONS

This study provides cross-sectional evidence.

CONCLUSIONS

Depression, anxiety and stress levels were still alarming one-year into COVID-19. Individuals experiencing financial insecurity, loneliness and intolerance of uncertainty perhaps benefit most from early interventions. Governments need to implement timely recovery plans to reduce financial insecurity, given its significant mental health impact and decision-making outcomes.

Change in Neuroticism and Extraversion among Pre-University Education Employees during the COVID-19 Pandemic

Background and objectives: Since the first reports of SARS-CoV-2 infection cases in China, the virus has rapidly spread to many countries, including Romania. In Romania, schools were closed in March 2020 to prevent the virus from spreading; since then, they have been sporadically opened, but only for a short time. Teachers had to adopt online education methods, experiencing real difficulties in their attempts to maintain high-quality teaching, as a result of social distancing from students and colleagues. The current study aimed to evaluate the burden on the neuroticism states of employees in the pre-university education system during the COVID-19 pandemic. Materials and Methods: A prospective study was conducted, in which personality trait data from 138 employees were collected via a questionnaire (EPI, Eysenck Personality Inventory), which measured extraversion–introversion and neuroticism scores before and during the COVID-19 pandemic. Initially, 150 subjects were invited to participate in the study, although 12 of them refused to participate. Based on the questionnaire not being fully filled in a further three subjects were excluded from the study, leaving a total of 135, of which 115 were woman and 20 were men. Results: The results demonstrate that the subjects included in the study expressed higher neuroticism during the COVID-19 pandemic than in the pre-pandemic period. This change could promote more stress and depression symptoms. Subjects with high school education had significantly lower neuroticism scores over time than those with university education (p = 0.006). Furthermore, we found extraversion scores to be statistically significant in our population (p = 0.022). Conclusion: The gender and living environment of the teachers were not significantly associated with the reduction in the extraversion score, but were more frequently found among older persons and in subjects without higher education. Subjects of Hungarian ethnicity had lower extraversion scores than those of Romanian ethnicity.

Emotional blunting in patients with depression. Part III: relationship with psychological trauma

BACKGROUND

This international online survey investigated the experience and impact of emotional blunting in the acute and remission phases of depression from the perspective of patients and healthcare providers (HCPs). This paper presents data on the history and severity of psychological trauma and its potential impact on emotional blunting in major depressive disorder (MDD); differences between patient and HCP perceptions are explored.

METHODS

Patient respondents (n = 752) were adults with a diagnosis of depression who were currently taking antidepressant therapy and reported emotional blunting during the past 6 weeks. HCPs provided details on two eligible patients: one in the acute phase of depression and one in remission from depression (n = 766). Trauma was assessed using questions based on the Childhood Trauma Questionnaire; emotional blunting was assessed using the Oxford Depression Questionnaire (ODQ). Multivariate regression analyses were applied to examine the relationship between trauma and ODQ score.

RESULTS

A history of any childhood or recent traumatic event was reported by 97% of patients in the self-assessed cohort and for 83% of those in the HCP-assessed cohort (difference, p < 0.01). Patients were more likely than HCPs to feel that this trauma had contributed to their/the patient's depression (58% vs 43%, respectively; p < 0.01) and that the depression was more severe because of trauma (70% vs 61%, respectively; p < 0.01). Emotional blunting was significantly worse in patients who reported severe trauma than in those who had not experienced severe trauma (mean total ODQ score, 90.1 vs 83.9, respectively; p < 0.01). In multivariate regression analyses, experiencing both severe childhood and recent trauma had a statistically significant impact on ODQ total score (p = 0.001).

CONCLUSIONS

A high proportion of patients with depression and emotional blunting self-reported exposure to childhood and/or recent traumatic events, and emotional blunting was more severe in patients who reported having experienced severe trauma. However, history of psychological trauma in patients with MDD appeared to be under-recognized by HCPs. Improved recognition of patients who have experienced psychological trauma and are experiencing emotional blunting may permit more targeted therapeutic interventions, potentially resulting in improved treatment outcomes.

Opinions and options about COVID-19: Personality correlates and sex differences in two European countries

In the initial months of the COVID-19 pandemic in 2020, we collected data (N = 1,420) from Portugal and Spain in relation to personality (i.e., Dark Triad traits, Big Five traits, religiousness, and negative affect) and attitudes related to COVID-19 about its origins, opinions on how to deal with it, and fear of it. The most pervasive patterns we found were: (1) neurotic-type dispositions were associated with stronger opinions about the origins of the virus and leave people to have more fear of the virus but also more trust in tested establishments to provide help. (2): religious people were less trusting of science, thought prayer was answer, and attributed the existence of the virus to an act of God. We also found that sex differences and country differences in attitudes towards COVID-19 were mediate by sex/country differences in personality traits like emotional stability, religiousness, and negative affect. For instance, women reported more fear of COVID-19 than men did, and this was verified by women’s greater tendency to have negative affect and low emotional stability relative to men. Results point to the central role of neuroticism in accounting for variance in broad-spectrum attitudes towards COVID-19.

Risk and Protective Factors of Psychological Distress in Patients Who Recovered From COVID-19: The Role of Cognitive Reserve

Recent studies reported the development of psychological distress symptoms in patients who recovered from COVID-19. However, evidence is still scarce and new data are needed to define the exact risk and protective factors that can explain the variability in symptoms manifestation. In this study, we enrolled 257 patients who recovered from COVID-19 and we evaluated the levels of psychological distress through the Symptoms Checklist-90-R scale. Data concerning illness-related variables were collected from medical records, while the presence of subjective cognitive difficulties, both before and after the illness, as well as the level of the cognitive reserve (CR), were assessed over a clinical interview. Results revealed that being female and reporting the presence of subjective cognitive difficulties after COVID-19 were associated with higher levels of psychological distress. At the same time, being admitted to the hospital and having a high CR were protective factors. Adding new information to this emerging research field, our results highlight the importance of a complete psychological and cognitive assessment in patients with COVID-19.

Pet Presence Can Reduce Anxiety in the Elderly: The Italian Experience during COVID-19 Lockdown Assessed by an Electronic Survey

The lockdown imposed in Italy due to the COVID-19 outbreak required restrictions that severely limited individual freedom to protect the population and reduce virus diffusion. This situation psychologically challenged the entire Italian population but mostly the elderly. The "Digital mental health approach" employs digital tools to evaluate and prevent increasing mental health problems. "Anonymous online electronic surveys" are digital tools that assess rates of mental health outcomes (using for example self-assessment/awareness tools). Immediately at the beginning of restrictions, we designed an electronic survey a) to remotely investigate the psychological impact of the lockdown and b) to compare the anxiety between pet owners and not-pet owners. A total of 3905 subjects filled out the survey; we focused our study on 781 (20%) elderly subjects. Dividing elderly patients between pet-owners (n = 405) and not-pet owners (n = 376), the pet owners showed a Zung scale score significantly lower in respect to the not-pet owners. We observed that, during the COVID-19 outbreak, the pet presence could have a positive effect on anxiety in the elderly subject. These results: (A) encourage the use of mobile technologies for the assessment of psychological disorders that can be promptly employed in emergencies such as the COVID-19 outbreak; (B) highlight the positive effect of pet interaction to mitigate the psychological distress in elderly people.

