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Xu L, Gao Y, Shi D, Wang Y, Li R, Cai Y. Social support moderates the relationship between sleep quality and mental health: A Chinese Fangcang shelter hospital-based study in asymptomatic COVID-19 carriers. Heliyon 2024; 10:e31782. [PMID: 38841459 PMCID: PMC11152662 DOI: 10.1016/j.heliyon.2024.e31782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 05/12/2024] [Accepted: 05/22/2024] [Indexed: 06/07/2024] Open
Abstract
This study aimed to determine the association between sleep quality and mental health in COVID-19 carriers in China and evaluate the moderating effects of perceived social support. 1283 asymptomatic COVID-19 carriers were enrolled from March 2022 to April 2022 among Ruijin Jiahe Fangcang shelter hospital in Shanghai, China. They were assessed using the Pittsburgh Sleep Quality Index (PSQI), the General Health Questionnaire (GHQ), and the Perceived Social Support Scale (PSSS) respectively. Participants had an average age of 39.64 years and 59.6 % of whom were male. In total, 34.3 % of participants presented with poor sleep quality; 41.1 % showed bad mental health. Sleep quality was positively related to mental health (r = 0.321, P < 0.001, 95 %CI = 0.267, 0.369) and social support was negatively related to mental health (r = -0.414, P < 0.001, 95 %CI = -0.457, -0.367). Meanwhile, social support played a moderating role between sleep quality and mental health (β = 0.066, P < 0.05, 95 %CI = 0.016, 0.117). These findings indicate that mental health resulting from the COVID-19 pandemic are increasingly apparent in China and provide a focus on sleep quality for the early prevention of mental health in asymptomatic carriers. And social support may be beneficial to the improvement of mental health, especially for people in crisis (e.g., COVID-19 pandemic).
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Affiliation(s)
- Lulu Xu
- Department of Public Health, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
- Center for Community Health Care, Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Ying Gao
- Department of Public Health, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
- Center for Community Health Care, Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Dake Shi
- Department of Infection Control, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Ying Wang
- Department of Public Health, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
- Center for Community Health Care, Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, 200025, China
| | - Rui Li
- Department of Nursing, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
| | - Yong Cai
- Department of Public Health, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China
- Center for Community Health Care, Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, 200025, China
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Carnes-Vendrell A, Piñol-Ripoll G, Ariza M, Cano N, Segura B, Junque C, Béjar J, Barrue C, Garolera M. Poor sleep quality may trigger cognitive deficits after recovery from COVID-19. Front Psychol 2024; 15:1382875. [PMID: 38860054 PMCID: PMC11164190 DOI: 10.3389/fpsyg.2024.1382875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 04/29/2024] [Indexed: 06/12/2024] Open
Abstract
Objective In the present study, we aimed to assess the cognition of post-COVID-19 condition (PCC) participants in relation to their subjective sleep quality (Pittsburgh Sleep Quality Index, PSQI) and to analyse possible moderators of this effect, such as quality of life (European Quality of Life-5 Dimensions, EQ-5D), fatigue (Chadler Fatigue Questionnaire, CFQ), cognitive reserve (Cognitive Reserve Questionnaire, CRC), and subjective cognitive complaints (Memory Failures of Everyday Questionnaire, MFE-30). Methods We included 373 individuals with PCC and 126 healthy controls (HCs) from the NAUTILUS Project (NCT05307549 and NCT05307575) who were assessed with a comprehensive neuropsychological battery and various questionnaires. Results We found that PCC participants with poor sleep quality had a 4.3% greater risk of immediate verbal memory deficits than those with good sleep quality, as indicated by the greater odds ratio (OR) of 1.043 and confidence interval (CI) of 1.023-1.063. Additionally, their risk of immediate verbal memory disorders was multiplied by 2.4 when their EQ-5D score was low (OR 0.33; CI 0.145-0.748), and they had a lower risk of delayed visual memory deficits with a greater CRC (OR 0.963; CI 0.929-0.999). With respect to processing speed, PCC participants with poor sleep quality had a 6.7% greater risk of deficits as the MFE increased (OR 1.059; CI 1.024-1.096), and the risk of slowed processing speed tripled with a lower EQ-5D (OR 0.021; CI 0.003-0.141). Conclusion These results indicate that poor subjective sleep quality is a potential trigger for cognitive deficits. Therapeutic strategies to maximize sleep quality could include reducing sleep disturbances and perhaps cognitive impairment in PCC individuals.
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Affiliation(s)
- A. Carnes-Vendrell
- Cognitive Disorders Unit, Cognition and Behavior Study Group, Hospital Universitari Santa Maria, Lleida, Spain
| | - G. Piñol-Ripoll
- Cognitive Disorders Unit, Cognition and Behavior Study Group, Hospital Universitari Santa Maria, Lleida, Spain
| | - M. Ariza
- Clinical Research Group for Brain, Cognition and Behavior, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - N. Cano
- Clinical Research Group for Brain, Cognition and Behavior, Consorci Sanitari de Terrassa, Terrassa, Spain
- Departament de Ciències Bàsiques, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - B. Segura
- Medical Psychology Unit, Department of Medicine, Universitat de Barcelona, Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - C. Junque
- Medical Psychology Unit, Department of Medicine, Universitat de Barcelona, Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - J. Béjar
- Faculty of Informatics of Barcelona (FIB), Polytechnic University of Catalonia, Barcelona, Spain
| | - C. Barrue
- Faculty of Informatics of Barcelona (FIB), Polytechnic University of Catalonia, Barcelona, Spain
| | - M. Garolera
- Clinical Research Group for Brain, Cognition and Behavior, Consorci Sanitari de Terrassa, Terrassa, Spain
- Neuropsychology Unit, Consorci Sanitari de Terrassa, Terrassa, Spain
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Webb EJ, King N, Howdon D, Carrol ED, Euden J, Howard P, Pallmann P, Llewelyn MJ, Thomas-Jones E, Shinkins B, Sandoe J. Evidence of quality of life for hospitalised patients with COVID-19: a scoping review. Health Technol Assess 2024:1-23. [PMID: 38798077 DOI: 10.3310/atpr4281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024] Open
Abstract
Background Information on the quality of life of people hospitalised with COVID-19 is important, both in assessing the burden of disease and the cost-effectiveness of treatments. However, there were potential barriers to collecting such evidence. Objective To review the existing evidence on quality of life for people hospitalised with COVID-19, with a focus on the amount of evidence available and methods used. Design A scoping review with systematic searches. Results A total of 35 papers were selected for data extraction. The most common study type was economic evaluation (N = 13), followed by cross-sectional (N = 10). All economic evaluations used published utility values for other conditions to represent COVID-19 inpatients' quality of life. The most popular quality-of-life survey measure was the Pittsburgh Sleep Quality Index (N = 8). There were 12 studies that used a mental health-related survey and 12 that used a sleep-related survey. Five studies used EQ-5D, but only one collected responses from people in the acute phase of COVID-19. Studies reported a negative impact on quality of life for people hospitalised with COVID-19, although many studies did not include a formal comparison group. Limitations Although it used systematic searches, this was not a full systematic review. Conclusion Quality-of-life data were collected from people hospitalised with COVID-19 from relatively early in the pandemic. However, there was a lack of consensus as to what survey measures to use, and few studies used generic health measures. Economic evaluations for COVID-19 treatments did not use utilities collected from people with COVID-19. In future health crises, researchers should be vigilant for opportunities to collect quality-of-life data from hospitalised patients but should try to co-ordinate as well as ensuring generic health measures are used more. Funding This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number NIHR132254.