Age-related cognitive effects of the COVID-19 pandemic restrictions and associated mental health changes in Germans

Restrictive means to reduce the spread of the COVID-19 pandemic have not only imposed broad challenges on mental health but might also affect cognitive health. Here we asked how restriction-related changes influence cognitive performance and how age, perceived loneliness, depressiveness and affectedness by restrictions contribute to these effects. 51 Germans completed three assessments of an online based study during the first lockdown in Germany (April 2020), a month later, and during the beginning of the second lockdown (November 2020). Participants completed nine online cognitive tasks of the MyBrainTraining and online questionnaires about their perceived strain and impact on lifestyle factors by the situation (affectedness), perceived loneliness, depressiveness as well as subjective cognitive performance. The results suggested a possible negative impact of depressiveness and affectedness on objective cognitive performance within the course of the lockdown. The younger the participants, the more pronounced these effects were. Loneliness and depressiveness moreover contributed to a worse evaluation of subjective cognition. In addition, especially younger individuals reported increased distress. As important educational and social input has partly been scarce during this pandemic and mental health problems have increased, future research should also assess cognitive long-term consequences.

Cognitive factors influenced physical distancing adherence during the COVID-19 pandemic in a population-specific way

Even early in the COVID-19 pandemic, adherence to physical distancing measures was variable, exposing some communities to elevated risk. While cognitive factors from the Health Belief Model (HBM) and resilience correlate with compliance with physical distancing, external conditions may preclude full compliance with physical distancing guidelines. Our objective was to identify HBM and resilience constructs that could be used to improve adherence to physical distancing even when full compliance is not possible. We examined adherence as expressed through 7-day non-work, non-household contact rates in two cohorts: 1) adults in households with children from Minnesota and Iowa; and 2) adults ≥50 years-old from Minnesota, one-third of whom had Parkinson's disease. We identified multiple cognitive factors associated with physical distancing adherence, specifically perceived severity, benefits, self-efficacy, and barriers. However, the magnitude, and occasionally the direction, of these associations was population-dependent. In Cohort 1, perceived self-efficacy for remaining 6-feet from others was associated with a 29% lower contact rate (RR 0.71; 95% CI 0.65, 0.77). This finding was consistent across all race/ethnicity and income groups we examined. The barriers to adherence of having a child in childcare and having financial concerns had the largest effects among individuals from marginalized racial and ethnic groups and high-income households. In Cohort 2, self-efficacy to quarantine/isolate was associated with a 23% decrease in contacts (RR 0.77; 95% CI 0.66, 0.89), but upon stratification by education level, the association was only present for those with at least a Bachelor's degree. Education also modified the effect of the barrier to adherence leaving home for work, increasing contacts among those with a Bachelor's degree and reducing contacts among those without. Our findings suggest that public health messaging tailored to the identified cognitive factors has the potential to improve physical distancing adherence, but population-specific needs must be considered to maximize effectiveness.

Telephone Interview for Cognitive Status (TICS): Italian adaptation, psychometrics and diagnostics

BACKGROUND

Telephone-based cognitive screening (TBCS) is crucial to telehealth care of neurological patients, prevention campaigns, and epidemiological studies on cognitive impairment. The Telephone Interview for Cognitive Status (TICS) is one of the most widespread and psychometrically/diagnostically sound TBCS test, with several versions developed worldwide (e.g., with and without a delayed recall item). In Italy, only attempts of adaptation and preliminary evidence of its statistical features have been provided so far. This study thus aimed at (1) developing an Italian version of the TICS and assessing its (2) psychometric and (3) diagnostic properties.

METHODS

A back-translated and culturally adapted version of the TICS was developed. Three-hundred and sixty-five healthy individuals from different regions of Italy (147 males, 216 females; age: 53.2 ± 16 years; education: 13 ± 4.5 years) were administered the TICS and the Italian telephone-based Mini-Mental State Examination (Itel-MMSE). Validity was tested by convergence and at the structure level, whereas reliability as internal consistency, test-retest, and inter-rater. Diagnostic accuracy, item difficulty, and discrimination were also examined.

RESULTS

The TICS featured a single component and its score converged with that of the Itel-MMSE (rs = .37). Reliability was excellent as inter-rater (ICC = .94), good as test-retest (ICC = .78), and acceptable as internal consistency (Cronbach's α = .63). Accuracy was high as tested against the Itel-MMSE (AUC = .83) and did not improve when adding the delayed recall. Backward subtraction was the most difficult and discriminative task.

DISCUSSION

The Italian TICS is a valid, reliable, and diagnostically accurate TBCS test. The original format of the TICS can be thus adopted in both clinical and research settings.

Psychological impact of the quarantine during the COVID-19 pandemic on the general European adult population: a systematic review of the evidence

AIMS

Due to the coronavirus disease 2019 (COVID-19) different countries implemented quarantine measures to limit the spread of the virus. Many studies analysed the mental health consequences of restrictive confinement, some of which focused their attention on specific populations. The general public's mental health also requires significant attention, however. This study aimed to evaluate the effects of the COVID-19 quarantine on the general population's mental health in different European countries. Risk and protective factors associated with the psychological symptoms were analysed.

METHODS

A systematic search was conducted on four electronic databases (PubMed, PsycINFO, Scopus and Google Scholar). Studies published up until 20th April 2021, and following eligibility criteria were selected for this review. One thousand three hundred thirty-five (1335) studies were screened, 105 of which were included. Via network analysis, the current study investigated the pathways that underlie possible risk factors for mental health outcomes.

RESULTS

Anxiety, depression, distress and post-traumatic symptoms are frequently experienced during the COVID-19 quarantine and are often associated with changes in sleeping and eating habits. Some socio-demographic and COVID-19-related variables were found to be risk factors for an individual's wellbeing. In particular, being female, young, having a low income, being unemployed and having COVID-19-like symptoms or chronic disorders, were found to be the most common risk factors for mental health symptoms.

CONCLUSIONS

The COVID-19 pandemic represented an unprecedented threat to mental health globally. In order to prevent psychological morbidity and offer support tailored to short-, medium- and long-term negative outcomes, it is essential to identify the direct and indirect psychosocial effects of the lockdown and quarantine measures, especially in certain vulnerable groups. In addition to measures to reduce the curve of viral transmission, policy makers should urgently take into consideration provisions to alleviate hazards to mental health.

Mental Health and Access to Information in Times of COVID-19: The Role of Social Work

The confinements and limited social interactions that have derived from COVID-19 have aggravated the situation of people with previous pathologies. As a result, access to health and its rehabilitation or support resources has been limited and redirected toward online care. People with mental health problems have considerably suffered during the pandemic because, for many of them, accessing different information resources through telematic means proved to be a great difficulty in their everyday lives. This exploratory research work aims to establish which elements have successfully facilitated access to online information for people with mental health problems. This is especially urgent in times of COVID-19 when misinformation has significantly harmed this group. To do so, we followed the communicative methodology and held interviews with two professionals and nine users who participated in the case study. The main results show that, in developing digital communicative competencies in accessing information with this group, individualization of care to overcome barriers, the link with social workers as references of truthful information, and the importance of emotional work and interactions are critical elements.

Impact of the COVID-19 lockdown on psychological health and nutritional habits in Italy: results from the #PRESTOinsieme study

OBJECTIVES

The present work aims to present the results of the 'PRESTOinsieme' (which is 'we will be together soon' in English). The web-based survey (www.prestoinsieme.com) describes changes in lifestyle habits and symptoms of psychological discomfort in the Italian population during the COVID-19 lockdown.

DESIGN

Cross-sectional online survey disseminated by messaging apps (ie, WhatsApp and Telegram) and social networks (ie, Instagram, Facebook and LinkedIn).

SETTING

Italy.

PARTICIPANTS

Italian population older than 16 years of age.

EXPOSURE

COVID-19 lockdown.

MAIN OUTCOMES AND MEASURES

Survey respondents filled out a set of validated questionnaires aimed at assessing lifestyle habits and psychological health, that is, the General Health Questionnaire (GHQ-12) to screen for psychological distress, the Impact of Event Scale-Revised (IES-R) to screen for post-traumatic stress and the Center for Epidemiologic Studies Depression Scale (CES-D).

RESULTS

Survey respondents totalled 5008. Moderate or severe psychological distress was reported in 25.5% and 22% of survey respondents, respectively. Lower age, female gender, being unemployed (OR 1.57, 95% CI 1.22 to 2.02) or being a student (OR 1.73, 95% CI 1.31 to 2.28) were predictors of more severe depressive symptoms.

CONCLUSIONS

The present study is one of the largest population-based surveys conducted in Italy during the first COVID-19 lockdown, providing valuable data about the Italian population's psychological health. Further studies should be conducted to understand whether psychological distress persists after the end of the lockdown.

COVCOG 1: Factors Predicting Physical, Neurological and Cognitive Symptoms in Long COVID in a Community Sample. A First Publication From the COVID and Cognition Study

Since its first emergence in December 2019, coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has evolved into a global pandemic. Whilst often considered a respiratory disease, a large proportion of COVID-19 patients report neurological symptoms, and there is accumulating evidence for neural damage in some individuals, with recent studies suggesting loss of gray matter in multiple regions, particularly in the left hemisphere. There are a number of mechanisms by which COVID-19 infection may lead to neurological symptoms and structural and functional changes in the brain, and it is reasonable to expect that many of these may translate into cognitive problems. Indeed, cognitive problems are one of the most commonly reported symptoms in those experiencing "Long COVID"-the chronic illness following COVID-19 infection that affects between 10 and 25% of patients. The COVID and Cognition Study is a part cross-sectional, part longitudinal, study documenting and aiming to understand the cognitive problems in Long COVID. In this first paper from the study, we document the characteristics of our sample of 181 individuals who had experienced COVID-19 infection, and 185 who had not. We explore which factors may be predictive of ongoing symptoms and their severity, as well as conducting an in-depth analysis of symptom profiles. Finally, we explore which factors predict the presence and severity of cognitive symptoms, both throughout the ongoing illness and at the time of testing. The main finding from this first analysis is that that severity of initial illness is a significant predictor of the presence and severity of ongoing symptoms, and that some symptoms during the initial illness-particularly limb weakness-may be more common in those that have more severe ongoing symptoms. Symptom profiles can be well described in terms of 5 or 6 factors, reflecting the variety of this highly heterogenous condition experienced by the individual. Specifically, we found that neurological/psychiatric and fatigue/mixed symptoms during the initial illness, and that neurological, gastrointestinal, and cardiopulmonary/fatigue symptoms during the ongoing illness, predicted experience of cognitive symptoms.

Coping with the COVID-19 Pandemic: Perceived Changes in Psychological Vulnerability, Resilience and Social Cohesion before, during and after Lockdown

The COVID-19 pandemic and associated lockdowns have posed unique and severe challenges to our global society. To gain an integrative understanding of pervasive social and mental health impacts in 3522 Berlin residents aged 18 to 65, we systematically investigated the structural and temporal relationship between a variety of psychological indicators of vulnerability, resilience and social cohesion before, during and after the first lockdown in Germany using a retrospective longitudinal study design. Factor analyses revealed that (a) vulnerability and resilience indicators converged on one general bipolar factor, (b) residual variance of resilience indicators formed a distinct factor of adaptive coping capacities and (c) social cohesion could be reliably measured with a hierarchical model including four first-order dimensions of trust, a sense of belonging, social interactions and social engagement, and one second-order social cohesion factor. In the second step, latent change score models revealed that overall psychological vulnerability increased during the first lockdown and decreased again during re-opening, although not to baseline levels. Levels of social cohesion, in contrast, first decreased and then increased again during re-opening. Furthermore, participants who increased in vulnerability simultaneously decreased in social cohesion and adaptive coping during lockdown. While higher pre-lockdown levels of social cohesion predicted a stronger lockdown effect on mental health, individuals with higher social cohesion during the lockdown and positive change in coping abilities and social cohesion during re-opening showed better mental health recovery, highlighting the important role of social capacities in both amplifying but also overcoming the multiple challenges of this collective crisis.

Subjective psychological impacts during COVID-19 lockdown on older people, risk profiles and coping strategies: Results of an online survey in Spain

This study explores the psychological impacts of lockdown among older people during the coronavirus disease 2019 pandemic in Spain, and identifies risk profiles and adaptative behaviors. A cross-sectional online survey was disseminated by social networks through snowball sampling (April-June 2020). The survey included ad-hoc questions about psychological impacts on subjective cognitive functioning, emotional distress, and loneliness. Open end-questions were coded according to Lazarus and Folkman's coping strategies framework. Of the 2010 respondents, 76% experienced impact in at least one cognitive function (11% reporting severe effects), 78% frequent sadness and 13% frequent loneliness. Age 80+, women and low education increased the risk of loneliness and severe impact in memory and processing speed. Living alone was an additional risk factor for loneliness and sadness. Lockdown is associated with cognitive impacts, emotional distress, and loneliness being risk profiles related to inequality axes. Coping strategies should inform aging policies to prevent psychological impacts during the lockdown.