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Affiliation(s)
- Edward Jd Webb
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Natalie King
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Daniel Howdon
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Enitan D Carrol
- Department of Clinical Infection Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Joanne Euden
- Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Philip Howard
- School of Healthcare, Faculty of Medicine and Health, University of Leeds, Leeds, UK
- Department of Medicines Management and Pharmacy, Leeds Teaching Hospitals, Leeds General Infirmary, Leeds, UK
| | - Philip Pallmann
- Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Martin J Llewelyn
- Brighton and Sussex Medical School, University of Sussex and University Hospitals Sussex NHS Foundation Trust, Brighton, UK
| | - Emma Thomas-Jones
- Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Bethany Shinkins
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
- Division of Health Sciences, Warwick Medical School, University of Warwick, Warwick, UK
| | - Jonathan Sandoe
- Healthcare Associated Infection Group, Leeds Institute of Medical Research, School of Medicine, University of Leeds, Leeds, UK
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
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Carnes-Vendrell A, Piñol-Ripoll G, Ariza M, Cano N, Segura B, Junque C, Béjar J, Barrue C, Garolera M. Sleep quality in individuals with post-COVID-19 condition: Relation with emotional, cognitive and functional variables. Brain Behav Immun Health 2024; 35:100721. [PMID: 38269302 PMCID: PMC10806261 DOI: 10.1016/j.bbih.2023.100721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/19/2023] [Indexed: 01/26/2024] Open
Abstract
The study aimed to assess sleep quality in PCC patients and its predictors by analysing its relationship with emotional, cognitive and functional variables, as well as possible differences based on COVID-19 severity. We included 368 individuals with PCC and 123 healthy controls (HCs) from the NAUTILUS Project (NCT05307549 and NCT05307575). We assessed sleep quality (Pittsburgh Sleep Quality Index, PSQI), anxiety (Generalized Anxiety Disorder, GAD-7), depression (Patient Health Questionnaire, PHQ-9), global cognition (Montreal Cognitive Assessment, MoCA), everyday memory failures (Memory Failures of Everyday Questionnaire, MFE-30), fatigue (Chadler Fatigue Questionnaire, CFQ), quality of life (European Quality of Life-5 Dimensions, EQ-5D), and physical activity levels (International Physical Activity Questionnaire, IPAQ). 203 were nonhospitalized, 83 were hospitalized and 82 were admitted to the intensive care unit (ICU). We found statistically significant differences in the PSQI total score between the PCC and HC groups (p < 0.0001), but there were no differences among the PCC groups. In the multiple linear regressions, the PHQ-9 score was a predictor of poor sleep quality for mild PCC patients (p = 0.003); GAD-7 (p = 0.032) and EQ-5D (p = 0.011) scores were predictors of poor sleep quality in the hospitalized PCC group; and GAD-7 (p = 0.045) and IPAQ (p = 0.005) scores were predictors of poor sleep quality in the group of ICU-PCC. These results indicate that worse sleep quality is related to higher levels of depression and anxiety, worse quality of life and less physical activity. Therapeutic strategies should focus on these factors to have a positive impact on the quality of sleep.
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Affiliation(s)
- A. Carnes-Vendrell
- Cognitive Disorders Unit, Cognition and Behavior Study Group, Hospital Universitari Santa Maria, Lleida, Spain
| | - G. Piñol-Ripoll
- Cognitive Disorders Unit, Cognition and Behavior Study Group, Hospital Universitari Santa Maria, Lleida, Spain
| | - M. Ariza
- Clinical Research Group for Brain, Cognition and Behavior, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - N. Cano
- Clinical Research Group for Brain, Cognition and Behavior, Consorci Sanitari de Terrassa, Terrassa, Spain
- Departament de Ciències Bàsiques, Universitat Internacional de Catalunya (UIC), Sant Cugat del Vallès, Barcelona, Spain
| | - B. Segura
- Medical Psychology Unit, Department of Medicine, Universitat de Barcelona, Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - C. Junque
- Medical Psychology Unit, Department of Medicine, Universitat de Barcelona, Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Barcelona, Spain
| | - J. Béjar
- Faculty of Informatics of Barcelona (FIB), Polytechnic University of Catalonia, Barcelona, Spain
| | - C. Barrue
- Faculty of Informatics of Barcelona (FIB), Polytechnic University of Catalonia, Barcelona, Spain
| | - M. Garolera
- Clinical Research Group for Brain, Cognition and Behavior, Consorci Sanitari de Terrassa, Terrassa, Spain
- Neuropsychology Unit, Consorci Sanitari de Terrassa, Terrassa, Spain
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Gui Z, Wang YY, Li JX, Li XH, Su Z, Cheung T, Lok KI, Ungvari GS, Ng CH, Zhang Q, Xiang YT. Prevalence of poor sleep quality in COVID-19 patients: a systematic review and meta-analysis. Front Psychiatry 2024; 14:1272812. [PMID: 38260776 PMCID: PMC10800583 DOI: 10.3389/fpsyt.2023.1272812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 12/11/2023] [Indexed: 01/24/2024] Open
Abstract
Objective The coronavirus disease (COVID-19) and the public health responses were associated with a huge health burden, which could influence sleep quality. This meta-analysis and systematic review examined the prevalence of poor sleep quality in COVID-19 patients. Methods PubMed, Web of Science, Embase, and PsycINFO were systematically searched from their respective inception to October 27, 2022. Prevalence rates of poor sleep were analyzed using a random effects model. Results Totally, 24 epidemiological and 12 comparative studies with 8,146 COVID-19 patients and 5,787 healthy controls were included. The pooled prevalence of poor sleep quality based on the included studies was 65.0% (95%CI: 59.56-70.44%, I2 = 97.6%). COVID-19 patients had a higher risk of poor sleep quality compared to healthy controls (OR = 1.73, 95% CI: 1.30-2.30, p < 0.01, I2 = 78.1%) based on the 12 comparative studies. Subgroup analysis revealed that COVID-19 patients in low-income countries (p = 0.011) and in studies using a lower Pittsburgh Sleep Quality Index score cut-off (p < 0.001) were more likely to have poor sleep quality. Meta-regression analyses revealed that being female (p = 0.044), older (p < 0.001) and married (p = 0.009) were significantly correlated with a higher risk of poor sleep quality while quality score (p = 0.014) were negatively correlated with the prevalence of poor sleep quality in COVID-19 patients. Conclusion Poor sleep quality was found to be very common in COVID-19 patients. Considering the negative effects of poor sleep quality on daily life, sleep quality should be routinely assessed and appropriately addressed in COVID-19 patients.
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Affiliation(s)
- Zhen Gui
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Faculty of Health Sciences, Institute of Translational Medicine, University of Macau, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Yue-Ying Wang
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Jia-Xin Li
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Xiao-Hong Li
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Ka-In Lok
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao SAR, China
| | - Gabor S. Ungvari
- Section of Psychiatry, University of Notre Dame Australia, Fremantle, WA, Australia
- Division of Psychiatry, School of Medicine, University of Western Australia, Perth, WA, Australia
| | - Chee H. Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, VIC, Australia
| | - Qinge Zhang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, Faculty of Health Sciences, Institute of Translational Medicine, University of Macau, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
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Karkala A, Tzinas A, Kotoulas S, Zacharias A, Sourla E, Pataka A. Neuropsychiatric Outcomes and Sleep Dysfunction in COVID-19 Patients: Risk Factors and Mechanisms. Neuroimmunomodulation 2023; 30:237-249. [PMID: 37757765 DOI: 10.1159/000533722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023] Open
Abstract
The ongoing global health crisis due to the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has significantly impacted all aspects of life. While the majority of early research following the coronavirus disease caused by SARS-CoV-2 (COVID-19) has focused on the physiological effects of the virus, a substantial body of subsequent studies has shown that the psychological burden of the infection is also considerable. Patients, even without mental illness history, were at increased susceptibility to developing mental health and sleep disturbances during or after the COVID-19 infection. Viral neurotropism and inflammatory storm damaging the blood-brain barrier have been proposed as possible mechanisms for mental health manifestations, along with stressful psychological factors and indirect consequences such as thrombosis and hypoxia. The virus has been found to infect peripheral olfactory neurons and exploit axonal migration pathways, exhibiting metabolic changes in astrocytes that are detrimental to fueling neurons and building neurotransmitters. Patients with COVID-19 present dysregulated and overactive immune responses, resulting in impaired neuronal function and viability, adversely affecting sleep and emotion regulation. Additionally, several risk factors have been associated with the neuropsychiatric sequelae of the infection, such as female sex, age, preexisting neuropathologies, severity of initial disease and sociological status. This review aimed to provide an overview of mental health symptoms and sleep disturbances developed during COVID-19 and to analyze the underlying mechanisms and risk factors of psychological distress and sleep dysfunction.
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Affiliation(s)
- Aliki Karkala
- Respiratory Failure Unit, G. Papanikolaou Hospital, Thessaloniki and Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Asterios Tzinas
- Respiratory Failure Unit, G. Papanikolaou Hospital, Thessaloniki and Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Athanasios Zacharias
- Respiratory Failure Unit, G. Papanikolaou Hospital, Thessaloniki and Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evdokia Sourla
- Respiratory Failure Unit, G. Papanikolaou Hospital, Thessaloniki and Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Athanasia Pataka
- Respiratory Failure Unit, G. Papanikolaou Hospital, Thessaloniki and Aristotle University of Thessaloniki, Thessaloniki, Greece
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Paranhos ACM, Dias ARN, Bastos TDR, Rodrigues AN, Santana KHY, Dias LHA, dos Santos LPM, Cerasi AJ, Mendes MCN, de Oliveira CL, Domingues MM, Koury GVH, Vasconcelos PFDC, Souza GS, Quaresma JAS, Falcão LFM. Persistent olfactory dysfunction associated with poor sleep quality and anxiety in patients with long COVID. Front Neurosci 2023; 17:1161904. [PMID: 37250390 PMCID: PMC10213228 DOI: 10.3389/fnins.2023.1161904] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 04/24/2023] [Indexed: 05/31/2023] Open
Abstract
Introduction Poor sleep quality have been widely reported in patients with long COVID. Determining the characteristics, type, severity, and relationship of long COVID with other neurological symptoms is essential for the prognosis and management of poor sleep quality. Methods This cross-sectional study was conducted at a public university in the eastern Amazon region of Brazil between November 2020 and October 2022. The study involved 288 patients with long COVID with self-report neurological symptoms. One hundred thirty-one patients were evaluated by using standardised protocols: Pittsburgh sleep quality index (PSQI), Beck Anxiety Inventory, Chemosensory Clinical Research Center (CCRC), and Montreal Cognitive Assessment (MoCA). This study aimed to describe the sociodemographic and clinical characteristics of patients with long COVID with poor sleep quality and their relationship with other neurological symptoms (anxiety, cognitive impairment, and olfactory disorder). Results Patients with poor sleep quality were mainly women (76.3%), 44.04 ± 12.73 years old, with >12 years of education (93.1%), and had monthly incomes of up to US $240.00 (54.2%). Anxiety and olfactory disorder were more common in patients with poor sleep quality. Discussion Multivariate analysis shows that the prevalence of poor sleep quality was higher in patients with anxiety, and olfactory disorder is associated with poor sleep quality. In this cohort of patients with long COVID, the prevalence of poor sleep quality was highest in the group tested by PSQI and were associated with other neurological symptoms, such as anxiety and olfactory dysfunction. A previous study indicates a significant association between poor sleep quality and psychological disorders over time. Recent studies involving neuroimaging found functional and structural changes in Long COVID patients with persistent olfactory disfunction. Poor sleep quality are integral part of complex changes related to Long COVID and should be part of patient's clinical management.
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Affiliation(s)
- Alna Carolina Mendes Paranhos
- Health and Biological Science Center, State University of Pará, Pará, Brazil
- Tropical Medicine Center, Federal University of Pará, Pará, Brazil
| | | | | | | | | | | | | | | | | | | | | | | | | | - Givago Silva Souza
- Tropical Medicine Center, Federal University of Pará, Pará, Brazil
- Biological Science Center, Federal University of Pará, Pará, Brazil
| | - Juarez Antônio Simões Quaresma
- Health and Biological Science Center, State University of Pará, Pará, Brazil
- Tropical Medicine Center, Federal University of Pará, Pará, Brazil
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Luiz Fábio Magno Falcão
- Health and Biological Science Center, State University of Pará, Pará, Brazil
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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8
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Monti L, Marconi E, Bocci MG, Kotzalidis GD, Mazza M, Galliani C, Tranquilli S, Vento G, Conti G, Sani G, Antonelli M, Chieffo DPR. COVID-19 pandemic in the intensive care unit: Psychological implications and interventions, a systematic review. World J Psychiatry 2023; 13:191-217. [PMID: 37123099 PMCID: PMC10130962 DOI: 10.5498/wjp.v13.i4.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 02/06/2023] [Accepted: 03/27/2023] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic produced changes in intensive care units (ICUs) in patient care and health organizations. The pandemic event increased patients’ risk of developing psychological symptoms during and after hospitalisation. These consequences also affected those family members who could not access the hospital. In addition, the initial lack of knowledge about the virus and its management, the climate of fear and uncertainty, the increased workload and the risk of becoming infected and being contagious, had a strong impact on healthcare staff and organizations. This highlighted the importance of interventions aimed at providing psychological support to ICUs, involving patients, their relatives, and the staff; this might involve the reorganisation of the daily routine and rearrangement of ICU staff duties.
AIM To conduct a systematic review of psychological issues in ICUs during the COVID-19 pandemic involving patients, their relatives, and ICU staff.
METHODS We investigated the PubMed and the ClinicalTrials.gov databases and found 65 eligible articles, upon which we commented.
RESULTS Our results point to increased perceived stress and psychological distress in staff, patients and their relatives and increased worry for being infected with severe acute respiratory syndrome coronavirus-2 in patients and relatives. Furthermore, promising results were obtained for some psychological programmes aiming at improving psychological measures in all ICU categories.
CONCLUSION As the pandemic limited direct inter-individual interactions, the role of interventions using digital tools and virtual reality is becoming increasingly important. All considered, our results indicate an essential role for psychologists in ICUs.