Some of the workforce face post COVID after the acute phase of the illness: The employer’s supportive role

BACKGROUND: A considerable proportion of workers that recover from an acute phase of COVID-19 are confronted with post COVID-19 symptoms of varying severity and duration. Employers have an important role in addressing this new condition. OBJECTIVE: The aim of this study was to review organisational practises that could help employees suffering from long COVID-19 return to work and to link these suggestions to theoretical frameworks from the field of work and organisational psychology. METHODS: Since scientific publications on post COVID-19 are published daily, but sound empirical studies are still scarce, the synthesis of the scientific and professional literature was performed in the form of a narrative review. RESULTS: The results were organised according to the healthy workplace model and explained through the lens of the job demands-resources theory. The role of the employer has three aspects: collaboration, instructional pillars, and key actors. The main guidelines for implementation of the policies are an individualised approach, flexibility, and support. Supportive policies, practises, and relationships might have a direct impact on workers’ psychological resources. CONCLUSIONS: The model could help employers understand the conditions and necessary adaptations for workers with post COVID-19, as well as advance research in work and organisational psychology.

Cognitive Health Worries, Reduced Physical Activity and Fewer Social Interactions Negatively Impact Psychological Wellbeing in Older Adults During the COVID-19 Pandemic

The Coronavirus pandemic has significantly affected psychological wellbeing in older adults, with cases of depression, anxiety and loneliness rising in the general population. Cognitive health has also potentially been affected, as social isolation can lead to cognitive decline. Worrying about cognitive health can be damaging to psychological wellbeing and is especially relevant to explore in the context of the Coronavirus pandemic. The objective of the present study was to explore the associations between cognitive health worries and wellbeing, and to investigate whether physical activity and social contact can mitigate negative effects of the pandemic on psychological wellbeing. Older adults (N = 191) completed an online survey which included measures of cognitive health worries, depression, anxiety, loneliness, social isolation, fatigue, impact of the Coronavirus pandemic, quality of life, subjective vitality, and physical activity. Analyses indicated that cognitive health worries, lower levels of physical activity and smaller amounts of social interaction were associated with poorer psychological and physical wellbeing. Results showed that worrying about cognitive health is associated with poorer wellbeing, and so interventions are needed to encourage positive cognitive functioning in times of social isolation. Promoting physical activity and social interaction is also beneficial, as results show that exercise and social contact are linked with improved wellbeing.

The Cognitive Consequences of the COVID-19 Pandemic on Members of the General Population in Italy: A Preliminary Study on Executive Inhibition

The pandemic period which has characterized the last two years has been associated with increasingly worsening psychological conditions, and previous studies have reported severe levels of anxiety, mood disorder, and psychopathological alteration in the general population. In particular, worldwide populations have appeared to present post-traumatic stress symptoms (PTSS). Surprisingly, no studies have evaluated the effect of COVID-related PTSS on cognitive functioning. This study focused on the association between high levels of PTSS related to COVID-19 and alterations in executive functioning by considering executive inhibitions in populations not infected by the virus. Ninety respondents from the Italian population participated in the study. A higher percentage of PTSS was reported. Moreover, respondents with high post-traumatic symptomatology presented deficits in the inhibition of preponderant responses, demonstrating an executive deficit which could be expressed by a difficulty in controlling goal-directed actions. This was underlined by worse performances in elaborating incongruent stimuli in the Stroop task and no-go stimuli in the Go/No-Go task. This report presents preliminary findings underlining the effect of the COVID-19 pandemic on cognitive functions. The results confirmed a persistently higher post-traumatic symptomatology related to the COVID-19 pandemic in the Italian population and highlighted an association with cognitive inhibition impairment.

Exploring the Protective Function of Positivity and Regulatory Emotional Self-Efficacy in Time of Pandemic COVID-19

Despite several empirical studies on the 2019 coronavirus disease (COVID-19) pandemic that have highlighted its detrimental effect on individuals' mental health, the identification of psychological factors that may moderate its impact on individuals' behavior and well-being remains partly unexplored. The present study was conceived to examine the mediation role of regulatory emotional self-efficacy in the relationship between positivity and anxiety, depression, and perceived self-efficacy in complying with the containment measures to contrast the COVID-19 spread. Furthermore, the moderation role of age was tested. A sample of 1258 participants (64.2% women; Mage = 42.09, SD = 13.62) enrolled from the Italian general population answered an online survey aimed at investigating the role of individual differences in facing the COVID-19 pandemic. We opted for a snowball recruiting procedure to find participants. The online survey was disseminated through email invitation and using social media platforms (i.e., Facebook, Instagram). A multi-group path analysis model was performed using Mplus 8.4 to explore the hypothesized relations among variables. The following criteria were employed to evaluate the goodness of fit: χ2 likelihood ratio statistic, CFI and TLI > 0.95, RMSEA < 0.06 and SRMR < 0.08. The findings corroborated the protective role of both positivity and regulatory emotional self-efficacy in reducing individuals' anxiety and depressive symptoms, as well as in fostering individuals' capabilities in complying with the containment measures imposed by the government to reduce the risk of illness and to contain the spread of the virus COVID-19. Specifically, regulatory emotional self-efficacy beliefs partially mediated the relations between positivity and anxiety and depressive symptoms and fully mediated the effect of positivity on perceived self-efficacy beliefs in complying with the containment measures. These paths were equal across ages. The results of the present study appear relevant to implementing psychological interventions aimed to reduce the deleterious effects of the COVID-19 pandemic on mental health through the promotion of individuals' optimistic orientation and emotion regulation.

Mental distress of parents with chronic diseases during the COVID-19 pandemic in Australia: A prospective cohort study

OBJECTIVE

To-date there has been limited examination of the experience of the COVID-19 pandemic in parents who suffer from chronic physical conditions. We aimed to 1) examine whether presence of a chronic disease predicts differential latent distress profile memberships, and 2) assess factors that could predict different distress profiles in the sub-group of parents with a chronic disease.

METHODS

We used a sample of 1618 parents, from the longitudinal COVID-19 Pandemic Adjustment Study, who completed a measure of mental distress (Depression, Anxiety and Stress Scale) at 13 data collection points. Distress profiles were assessed with the latent profile analysis.

RESULTS

We identified four distinct mental distress profile memberships, with the most common membership characterised by very low (48.1%), followed by low (31.9%), moderate (15.7%), and high (4.3%) distress scores. A higher proportion of parents with chronic diseases belonged to profiles experiencing low (34.7% vs. 30.4%), moderate (18.7% vs. 14.1%), and high (5.5% vs. 3.7%) compared to very low (41.2% vs. 51.8%) distress levels than other parents. Residing in Victoria, younger age, lower levels of social support and appraisal of COVID as risk were associated with membership to higher compared to very low distress profiles.

CONCLUSION

Our findings highlight the importance of considering chronic disease co-morbidity as an additive risk factor in addressing mental health outcomes of parents during pandemic-like events, since parents with chronic conditions are more vulnerable to experiencing worse mental distress. Future interventions should focus on ways to strengthen social support and provide guidance for managing threat appraisal.

Active Life for Brain Health: A Narrative Review of the Mechanism Underlying the Protective Effects of Physical Activity on the Brain

A growing body of evidence clearly indicates the beneficial effects of physical activity (PA) on cognition. The importance of PA is now being reevaluated due to the increase in sedentary behavior in older adults during the COVID-19 pandemic. Although many studies in humans have revealed that PA helps to preserve brain health, the underlying mechanisms have not yet been fully elucidated. In this review, which mainly focuses on studies in humans, we comprehensively summarize the mechanisms underlying the beneficial effects of PA or exercise on brain health, particularly cognition. The most intensively studied mechanisms of the beneficial effects of PA involve an increase in brain-derived neurotrophic factor (BDNF) and preservation of brain volume, especially that of the hippocampus. Nonetheless, the mutual associations between these two factors remain unclear. For example, although BDNF presumably affects brain volume by inhibiting neuronal death and/or increasing neurogenesis, human data on this issue are scarce. It also remains to be determined whether PA modulates amyloid and tau metabolism. However, recent advances in blood-based biomarkers are expected to help elucidate the beneficial effects of PA on the brain. Clinical data suggest that PA functionally modulates cognition independently of neurodegeneration, and the mechanisms involved include modulation of functional connectivity, neuronal compensation, neuronal resource allocation, and neuronal efficiency. However, these mechanisms are as yet not fully understood. A clear understanding of the mechanisms involved could help motivate inactive persons to change their behavior. More accumulation of evidence in this field is awaited.

Age- and gender-related differences in the evolution of psychological and cognitive status after the lockdown for the COVID-19 outbreak: a follow-up study

OBJECTIVE

Individuals experienced psychological symptoms in response to quarantine for the COVID-19 pandemic. Therefore, we aimed to investigate the possible effect of age and gender on the evolution of mental health status after the quarantine in the Italian population and the baseline predictors of post-traumatic stress symptoms.

METHODS

An online follow-up questionnaire including an assessment of depression, anxiety, anger, post-traumatic stress, subjective cognitive failures, resilience, and coping style was completed by participants 2 months after the end of the quarantine (n = 758).

RESULTS

Individuals experienced psychological symptoms also 2 months after the end of the quarantine. No decrease in depression and anxiety scores emerged, but younger individuals and females experienced more severe symptoms. Anger symptoms decreased in young adults, whereas they increased in older adults. Moreover, individuals reported more cognitive failures at follow-up. No changes were observed in resilience, whereas participants reported adopting fewer coping strategies at follow-up. Finally, post-traumatic stress symptoms 2 months after the end of the lockdown were associated with more severe psychological symptoms and more fear of getting infected at baseline.

CONCLUSIONS

Our findings demonstrate that the long-term psychological impact and the cognitive consequences of quarantine differ according to age and gender. The identification of more vulnerable groups allows the implementation of interventions to reduce psychological symptoms and the risk for cognitive impairment.

Conceptualizing Vulnerability for Health Effects of the COVID-19 Pandemic and the Associated Measures in Utrecht and Zeist: A Concept Map

The COVID-19 pandemic and the associated measures have impacted the health of many. Not all population groups are equally vulnerable to such health effects, possibly increasing health inequalities. We performed a group concept mapping procedure to define a common, context-specific understanding of what makes people vulnerable to health effects of the pandemic and the measures. We organized a two-step, blended brainstorming session with locally involved community members, using the brainstorm focus prompt 'What I think makes people vulnerable for the COVID-19 pandemic and the measures is…'. We asked participants to generate as many statements as possible. Participants then individually structured (sorted and ranked) these statements. The structuring data was analysed using the groupwisdom^TM software and then interpreted by the researchers to generate the concept map. Ninety-eight statements were generated by 19 participants. Sixteen participants completed both structuring tasks. The final concept map consisted of 12 clusters of vulnerability factors, indicating a broad conceptualization of vulnerability during the pandemic. It is being used as a basis for future research and local supportive interventions. Concept mapping is an effective method to arrive at a vulnerability assessment in a community in a short time and, moreover, a method that promotes community engagement.

The impact of COVID-19 lockdown on brain metabolism

This study aims to evaluate the impact of French national lockdown of 55 days on brain metabolism of patients with neurological disorders. Whole‐brain voxel‐based PET analysis was used to correlate ¹⁸F‐FDG metabolism to the number of days after March 17, 2020 (in 95 patients; mean age: 54.3 years ± 15.7; 59 men), in comparison to the same period in 2019 before the SARS‐CoV‐2 outbreak (in 212 patients; mean age: 59.5 years ± 15.8; 114 men), and to the first 55 days of deconfinement (in 188 patients; mean age: 57.5 years ± 16.5; 93 men). Lockdown duration was negatively correlated to the metabolism of the sensory‐motor cortex with a prevailing effect on the left dominant pyramidal tract and on younger patients, also including the left amygdala, with only partial reversibility after 55 days of deconfinement. Weak overlap was found with the reported pattern of hypometabolism in long COVID (<9%). Restriction of physical activities, and possible related deconditioning, and social isolation may lead to functional disturbances of sensorimotor and emotional brain networks. Of note, this metabolic pattern seems distinct to those reported in long COVID. Further longitudinal studies with longer follow‐up are needed to evaluate clinical consequences and relationships on cognitive and mental health against functional deactivation hypothesis, and to extend these findings to healthy subjects in the context of lockdown.

Offering Psychological Support to University Students in Poland During the COVID-19 Pandemic: Lessons Learned From an Initial Evaluation

This perspective article aims to present insights into an initiative to provide free psychological support to students at the University of Gdańsk (UG) - one of the first universities in Poland to offer such help - during the first major COVID-19 pandemic lockdown in March 2020. We begin by introducing key psychological consequences of the pandemic, with particular emphasis on university students, according to Pandemic Management Theory (PMT). Next, we highlight the most significant challenges reported to us by the students in response to the support initiative and applied psychological interventions (including psychoeducation, relaxation, arranging day plans, taking care of relationships, and "just" talking). We conclude by reflecting on the challenges for mental health posed by the COVID-19 pandemic as well as the outcome of our initiative - the creation of the Academic Psychological Support Centre at the University of Gdańsk. These insights and lessons learned from developing our practice can help enhance the effectiveness of future psychological support programs through the pandemic and beyond.