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Affiliation(s)
- Laura Monti
- UOS Psicologia Clinica, Governo Clinico, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
| | - Elisa Marconi
- UOS Psicologia Clinica, Governo Clinico, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
| | - Maria Grazia Bocci
- UOC Anestesia, Rianimazione, Terapia Intensiva e Tossicologia Clinica, Dipartimento di Scienze Dell’Emergenza, Anestesiologiche e Della Rianimazione, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
| | - Georgios Demetrios Kotzalidis
- UOC Psichiatria Clinica e d’Urgenza, Dipartimento di Scienze Dell’Invecchiamento, Neurologiche, Ortopediche e Della Testa-collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- NESMOS Department, Facoltà di Medicina e Psicologia, Sant’Andrea University Hospital, Rome 00189, Italy
| | - Marianna Mazza
- UOC Psichiatria Clinica e d’Urgenza, Dipartimento di Scienze Dell’Invecchiamento, Neurologiche, Ortopediche e Della Testa-collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Carolina Galliani
- Department of Psychology, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Sara Tranquilli
- Department of Psychology, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Giovanni Vento
- UOC Neonatologia, Dipartimento di Scienze Della Salute Della Donna, Del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- UOC Neonatologia, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Giorgio Conti
- UOC Terapia Intensiva Pediatrica e Trauma Center Pediatrico, Dipartimento di Scienze Dell’Emergenza, Anestesiologiche e Della Rianimazione, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- UOC Terapia Intensiva Pediatrica e Trauma Center Pediatrico, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Gabriele Sani
- UOC Psichiatria Clinica e d’Urgenza, Dipartimento di Scienze Dell’Invecchiamento, Neurologiche, Ortopediche e Della Testa-collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- Department of Psychiatry, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Massimo Antonelli
- UOC Anestesia, Rianimazione, Terapia Intensiva e Tossicologia Clinica, Dipartimento di Scienze Dell’Emergenza, Anestesiologiche e Della Rianimazione, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- Department of Anesthesiology and Intensive Care Medicine, Università Cattolica del Sacro Cuore, Rome 00168, Italy
| | - Daniela Pia Rosaria Chieffo
- UOS Psicologia Clinica, Governo Clinico, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome 00168, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Rome 00168, Italy
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9
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Kapusta J, Chudzik M, Kałuzińska-Kołat Ż, Kołat D, Burzyńska M, Jankowski P, Babicki M. Do selected lifestyle parameters affect the severity and symptoms of COVID-19 among elderly patients? The retrospective evaluation of individuals from the STOP-COVID registry of the PoLoCOV study. J Infect Public Health 2023; 16:143-153. [PMID: 36521330 PMCID: PMC9743693 DOI: 10.1016/j.jiph.2022.12.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 11/30/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Older individuals tend to include less physical activity in their routine and are more prone to chronic diseases and severe medical complications, making them the most burdened group that is losing years of life due to pandemic-related premature mortality. This research aimed to assess the lifestyle factors that affect the COVID-19 course among patients ≥ 65 years old. METHODS The study included 568 convalescents (64.1% women and 35.9% men) with persistent clinical symptoms after isolation. The mean age was 70.41 ± 4.64 years (minimum: 65 years; maximum: 89 years). The patients completed the questionnaire during their in-person visit to the medical center. The survey included questions regarding their health status when suffering from COVID-19, basic sociodemographic data, and medical history concerning chronic conditions and lifestyle. RESULTS Physical inactivity (p < 0.001) and feeling nervous (p = 0.026) increased the risk of having a severe disease course. Coronary artery disease raised both the risk of a severe disease course (p = 0.002) and the number of present symptoms up to 4 weeks (p = 0.039). Sleep disturbances increased the number of symptoms during infection (p = 0.001). The occurrence of any symptoms was also associated with the female sex (p = 0.004). The severity of the course was associated with longer persistent symptoms (p < 0.001) and a greater number of symptoms (p = 0.004); those with a more severe course were also at a greater risk of persistent symptoms for up to 4 weeks (p = 0.006). Senior citizens in the third pandemic wave suffered with more severe disease (p = 0.004), while illness during the fourth (p = 0.001) and fifth (p < 0.001) waves was associated with a lower risk of persistent symptoms for up to 4 weeks. The disease duration was significantly shorter among vaccinated patients (p = 0.042). CONCLUSIONS Elderly COVID-19 patients should re-think their lifestyle habits to consider a physical activity level that is adjusted to their abilities, in order to decrease the risk of a severe disease course and to further limit both the number and duration of symptoms. The research was carried out in accordance with the Declaration of Helsinki, and approval from the Bioethics Committee of Lodz Regional Medical Chamber to conduct the study was obtained (approval number 0115/2021). The PoLoCOV-Study ClinicalTrials.gov identifier is NCT05018052.
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Affiliation(s)
- Joanna Kapusta
- Department of Internal Medicine and Cardiac Rehabilitation, Medical University of Lodz, 70–445 Lodz, Poland,Corresponding author
| | - Michał Chudzik
- Department of Internal Medicine and Geriatric Cardiology, Medical Centre for Postgraduate Education, 01–813 Warsaw, Poland,Boruta Medical Center, 95–100 Zgierz, Poland,Corresponding author at: Department of Internal Medicine and Geriatric Cardiology, Medical Centre for Postgraduate Education, 01–813 Warsaw, Poland
| | - Żaneta Kałuzińska-Kołat
- Boruta Medical Center, 95–100 Zgierz, Poland,Department of Experimental Surgery, Medical University of Lodz, 90–136 Lodz, Poland
| | - Damian Kołat
- Boruta Medical Center, 95–100 Zgierz, Poland,Department of Experimental Surgery, Medical University of Lodz, 90–136 Lodz, Poland
| | - Monika Burzyńska
- Department of Epidemiology and Biostatistics, Social and Preventive Medicine of the Medical University of Lodz, 90–752 Lodz, Poland
| | - Piotr Jankowski
- Department of Internal Medicine and Geriatric Cardiology, Medical Centre for Postgraduate Education, 01–813 Warsaw, Poland
| | - Mateusz Babicki
- Department of Family Medicine, Wroclaw Medical University, 51–141 Wroclaw, Poland
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Tsaava M, Oniani N, Eliozishvili M, Sakhelashvili I, Tkemaladze N, Aladashvili T, Basishvili T, Darchia N. Age-Based Differences in Sleep Quality, Pre-Sleep Arousal, and Psychosocial Factors during the Second Wave Lockdown of the COVID-19 Pandemic in Georgia-A Higher Vulnerability of Younger People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16221. [PMID: 36498297 PMCID: PMC9735985 DOI: 10.3390/ijerph192316221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
The COVID-19 pandemic has deeply disrupted sleep and mental health of people around the world. We aimed to investigate age-based differences in the prevalence of and relationship between sleep quality, pre-sleep arousal, and psychosocial factors during the second wave lockdown of the COVID-19 pandemic in Georgia. Data were collected through an online survey (n = 1117). Participants were categorized into four age groups: 18-29, 30-41, 42-53, and 54-70 years. The youngest participants reported the most prevalent disruption of sleep behavior. Overall, 58.3% of respondents were poor sleepers. The Pittsburgh Sleep Quality Index (PSQI) global score was highest in the youngest age group but the difference was not significant. There was a significant difference in the PSQI component scores for subjective sleep quality, sleep latency, and daytime dysfunction, all being worse in young respondents. We also observed a significantly higher prevalence rate of worse sleep quality in the youngest age group, relative to the pre-pandemic period. On the other hand, the oldest respondents showed significantly greater use of sleeping medications. Significantly higher levels of somatic and cognitive pre-sleep arousal, perceived stress, feeling depressed, anxious, and socially isolated were reported by the youngest age group. Study findings indicate a higher vulnerability of younger people to the impact of the COVID-19 pandemic. Assessment of pre-sleep arousal and implementation of specific, age-based interventions may prove beneficial to improve possible consequences of the pandemic on sleep and mental health.
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Zangeneh Soroush M, Tahvilian P, Koohestani S, Maghooli K, Jafarnia Dabanloo N, Sarhangi Kadijani M, Jahantigh S, Zangeneh Soroush M, Saliani A. Effects of COVID-19-related psychological distress and anxiety on quality of sleep and life in healthcare workers in Iran and three European countries. Front Public Health 2022; 10:997626. [PMID: 36504977 PMCID: PMC9732084 DOI: 10.3389/fpubh.2022.997626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 10/03/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction The COVID-19 pandemic has considerably affected human beings most of whom are healthcare workers (HCWs) combating the disease in the front line. Methods This cross-sectional study aims to explore the effects of stress and anxiety caused by COVID-19 on the quality of sleep and life in HCWs, including physicians, nurses, and other healthcare staff. In this global study, we asked 1,210 HCWs (620 and 590 volunteers from Iran and European countries, including Germany, the Netherlands, and Italy, respectively), who age 21-70, to participate in the test. Several measures of COVID-related stress, anxiety, sleep, and life quality, including the 12-item General Health Questionnaire (GHQ-12), Fear of COVID-19 scale (FCV-19S), Beck Anxiety Inventory (BAI), the Pittsburgh Sleep Quality Index (PSQI), and World Health Organization Quality of Life-BREF (WHOQOL-BREF) are recorded. Results Volunteers reported high rates of stress and anxiety and poor sleep quality as well as lower quality of life. The correlation analysis between the measures is reported. According to the results, regardless of the location, HCWs, predominantly female nurses, developed anxiety and stress symptoms which consequently resulted in lower sleep and life quality. Both for Iranian and the European HCWs, significant differences existed between nurses and the other two groups, with the p-values equal to 0.0357 and 0.0429 for GHQ-12, 0.0368, and 0.714 for BAI measure. Even though nurses reported the most stress, anxiety, fear of COVID-19, lower quality of life and sleep in both countries, and also an increase in other measures as well, there existed no statistically significant difference in FCV-19S, PSQI, and WHOQOL-BREF. Discussion This study helps to expand our knowledge the effects of pandemics on HCWs and also for healthcare management to predict HCW's mental health conditions in similar situations.
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Affiliation(s)
- Morteza Zangeneh Soroush
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Bio-Intelligence Research Unit, Electrical Engineering Department, Sharif University of Technology, Tehran, Iran
- Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
- Engineering Research Center in Medicine and Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Parisa Tahvilian
- Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
- Engineering Research Center in Medicine and Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Sepideh Koohestani
- Department of Electrical Engineering, Islamic Azad University, Qazvin Branch, Qazvin, Iran
| | - Keivan Maghooli
- Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
- Engineering Research Center in Medicine and Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Nader Jafarnia Dabanloo
- Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
- Engineering Research Center in Medicine and Biology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | | | - Sepehr Jahantigh
- Department Chemical Engineering, Sahand University of Technology, Tabriz, Iran
| | | | - Amitis Saliani
- Department of Genomic Medicine, Queen Mary University of London, London, United Kingdom
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12
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Xie X, Zhang N, Fu J, Wang Z, Ye Z, Liu Z. The potential for traditional Chinese therapy in treating sleep disorders caused by COVID-19 through the cholinergic anti-inflammatory pathway. Front Pharmacol 2022; 13:1009527. [PMID: 36299906 PMCID: PMC9589290 DOI: 10.3389/fphar.2022.1009527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 09/23/2022] [Indexed: 11/23/2022] Open
Abstract
Since the outbreak of Coronavirus disease (COVID-19) in 2019, it has spread rapidly across the globe. Sleep disorders caused by COVID-19 have become a major concern for COVID-19 patients and recovered patients. So far, there’s no effective therapy on this. Traditional Chinese therapy (TCT) has a great effect on sleep disorders, with rare side effects and no obvious withdrawal symptoms. The cholinergic anti-inflammatory pathway, a neuroregulatory pathway in the central nervous system that uses cholinergic neurons and neurotransmitters to suppress inflammatory responses, has been reported to be associated with sleep disorders and psychiatric symptoms. Many studies have shown that TCT activates the cholinergic anti-inflammatory pathway (CAP), inhibits inflammation, and relieves associated symptoms. Therefore, we believe that TCT may be a potential therapeutic strategy to alleviate sleep disorders induced by COVID-19 through CAP. In this review, we analyzed the relationship between cytokine storm induced by Coronavirus and sleep disorders, explained the influence of CAP on sleep disorders, discussed the TCT’s effect on CAP, and summarized the treatment effect of TCT on sleep disorders. Based on these practical researches and theoretical basis, we propose potential strategies to effectively improve the sleep disorders caused by COVID-19.
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Affiliation(s)
- Xiaoxia Xie
- Institute of Regenerative and Reconstructive Medicine, Med-X Institute, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Shaanxi University of Chinese Medicine, Xian yang, China
| | - Nana Zhang
- Institute of Regenerative and Reconstructive Medicine, Med-X Institute, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Shaanxi Provincial Center for Regenerative Medicine and Surgical Engineering, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Jingya Fu
- Institute of Regenerative and Reconstructive Medicine, Med-X Institute, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Shaanxi University of Chinese Medicine, Xian yang, China
| | - Zhenzhi Wang
- Institute of Regenerative and Reconstructive Medicine, Med-X Institute, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Shaanxi University of Chinese Medicine, Xian yang, China
| | - Zirun Ye
- Institute of Regenerative and Reconstructive Medicine, Med-X Institute, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Shaanxi Provincial Center for Regenerative Medicine and Surgical Engineering, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Zhijun Liu
- Institute of Regenerative and Reconstructive Medicine, Med-X Institute, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Shaanxi Provincial Center for Regenerative Medicine and Surgical Engineering, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- *Correspondence: Zhijun Liu,
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13
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Ahmet’yanov MA, Reikhert LI, Kicherova OA, Veeva DM, Makarova DV. Sleep Disorders in Patients after COVID-19. NEUROSCIENCE AND BEHAVIORAL PHYSIOLOGY 2022; 52:645-648. [PMID: 36119651 PMCID: PMC9468523 DOI: 10.1007/s11055-022-01290-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 06/11/2021] [Indexed: 11/21/2022]
Abstract
Healthy sleep is required to ensure the body’s homeostatic stability, the consistency of immunological reactions, and optimum functioning of the internal organs, the nervous system, and cognitive functions. Patterns of changes to the circadian rhythms have been studied in many diseases, though infection with SARS-CoV-2 is a new reality and the basic mechanisms of functioning of the body in this pathology require deeper investigation. Despite the difficulty of analytical investigations in pandemic conditions, experience of the diagnosis of COVID-19 has now been acquired and treatment algorithms have been developed for different clinical situations; vaccines have been developed. Least studied are questions of the long-term sequelae of COVID-19. At the same time, there are good grounds for suggesting that patients need long-term rehabilitation in the post-covid period of SARS-CoV-2, for reasons including damage to the nervous system. Analysis of publications – from descriptions of clinical cases to literature reviews – allows empirical experience to be accumulated, providing the opportunity for future identification of prognostic markers for the disease for effective prevention of long-term sequelae. The results of current prospective studies draw attention to the occurrence of dyssomnia and obstructive sleep apnea not only as a common consequence of coronavirus infection, but also as a factor significantly worsening the prognosis in the acute period of illness. It has repeatedly been shown that sleep deprivation has adverse influences on the body’s resistance, including to SARS-CoV-2, and requires correction to improve prognoses in the acute and long-term periods of illness in COVID-19 patients.
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Pellitteri G, Surcinelli A, De Martino M, Fabris M, Janes F, Bax F, Marini A, Milanic R, Piani A, Isola M, Gigli GL, Valente M. Sleep alterations following COVID-19 are associated with both neuroinflammation and psychological disorders, although at different times. Front Neurol 2022; 13:929480. [PMID: 36062000 PMCID: PMC9428349 DOI: 10.3389/fneur.2022.929480] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/27/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionBy the end of 2019, severe acute respiratory syndrome coronavirus 2 rapidly spread all over the world impacting mental health and sleep habits. Insomnia, impaired sleep quality, and circadian rhythm alterations were all observed during the pandemic, especially among healthcare workers and in patients with acute and post-acute COVID-19. Sleep disruption may induce a pro-inflammatory state associated with an impairment of immune system function.ObjectiveWe investigated the relationship between sleep alterations, psychological disorders, and inflammatory blood biomarkers in patients with post-acute COVID-19.MethodsWe enrolled 47 subjects diagnosed with COVID-19 pneumonia at Santa Maria della Misericordia University Hospital (Udine, Italy) between March and May 2020. Selected patients were evaluated at 2 months (T1) and 10 months (T2) after discharge. Each time, we collected clinical interviews, neurological examinations, and self-administered questionnaires to assess sleep and life quality, anxiety, depression, and post-traumatic stress disorder. Blood biomarkers of endothelial activation, neuroinflammation, and inflammatory cytokines were also measured at each follow-up. Collected variables were analyzed using comparisons between groups and linear regression models.ResultsPrevalence of insomnia increased from 10.6% up to 27.3% after COVID-19. Poor sleep quality was found in 41.5% of patients at both study visits. At T1 follow-up, poor sleepers showed higher levels of neurofilament light chain, vascular cell adhesion molecule 1, and interleukin 10; no significant associations were found between sleep quality and psychological disorders. At T2 follow-up, lower sleep quality was associated with higher levels of vascular cell adhesion molecule 1 and interleukin 8, but also with higher scores for anxiety, depression, and post-traumatic stress disorder.ConclusionOur results suggest an association of poor sleep quality with both psychological disorders and neuroinflammation, although at different times, in previously hospitalized patients with moderate-to-critical COVID-19.