Impact of COVID-19 Pandemic on the Psychological Status of Palestinian Adults in the West Bank, Palestine; A Cross-Sectional Study

Background:

Coronavirus Disease 2019 (COVID-19) rapid manifestation and spread have disrupted world norms and affected people's daily activities and life. Many ministries chose mass lockdown protocol as a way to control the virus spread. Though this protocol has shown to be effective in limiting the Virus transmission, it might have a negative impact on the population's psychological status, such as boredom, confusion, psychological stress, anxiety, depression, and physical effects.

Objective:

This study aimed to find the impact of the COVID-19 pandemic on the Palestinian adults' psychological status by assessing the participant's practices, reports of anxiety and depression during the pandemics

Methods:

An observational descriptive cross-sectional study was conducted among Palestinian adults in the West Bank, at the occupied Palestinian territories, between July and September 2020. The questionnaire was structured into two domains: the first domain includes nine questions about sociodemographic data. The second consisted of 33 (yes and no) questions evaluating the participant's psychological status.

Results:

739 participants with a mean age of 31.76, filled the online questionnaire. Around one-third of respondents revealed having many signs of anxiety, and around 42% of respondents expressed having many signs of depression. Females were significantly more likely to have signs of depression, whereas front-line COVID-19 health care workers were significantly the least likely to have signs of depression and no signs of depression were found among participants with high incomes.

Conclusion:

COVID-19 pandemic has a negative effect on mental status; most participants have signs of anxiety and depression.

Emotional, Psychological, and Cognitive Changes Throughout the COVID-19 Pandemic in Italy: Is There an Advantage of Being an Older Adult?

Introduction: The study examined age-related differences between young and older adults’ emotional and psychological experience as well as cognitive functioning throughout different phases of the COVID-19 pandemic in Italy.

Materials and Methods: Participants were interviewed by phone when confined at home during the national lockdown (T1-May 2020; N = 138 young adults; N = 119 older adults) and after the first wave of contagions, when restrictions were discarded (T2-September 2020; N = 52 young adults; N = 59 older adults). A sub-sample also participated in a third assessment (T3-December 2020). Participants completed questionnaires assessing their emotional and psychological functioning (i.e., positive and negative affect, perceived social and emotional loneliness, resilience) along with memory tasks (Backward Digit Span task and words list recall).

Results: Although individuals reported less positive and more negative emotions during the lockdown than at T2, results showed that older adults displayed overall fewer negative emotions and greater resilience than young adults. The latter were those who reported feeling more emotionally lonely when compared to their older counterpart during the lockdown than afterward. Older adults’ advantage in emotional and psychological functioning was also confirmed 7 months after the national lockdown. Only age-related differences in favor of young adults for the memory tasks were found. The measures of interest were also susceptible to mood and/or concerns of COVID-19 effects.

Discussion: These findings further highlight the age-related advantage of older adults managing the emotional and psychological experience even when facing an unexpected, prolonged, and unpredictable, stressful life event such as the COVID-19 pandemic.

A Standardized Prospective Memory Evaluation of the Effects of COVID-19 Confinement on Young Students

The restriction imposed worldwide for limiting the spread of coronavirus disease 2019 (COVID-19) globally impacted our lives, decreasing people’s wellbeing, causing increased anxiety, depression, and stress and affecting cognitive functions, such as memory. Recent studies reported decreased working memory (WM) and prospective memory (PM), which are pivotal for the ability to plan and perform future activities. Although the number of studies documenting the COVID-19 effects has recently blossomed, most of them employed self-reported questionnaires as the assessment method. The main aim of our study was to use standardized tests to evaluate WM and PM in a population of young students. A sample of 150 female psychology students was recruited online for the administration of two self-reported questionnaires that investigated psychological wellbeing (DASS-21), prospective, and retrospective memory (PRMQ). Subjects were also administered two standardized tests for WM (PASAT) and PM (MIST). We found increased anxiety, depression, and stress and decreased PM as measured by self-reports. The perceived memory failures agreed with the results from the standardized tests, which demonstrated a decrease in both WM and PM. Thus, COVID-19 restriction has strongly impacted on students’ mental health and memory abilities, leaving an urgent need for psychological and cognitive recovery plans.

The Relationship Between Perceived Stress and Subjective Cognitive Decline During the COVID-19 Epidemic

During the outbreak of the COVID-19 epidemic, fear of disease and its consequences, recommended lifestyle changes, and severe restrictions set by governments acted as stressors and affected people's mood, emotions, mental health, and wellbeing. Many studies conducted during this crisis focused on affective and physiological responses to stress, but few studies examined how the crisis affected cognition. The present cross-sectional study examined the relationship between physiological, affective, and cognitive responses to the epidemic. In an online survey conducted at the height of the first wave of the epidemic in Slovenia (April 15-25, 2020), 830 Slovenian residents aged 18-85 years reported the effects of stressors (confinement, problems at home, problems at work, lack of necessities, and increased workload), experienced emotions, generalized anxiety, perceived stress, changes in health, fatigue and sleep quality, and perceived changes in cognition during the epidemic. Risk factors for stress (neuroticism, vulnerability, general health, gender, and age) were also recorded. We hypothesized that stressors and stress risk factors will be related to subjective cognitive decline, with negative emotions, generalized anxiety, perceived stress, and physical symptoms acting as mediator variables. On average, the results showed a mild subjective cognitive decline during the epidemic. In structural equation modeling, 34% of its variance was predicted by the mediator variables, with negative emotions and physical symptoms having the largest contribution. Stress risk factors were predictably related to the four mediator variables. Among the stressors, confinement showed the strongest effect on the four mediator variables, implying the importance of thoughtful communication about necessary restrictive measures during emergency circumstances. The results of this study indicate that the possibility of altered cognitive function should be considered when planning work and study activities during the epidemic.

SARS-CoV-2 and the Brain: What Do We Know about the Causality of 'Cognitive COVID?