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Affiliation(s)
- Gaia Pellitteri
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
- *Correspondence: Gaia Pellitteri
| | - Andrea Surcinelli
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Maria De Martino
- Division of Medical Statistics, Department of Medical Area, University of Udine, Udine, Italy
| | - Martina Fabris
- Institute of Clinical Pathology, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Francesco Janes
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Francesco Bax
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | | | - Romina Milanic
- Institute of Clinical Pathology, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Antonella Piani
- Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Miriam Isola
- Division of Medical Statistics, Department of Medical Area, University of Udine, Udine, Italy
| | - Gian Luigi Gigli
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
- Department of Medical Area (DAME), University of Udine, Udine, Italy
| | - Mariarosaria Valente
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
- Department of Medical Area (DAME), University of Udine, Udine, Italy
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Malik M, Atiq A, Tahir MJ, Akhtar FK, Malik MI, Hassan W, Asad Khan FM, Akram I, Manhas N, Ullah I, Asghar MS. Comparison of sleep quality among COVID-19 patients and non-COVID-19 population in Pakistan: A cross sectional study during the COVID-19 pandemic. Ann Med Surg (Lond) 2022; 78:103894. [PMID: 35693099 PMCID: PMC9166271 DOI: 10.1016/j.amsu.2022.103894] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/24/2022] [Accepted: 05/29/2022] [Indexed: 11/09/2022] Open
Abstract
Background Adverse effects on the health and well-being changes may also express as a decreased sleep quality in COVID-19 patients. This study aimed to assess sleep quality among confirmed COVID-19 patients and the non-COVID-19 Pakistani population. Methods An online cross-sectional survey was conducted between April and September 2020 in Punjab province, Pakistan. Information about demographic characteristics, COVID-19 diseased status, prior knowledge about COVID-19, and sleep quality using the Pittsburgh Sleep Quality Index (PSQI) was collected. Results A total of 597 participants were included in this study, 296 (49.6%) COVID-19 patients and 301(50.4%) non-COVID-19 population. The PQSI was used to measure seven distinct sleep components; subjective quality, latency, duration, efficiency, disturbances, medication, and daytime dysfunction. Where mean ± standard deviation (SD) were 0.96 ± 0.743, 1.47 ± 1.032, 0.97 ± 1.006, 0.61 ± 0.995, 1.13 ± 0.649, 0.23 ± 0.651, 1.02 ± 0.861 respectively in total population (N = 597). Sleep latency, sleep duration, and sleep efficiency did not show a significant difference in the T-Test. While sleep quality, sleep disturbances, sleep medication, and daytime dysfunction showed a significant difference between both populations. Conclusion In conclusion, we highlighted the poor sleep quality in COVID-19 patients as compared to the non-COVID-19 population. This study highlighted the poor sleep quality in COVID-19 patients as compared to the non-COVID-19 population. Sleep latency, sleep duration, and sleep efficiency did not show a significant difference. We found that Sleep quality, sleep disturbances, sleep medication, and daytime dysfunction components showed a significant difference.
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16
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Zürcher SJ, Banzer C, Adamus C, Lehmann AI, Richter D, Kerksieck P. Post-viral mental health sequelae in infected persons associated with COVID-19 and previous epidemics and pandemics: Systematic review and meta-analysis of prevalence estimates. J Infect Public Health 2022; 15:599-608. [PMID: 35490117 PMCID: PMC9020842 DOI: 10.1016/j.jiph.2022.04.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 03/04/2022] [Accepted: 04/13/2022] [Indexed: 12/14/2022] Open
Abstract
AIMS Post-viral mental health problems (MHP) in COVID-19 patients and survivors were anticipated already during early stages of this pandemic. We aimed to synthesize the prevalence of the anxiety, depression, post-traumatic and general distress domain associated with virus epidemics since 2002. METHODS In this systematic review and meta-analysis, we searched PubMed, PsycINFO, and Embase from 2002 to April 14, 2021 for peer-reviewed studies reporting prevalence of MHP in adults with laboratory-confirmed or suspected SARS-CoV-1, H1N1, MERS-CoV, H7N9, Ebolavirus, or SARS-CoV-2 infection. We included studies that assessed post-viral MHP with validated and frequently used scales. A three-level random-effects meta-analysis for dependent effect sizes was conducted to account for multiple outcome reporting. We pooled MHP across all domains and separately by severity (above mild or moderate-to-severe) and by acute (one month), ongoing (one to three months), and post-illness stages (longer than three months). A meta-regression was conducted to test for moderating effects, particularly for exploring estimate differences between SARS-Cov-2 and previous pandemics and epidemics. PROSPERO registration: CRD42020194535. RESULTS We identified 59 studies including between 14 and 1002 participants and providing 187 prevalence estimates. MHP, in general, decreased from acute to post-illness from 46.3% to 38.8% and for mild and moderate-to-severe from 22.3% to 18.8%, respectively. We found no evidence of moderating effects except for non-random sampling and H1N1 showing higher prevalence. There was a non-significant trend towards lower MHP for SARS-CoV-2 compared to previous epidemics. CONCLUSIONS MHP prevalence estimates decreased over time but were still on a substantial level at post-illness. Post-viral mental health problems caused by SARS-CoV-2 could have been expected much earlier, given the previous post-viral sequelae.
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Affiliation(s)
- Simeon Joel Zürcher
- Center for Psychiatric Rehabilitation, Universitäre Psychiatrische Dienste Bern (UPD), Bern, Switzerland; University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
| | - Céline Banzer
- Center for Psychiatric Rehabilitation, Universitäre Psychiatrische Dienste Bern (UPD), Bern, Switzerland
| | - Christine Adamus
- Center for Psychiatric Rehabilitation, Universitäre Psychiatrische Dienste Bern (UPD), Bern, Switzerland; University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Anja I Lehmann
- Epidemiology, Biostatistics and Prevention Institute, Public and Organizational Health, University of Zurich, Zurich, Switzerland
| | - Dirk Richter
- Center for Psychiatric Rehabilitation, Universitäre Psychiatrische Dienste Bern (UPD), Bern, Switzerland; University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Philipp Kerksieck
- Epidemiology, Biostatistics and Prevention Institute, Public and Organizational Health, University of Zurich, Zurich, Switzerland
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Mariniello A, Schiavolin S, Magnani F, Cristillo V, Piccinelli SC, Zoppi N, Bonzi G, Sattin D, Silvaggi F, Raggi A, Cacciatore M, Guastafierro E, Toppo C, Gipponi S, Libri I, Bezzi M, Leonardi M, Pilotto A, Padovani A. Neurological involvement associated with COVID-19 disease: a study on psychosocial factors. Neurol Sci 2022; 43:2187-2193. [PMID: 35064346 PMCID: PMC8782679 DOI: 10.1007/s10072-022-05907-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 01/17/2022] [Indexed: 12/15/2022]
Abstract
Background Objective Methods Results Conclusion Supplementary Information
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18
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Jahrami HA, Alhaj OA, Humood AM, Alenezi AF, Fekih-Romdhane F, AlRasheed MM, Saif ZQ, Bragazzi NL, Pandi-Perumal SR, BaHammam AS, Vitiello MV. Sleep disturbances during the COVID-19 pandemic: A systematic review, meta-analysis, and meta-regression. Sleep Med Rev 2022; 62:101591. [PMID: 35131664 PMCID: PMC8782754 DOI: 10.1016/j.smrv.2022.101591] [Citation(s) in RCA: 147] [Impact Index Per Article: 73.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/15/2021] [Accepted: 01/11/2022] [Indexed: 02/07/2023]
Abstract
This systematic review and meta-analysis evaluated the extent of sleep disturbances during the COVID-19 pandemic. Eleven databases and six preprint repositories were searched for the period from November 1, 2019, to July 15, 2021. The DerSimonian and Laird method was used to develop random-effect meta-analyses. Two hundred and fifty studies comprising 493,475 participants from 49 countries were included. During COVID-19, the estimated global prevalence of sleep disturbances was 40.49% [37.56; 43.48%]. Bayesian meta-analysis revealed an odds of 0.68 [0.59; 0.77] which translates to a rate of approximately 41%. This provides reassurance that the estimated rate using classical meta-analysis is robust. Six major populations were identified; the estimated prevalence of sleep problem was 52.39% [41.69; 62.88%] among patients infected with COVID-19, 45.96% [36.90; 55.30%] among children and adolescents, 42.47% [37.95; 47.12%] among healthcare workers, 41.50% [32.98; 50.56%] among special populations with healthcare needs, 41.16% [28.76; 54.79%] among university students, and 36.73% [32.32; 41.38%] among the general population. Sleep disturbances were higher during lockdown compared to no lockdown, 42.49% versus 37.97%. Four in every ten individuals reported a sleep problem during the COVID-19 pandemic. Patients infected with the disease, children, and adolescents appeared to be the most affected groups.
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Affiliation(s)
- Haitham A Jahrami
- Ministry of Health, Bahrain; College of Medicine and Medical Sciences, Arabian Gulf University, Bahrain.
| | - Omar A Alhaj
- Department of Nutrition, Faculty of Pharmacy and Medical Science, University of Petra, Amman, Jordan
| | - Ali M Humood
- College of Medicine and Medical Sciences, Arabian Gulf University, Bahrain
| | - Ahmad F Alenezi
- College of Medicine and Medical Sciences, Arabian Gulf University, Bahrain
| | - Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Psychiatry Department "Ibn Omrane", Tunisia; Tunis El Manar University, Faculty of Medicine of Tunis, Tunisia
| | - Maha M AlRasheed
- Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | | | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University, Toronto, Canada
| | - Seithikurippu R Pandi-Perumal
- Somnogen Canada Inc., College Street, Toronto, Canada; Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Ahmed S BaHammam
- Department of Medicine, College of Medicine, University Sleep Disorders Center, King Saud University, Saudi Arabia; The Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, Riyadh, Saudi Arabia
| | - Michael V Vitiello
- Psychiatry & Behavioral Sciences, Gerontology & Geriatric Medicine, and Biobehavioral Nursing, University of Washington, Seattle, WA 98195-6560, United States
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YAVUZ D, DOĞRU BALAKBABALAR AP, DEMİRAG MD, SEZER S. COVID-19 pandemic: depression and sleep quality in hemodialysis patients. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1054899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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20
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Abstract
The COVID-19 pandemic affected sleep in several people. Though most of the studies argued that age, gender, employment, finances, responsibilities, and exposure to sunlight governed sleep-wake schedule and sleep disturbances, there is also scientific evidence to suggest that these issues could have aroused because of the infiltration of the central nervous system (CNS) by SARS-CoV-2. Sleep disturbances must be addressed during the pandemic as sleep disturbances and systemic inflammation run in a vicious cycle; quality of sleep and timing of vaccination can influence the immune response to vaccination and subjects having obstructive sleep apnea (OSA) are at higher risk for having SARS-CoV-2 infection-related complications.
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Affiliation(s)
- Niraj Kumar
- Department of Neurology, Division of Sleep Medicine, All India Institute of Medical Sciences, Rishikesh 249203, India
| | - Ravi Gupta
- Department of Psychiatry, Division of Sleep Medicine, All India Institute of Medical Sciences, Rishikesh 249203, India.
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21
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Abstract
This chapter summarizes the known associations between COVID-19 and sleep dysfunction, including insomnia, excessive daytime sleepiness, restless legs syndrome and nightmares, and touches upon pandemic-related considerations for obstructive sleep apnea and continuous positive airway pressure treatment. Treatment strategies and management approaches are also briefly discussed.
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Affiliation(s)
- Sushanth Bhat
- Hackensack Meridian-Health JFK University Medical Center, 65 James Street, Edison, NJ, 08818, USA.
| | - Sudhansu Chokroverty
- Sleep Medicine Research, and Co-Chair Emeritus of Neurology, Hackensack Meridian-Health JFK University Medical Center, 65 James Street, Edison, NJ, 08818, USA.
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22
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Abstract
PURPOSE OF REVIEW We reviewed current evidence on the impact of coronavirus disease 2019 (COVID-19) pandemic on sleep of different populations. RECENT FINDINGS Several studies demonstrated that sleep deprivation may cause immune system dysregulation, which deteriorates the course of COVID-19. The increased prevalence of sleep disorders among COVID-19 patients has been associated with more severe disease and worse clinical outcomes. Healthcare workers who were subjected to atypical workload and more nightshifts developed sleep disorders which associated with work-related errors and COVID-19 infection susceptibility. In general population, circadian misalignment and excessive stressors impaired sleep quality. Sleep dysfunction has been recorded due to the pandemic. It is essential to implement interventions in order to alleviate pandemic-related sleep disorders. Telemedicine, cognitive behavioral therapy, and sleep hygiene practices appear to be helpful. Psychotropic medication should be cautiously administered, while other pharmacological agents, such as melatonin, have shown promising results.
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23
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Chhajer R, Shukla SD. Sleep Quality of Covid-19 Recovered Patients in India. Neurosci Insights 2022; 17:26331055221109174. [PMID: 35770183 PMCID: PMC9235310 DOI: 10.1177/26331055221109174] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 05/11/2022] [Indexed: 11/16/2022] Open
Abstract
Objective: The second wave of the Covid-19 pandemic in India was widespread and caused
psychological distress among the citizens. Hospitals were running at a
premium, increasing deaths and trepidation stories were on air by media,
this generated sleep disturbances for many. This study aimed to examine the
sleep quality of Covid-19 recovered patients in India during the second wave
of the pandemic. Methods: Patients who had recently recovered from Covid-19 were invited to participate
in this cross-sectional study using various social media platforms. An
online survey questionnaire, including socio-demographics, health-related
information, Covid-19 related information, and the Pittsburgh Sleep Quality
Index (PSQI), was administered in June 2021. Descriptive statistics were
used to compare the scores among the mild, moderate, and severe groups.
ANOVA was used to find the difference between the groups for global PSQI
scores. Results: A total of 311 participants (261 mild, 45 moderate, and 5 severe) provided
usable responses. The Global PSQI score for the overall study sample was
8.22 ± 3.79. In the severe group, scores were higher 16.8 ± 2.59, and
statistically significant from mild or moderate groups. Sleep quality of
Covid-19 recovered patients was found to be statistically significantly
different based on their gender (P < .001), annual
income (P < .001), employment status
(P < .001), and marital status
(P < .001). Conclusion: Females, employment in the private sector, annual income below rupees 11
lakh, and unmarried Covid-19 recovered patients reported poor sleep quality.
As our findings indicate poor sleep quality among the Covid-19 recovered
patients during the second wave in India, designing psychological
interventions is recommended to support their wellbeing post-recovery.
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Affiliation(s)
- Raina Chhajer
- Humanities and Social Science Area, Indian Institute of Management Indore, Madhya Pradesh, India
| | - Sunil Dutt Shukla
- Department of Zoology, Government Meera Girls College, Udaipur, Rajasthan, India
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24
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Fahriani M, Ilmawan M, Fajar JK, Maliga HA, Frediansyah A, Masyeni S, Yusuf H, Nainu F, Rosiello F, Sirinam S, Keam S, Ophinni Y. Persistence of long COVID symptoms in COVID-19 survivors worldwide and its potential pathogenesis - A systematic review and meta-analysis. NARRA J 2021; 1:e36. [PMID: 38449463 PMCID: PMC10914031 DOI: 10.52225/narraj.v1i2.36] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 07/03/2021] [Indexed: 10/16/2023]
Abstract
The study sought to determine the prevalence of persistent long COVID symptoms such as anxiety, depression, dizziness, chest pain, sleep difficulty, palpitations, weight loss, and hair loss among coronavirus disease 2019 (COVID-19) survivors worldwide and to discuss the potential pathogeneses. Potential studies were searched in three databases (PubMed, Scopus, and Web of Science) as of January 30, 2021. Data on study characteristics, patient characteristics during the follow-up, the number of patients with persistent long COVID symptoms and total COVID-19 survivors were collected according to PRISMA guidelines. To assess the quality of studies, the Newcastle-Ottawa scale was used. The estimated prevalence of each long COVID symptom and the association between COVID-19 severity and the occurrence of prolonged symptoms was assessed, if appropriate. The global prevalence of prolonged anxiety was 15.76% (95%CI: 6.36%, 25.15%). Chest pain persisted in 10.36% (239/3,224) of COVID-19 patients (95%CI: 4.92%, 15.80%). Prolonged depression was found in 24 of 548 COVID-19 survivors with an estimated prevalence of 4.32% (95%CI: 2.62%, 6.03%) and dizziness was presented in 4.83% (118/2,219, 95%CI: 1.50%, 8.16%) after recovery. Hair loss was complained by 527 of 2,251 recovered patients (cumulative prevalence of 24.76%, 95%CI: 19.60%, 29.91%), while weight loss was identified in 37 cases among 452 COVID-19 survivors (8.19%, 95%CI: 5.66%, 10.71%). Prolonged palpitation was experienced by 19.38% (211/1,926) survivors with 95%CI: 2.40%, 41.16%. Sleep difficulty was found in 541 of 2,622 COVID-19 survivors (17.87%, 95%CI: 7.55%, 28.20%). The association between COVID-19 severity and the occurrence of persistent long COVID symptoms was not analyzed due to the lack of data. In conclusion, persistent psychological symptoms are frequently reported among COVID-19 survivors. Follow-up studies with a longer duration and larger population are warranted to assess the extent of prolonged symptoms and the quality of life of COVID-19 survivors. Despite various potential pathogeneses that have been hypothesized, a definitive mechanism is yet to be addressed. PROSPERO registration: CRD42021247172.