The second year of the COVID-19 (coronavirus disease) pandemic has seen the need to identify and assess the long-term consequences of a SARS-CoV-2 infection on an individual's overall wellbeing, including adequate cognitive functioning. 'Cognitive COVID' is an informal term coined to interchangeably refer to acute changes in cognition during COVID-19 and/or cognitive sequelae with various deficits following the infection. These may manifest as altered levels of consciousness, encephalopathy-like symptoms, delirium, and loss of various memory domains. Dysexecutive syndrome is a peculiar manifestation of 'Cognitive COVID' as well. In the previous major outbreaks of viruses like SARS-CoV, MERS-CoV and Influenza. There have been attempts to understand the underlying mechanisms describing the causality of similar symptoms following SARS-CoV-2 infection. This review, therefore, is attempting to highlight the current understanding of the various direct and indirect mechanisms, focusing on the role of neurotropism of SARS-CoV-2, the general pro-inflammatory state, and the pandemic-associated psychosocial stressors in the causality of 'Cognitive COVID.' Neurotropism is associated with various mechanisms including retrograde neuronal transmission via olfactory pathway, a general hematogenous spread, and the virus using immune cells as vectors. The high amounts of inflammation caused by COVID-19, compounded with potential intubation, are associated with a deleterious effect on the cognition as well. Finally, the pandemic's unique psychosocial impact has raised alarm due to its possible effect on cognition. Furthermore, with surfacing reports of post-COVID-vaccination cognitive impairments after vaccines containing mRNA encoding for spike glycoprotein of SARS-CoV-2, we hypothesize their causality and ways to mitigate the risk. The potential impact on the quality of life of an individual and the fact that even a minor proportion of COVID-19 cases developing cognitive impairment could be a significant burden on already overwhelmed healthcare systems across the world make it vital to gather further evidence regarding the prevalence, presentation, correlations, and causality of these events and reevaluate our approach to accommodate early identification, management, and rehabilitation of patients exhibiting cognitive symptoms.

Psychological functioning in survivors of COVID-19: Evidence from recognition of fearful facial expressions

Evidence about the psychological functioning in individuals who survived the COVID-19 infectious is still rare in the literature. In this paper, we investigated fearful facial expressions recognition, as a behavioural means to assess psychological functioning. From May 15th, 2020 to January 30th, 2021, we enrolled sixty Italian individuals admitted in multiple Italian COVID-19 post-intensive care units. The detection and recognition of fearful facial expressions were assessed through an experimental task grounded on an attentional mechanism (i.e., the redundant target effect). According to the results, our participants showed an altered behaviour in detecting and recognizing fearful expressions. Specifically, their performance was in disagreement with the expected behavioural effect. Our study suggested altered processing of fearful expressions in individuals who survived the COVID-19 infectious. Such a difficulty might represent a crucial sign of psychological distress and it should be addressed in tailored psychological interventions in rehabilitative settings and after discharge.

Impact of COVID-19 outbreak on Italian healthcare workers versus general population: Results from an online survey

Objective

COVID‐19 pandemic has been a stressful condition. We explored life changes and health‐related consequences of COVID‐19 outbreak in Italian healthcare workers in comparison to the general population.

Methods

A total of 593 subjects participated to the online CoRonavIruS Health Impact Survey. Life events and changes, physical health and worries were evaluated referring to 2 weeks prior to the survey. Mood states and daily behaviour were retrospectively evaluated referring to 3 months before COVID‐19 (T1) and 2 weeks prior to the survey (T2). Student t test, Mann–Whitney test and multivariate logistic regression analyses were run.

Results

Five hundred and twenty‐one subjects were analysed (healthcare workers: n = 163, 31.84%; general population: n = 349, 68.16%). Healthcare workers were more likely to report fatigue and have spent more time outside home during the 2 weeks prior to the survey than the general population (χ²_(df) = 266.0₃₍₁₇₎, p < 0.001, R² = 0.57). From T1 to T2, healthcare workers had a significant increase in negative mood, worry, restlessness, loneliness and a decrease in happiness, while subjects from the general population had a statistically significant increase in negative mood, worry, attention, concentration difficulties and a decrease in happiness, pleasure related to daily activities, time spent outdoors and alcohol use.

Conclusion

In the framework of a growing literature on healthcare workers' status during the COVID‐19 pandemic, the present study allowed to identify fatigue and loneliness as psychosomatic modifiable variables in need of being monitored and, possibly managed, to ameliorate the health status of healthcare workers.

Lockdown Effects on Healthy Cognitive Aging During the COVID-19 Pandemic: A Longitudinal Study

The COVID-19 pandemic is a health issue leading older adults to an increased vulnerability to unfavorable outcomes. Indeed, the presence of physical frailty has recently led to higher mortality due to SARS-CoV-2 infection. However, no longitudinal studies have investigated the role of neuropsychogeriatric factors associated with lockdown fatigue in healthy cognitive aging. Eighty-one healthy older adults were evaluated for their neuropsychological characteristics, including physical frailty, before the pandemic (T0). Subsequently, 50 of them agreed to be interviewed and neuropsychologically re-assessed during the lockdown (T1) and immediately after it (T2). Moreover, during another home confinement, they performed a psychological screening (T3) to evaluate possible mood changes and fatigue. According to Fried's frailty criteria, at T0, 63% of the sample was robust, 34.5% pre-frail, and only 2.5% frail. Significantly, these subjects presented a decrease in handgrip strength and walking speed (29.6 and 6.1%, respectively). Results from Principal Component Analyses and multiple regression models highlighted the contribution of “cognitive” and “psychological” factors (i.e., attentive-executive performance and mood deflections) in explaining handgrip strength and gait speed. At T3, lockdown fatigue was explained by higher scores on the Beck Depression Inventory and lower scores on the Trail Making Test part A. Results from a moderated-mediation model showed that the effect of psychomotor speed on lockdown fatigue was mediated by depression, with a moderating effect of gait speed. Our findings highlight the complex interrelationship between cognitive, psychological, and physical factors in the emergence of pandemic fatigue in a carefully selected older population.

COVID-19: Impact of diagnosis threat and suggestibility on subjective cognitive complaints

A subset of recovered COVID-19 patients report persistent neurological symptoms. These include non-specific symptoms (e.g., headaches and fatigue) which were found to be affected by psychological processes in other disorders (e.g., post-concussion syndrome, PCS, after mild traumatic brain injury). The current study assessed the impact of diagnosis threat (i.e., information regarding the long-term neurological impact of COVID-19) and suggestibility on endorsed symptoms of both recovered patients and healthy controls. Method: Recovered patients (n = 90) and healthy controls (n = 210) described their cognitive functioning after being randomly assigned to: (a) Experimental group: These participants read an article that explored long-term neurological symptoms among COVID-19 survivors. (b) Control group: These participants read an article providing general information regarding the disease. Results: Recovered patients, but not healthy controls, endorsed more symptoms in the experimental condition compared to the control condition. Moreover, suggestibility was correlated with endorsement of symptoms. Conclusions: Post COVID-19 neurological symptoms may, at least partially, be affected by non-neurological factors such as diagnosis threat. Information regarding long-term effects of COVID-19 may skew reported symptoms with highly suggestible individuals particularly susceptible to these effects. Further research, however, is needed to validate and elaborate upon these initial findings.

COVID-19 lockdown and lifestyles: A narrative review

Background: The primary objective worldwide during the coronavirus disease 2019 (COVID-19) pandemic has been controlling disease transmission. However, lockdown measures used to mitigate transmission have affected human behavior and altered lifestyles, with a likely impact on chronic non-communicable diseases. More than a year into the pandemic, substantial peer-reviewed literature has emerged on altered lifestyles following the varying lockdown measures imposed globally to control the virus spread. We explored the impact of lockdown measures on six lifestyle factors, namely diet, physical activity, sleep, stress, social connectedness, and the use of tobacco, alcohol, or other harmful substances. Methods: We comprehensively searched PubMed and the World Health Organization’s global literature database on COVID-19 and retrieved 649 relevant articles for the narrative review. A critical interpretative synthesis of the articles was performed. Results: Most of the articles included in the review identified the negative effect of lockdown measures on each of the lifestyle factors in many parts of the world. Encouraging lifestyle trends were also highlighted in a few articles. Such trends can positively influence the outcome of lifestyle-related chronic diseases, such as obesity and diabetes. Conclusions: The COVID-19 pandemic provides an opportunity to better understand the negative impact of strict lockdown measures on lifestyles. At the same time, it helps us identify and initiate positive behavioral changes, which, if consolidated, could improve chronic disease outcomes. It is up to governments, communities, and healthcare/academic entities to derive benefit from lessons learned from the pandemic, with the ultimate objective of better educating and promoting healthy lifestyles among communities.

To contrast and reverse skeletal muscle weakness by Full-Body In-Bed Gym in chronic COVID-19 pandemic syndrome

Mobility-impaired persons, either very old or younger but suffering with systemic neuromuscular disorders or chronic organ failures, spend small amounts of time for daily physical activity, contributing to aggravate their poor mobility by resting muscle atrophy. Sooner or later the limitations to their mobility enforce them to bed and to more frequent hospitalizations. We include among these patients at risk those who are negative for the SARS-COV-2 infection, but suffering with COVID-19 pandemic syndrome. Beside managements of psychological symptoms, it is mandatory to offer to the last group physical rehabilitation approaches easy to learn and self-managed at home. Inspired by the proven capability to recover skeletal muscle contractility and strength by home-based volitional exercises and functional electrical stimulation, we suggest also for chronic COVID-19 pandemic syndrome a 10-20 min long daily routine of easy and safe physical exercises that can activate, and recover from weakness, the main 400 skeletal muscles used for every-day mobility activities. Persons can do many of them in bed (Full-Body in-Bed Gym), and hospitalized patients can learn this light training before leaving the hospital. It is, indeed, an extension of well-established cardiovascular-respiratory rehabilitation training performed after heavy surgical interventions. Blood pressure readings, monitored before and after daily routine, demonstrate a transient decrease in peripheral resistance due to increased blood flow of many muscles. Continued regularly, Full-Body in-Bed Gym may help maintaining independence of frail people, including those suffering with the COVID-19 pandemic syndrome.

Drastic Reductions in Mental Well-Being Observed Globally During the COVID-19 Pandemic: Results From the ASAP Survey

Most countries affected by the COVID-19 pandemic have repeatedly restricted public life to control the contagion. However, the health impact of confinement measures is hitherto unclear. We performed a multinational survey investigating changes in mental and physical well-being (MWB/PWB) during the first wave of the pandemic. A total of 14,975 individuals from 14 countries provided valid responses. Compared to pre-restrictions, MWB, as measured by the WHO-5 questionnaire, decreased considerably during restrictions (68.1 ± 16.9 to 51.9 ± 21.0 points). Whereas 14.2% of the participants met the cutoff for depression screening pre-restrictions, this share tripled to 45.2% during restrictions. Factors associated with clinically relevant decreases in MWB were female sex (odds ratio/OR = 1.20, 95% CI: 1.11-1.29), high physical activity levels pre-restrictions (OR = 1.29, 95% CI 1.16-1.42), decreased vigorous physical activity during restrictions (OR = 1.14, 95% CI: 1.05-1.23), and working (partially) outside the home vs. working remotely (OR = 1.29, 95% CI: 1.16-1.44/OR = 1.35, 95% CI: 1.23-1.47). Reductions, although smaller, were also seen for PWB. Scores in the SF-36 bodily pain subscale decreased from 85.8 ± 18.7% pre-restrictions to 81.3 ± 21.9% during restrictions. Clinically relevant decrements of PWB were associated with female sex (OR = 1.62, 95% CI: 1.50-1.75), high levels of public life restrictions (OR = 1.26, 95% CI: 1.18-1.36), and young age (OR = 1.10, 95% CI: 1.03-1.19). Study findings suggest lockdowns instituted during the COVID-19 pandemic may have had substantial adverse public health effects. The development of interventions mitigating losses in MWB and PWB is, thus, paramount when preparing for forthcoming waves of COVID-19 or future public life restrictions.

To contrast and reverse skeletal muscle weakness by Full-Body In-Bed Gym in chronic COVID-19 pandemic syndrome

Mobility-impaired persons, either very old or younger but suffering with systemic neuromuscular disorders or chronic organ failures, spend small amounts of time for daily physical activity, contributing to aggravate their poor mobility by resting muscle atrophy. Sooner or later the limitations to their mobility enforce them to bed and to more frequent hospitalizations. We include among these patients at risk those who are negative for the SARS-COV-2 infection, but suffering with COVID-19 pandemic syndrome. Beside managements of psychological symptoms, it is mandatory to offer to the last group physical rehabilitation approaches easy to learn and self-managed at home. Inspired by the proven capability to recover skeletal muscle contractility and strength by home-based volitional exercises and functional electrical stimulation, we suggest also for chronic COVID-19 pandemic syndrome a 10–20 min long daily routine of easy and safe physical exercises that can activate, and recover from weakness, the main 400 skeletal muscles used for every-day mobility activities. Persons can do many of them in bed (Full-Body in-Bed Gym), and hospitalized patients can learn this light training before leaving the hospital. It is, indeed, an extension of well-established cardiovascular-respiratory rehabilitation training performed after heavy surgical interventions. Blood pressure readings, monitored before and after daily routine, demonstrate a transient decrease in peripheral resistance due to increased blood flow of many muscles. Continued regularly, Full-Body in-Bed Gym may help maintaining independence of frail people, including those suffering with the COVID-19 pandemic syndrome.