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Affiliation(s)
- Marhami Fahriani
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia
| | - Muhammad Ilmawan
- Faculty of Medicine, Universitas Brawijaya, Malang, East Java, Indonesia
| | - Jonny K. Fajar
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia
- Brawijaya Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, East Java, Indonesia
| | - Helnida A. Maliga
- Faculty of Medicine, Universitas Brawijaya, Malang, East Java, Indonesia
| | - Andri Frediansyah
- Research Division for Natural Product Technology (BPTBA), Indonesian Institute of Sciences (LIPI), Wonosari, Indonesia
| | - Sri Masyeni
- Department of Internal Medicine, Faculty of Medicine and Health Sciences Universitas Warmadewa, Denpasar, Bali, Indonesia
- Department of Internal Medicine, Sanjiwani Hospital, Denpasar, Bali, Indonesia
| | - Hanifah Yusuf
- Department of Pharmacology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Aceh, Indonesia
| | - Firzan Nainu
- Faculty of Pharmacy, Hasanuddin University, Makassar, South Sulawesi, Indonesia
| | - Francesco Rosiello
- Department of Public Health and Infectious Disease, Sapienza-University of Rome, Rome, Italy
| | - Salin Sirinam
- Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Synat Keam
- School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Youdiil Ophinni
- Ragon Institute of MGH, MIT and Harvard, Harvard Medical School, Harvard University, Cambridge, MA, USA
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25
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Salehinejad MA, Azarkolah A, Ghanavati E, Nitsche MA. Circadian disturbances, sleep difficulties and the COVID-19 pandemic. Sleep Med 2021; 91:246-252. [PMID: 34334305 PMCID: PMC8277544 DOI: 10.1016/j.sleep.2021.07.011] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 06/12/2021] [Accepted: 07/07/2021] [Indexed: 12/24/2022]
Abstract
The COVID-19 pandemic has imposed extraordinary and unpredictable changes on our lifestyle for an unknown duration. Consequently, core aspects of wellbeing including behavior, emotion, cognition, and social interactions are negatively affected. Sleep and circadian rhythms, with an extensive impact on physiology, behavior, emotion, and cognition are affected too. We provided an updated overview of the impact of the COVID-19 pandemic on circadian rhythms and sleep based on the results of published studies (n = 48) in three sections. First, we focus on circadian misalignment due to the pandemic in the general population (including shift workers, health staff, students) and COVID-19 patients and summarize the most critically contributing factors to circadian misalignment. Next, we address sleep difficulties and poor sleep quality during the pandemic, their contributing factors, rate and prevalence, and their effects on both the general population and COVID-19 patients. Finally, we summarize the currently applied/recommended interventions for aligning circadian rhythms and improving sleep quality in both, the general population, and COVID-19 patients during the pandemic situation. Briefly, circadian misalignment and sleep difficulties are common consequences of the pandemic in the general population (with elderly, students, children, health and night-work shifters as risk groups) and COVID-19 patients. Home confinement and its physiological, circadian, and psychological derivates are central to these difficulties. Symptoms severity, treatment progress, recovery duration, and even diagnosis of COVID-19 patients are considerably affected by circadian and sleep difficulties. Behavioral interventions for normalizing the factors that contribute to circadian and sleep difficulties are helpful.
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Affiliation(s)
- Mohammad Ali Salehinejad
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.
| | - Anita Azarkolah
- Department of Psychiatry, Fatemi Hospital, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Elham Ghanavati
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany; Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
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26
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Alimoradi Z, Gozal D, Tsang HWH, Lin CY, Broström A, Ohayon MM, Pakpour AH. Gender-specific estimates of sleep problems during the COVID-19 pandemic: Systematic review and meta-analysis. J Sleep Res 2021; 31:e13432. [PMID: 34245055 PMCID: PMC8420603 DOI: 10.1111/jsr.13432] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 05/13/2021] [Accepted: 06/16/2021] [Indexed: 02/05/2023]
Abstract
The outbreak of the novel coronavirus disease 2019 (COVID‐19) changed lifestyles worldwide and subsequently induced individuals’ sleep problems. Sleep problems have been demonstrated by scattered evidence among the current literature on COVID‐19; however, little is known regarding the synthesised prevalence of sleep problems (i.e. insomnia symptoms and poor sleep quality) for males and females separately. The present systematic review and meta‐analysis aimed to answer the important question regarding prevalence of sleep problems during the COVID‐19 outbreak period between genders. Using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guideline and Newcastle–Ottawa Scale checklist, relevant studies with satisfactory methodological quality searched for in five academic databases (Scopus, PubMed Central, ProQuest, Web of Science , and EMBASE) were included and analysed. The protocol of the project was registered in the International Prospective Register of Systematic Reviews (PROSPERO; identification code CRD42020181644). A total of 54 papers (N = 67,722) in the female subgroup and 45 papers (N = 45,718) in the male subgroup were pooled in the meta‐analysis. The corrected pooled estimated prevalence of sleep problems was 24% (95% confidence interval [CI] 19%–29%) for female participants and 27% (95% CI 24%–30%) for male participants. Although in both gender subgroups, patients with COVID‐19, health professionals and general population showed the highest prevalence of sleep problems, it did not reach statistical significance. Based on multivariable meta‐regression, both gender groups had higher prevalence of sleep problems during the lockdown period. Therefore, healthcare providers should pay attention to the sleep problems and take appropriate preventive action.
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Affiliation(s)
- Zainab Alimoradi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - David Gozal
- Department of Child Health and the Child Health Research Institute, The University of Missouri School of Medicine, Columbia, MO, USA
| | - Hector W H Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Anders Broström
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Maurice M Ohayon
- Stanford Sleep Epidemiology Research Center (SSERC), School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Amir H Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.,Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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27
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Tanriverdi A, Savci S, Kahraman BO, Ozpelit E. Extrapulmonary features of post-COVID-19 patients: muscle function, physical activity, mood, and sleep quality. Ir J Med Sci 2021; 191:969-975. [PMID: 34080125 PMCID: PMC8172250 DOI: 10.1007/s11845-021-02667-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 05/26/2021] [Indexed: 12/24/2022]
Abstract
Background Coronavirus disease 2019 (COVID-19) represents a wide range of clinical manifestations, even if mild disease severity. It has been known that pulmonary function is affected by COVID-19 during infection and mid-to-long term. However, there is inadequate evidence about extrapulmonary features in post-COVID-19 patients. Aims This study aimed to investigate extrapulmonary features in post-COVID-19 patients who recovered from mild and moderate disease severity in the mid-term. Methods This cross-sectional study was carried out after at least 12 weeks from the COVID-19 diagnosis. Disease severity was defined using criteria for clinical severity of confirmed COVID-19 pneumonia. The peripheral muscle strength was measured using the dynamometer. Physical performance was assessed with five times sit-to-stand and 4-m gait speed. Physical activity level (PAL), mood, and sleep quality were assessed with the International Physical Activity Questionnaire, Hospital Anxiety, and Depression Scale, and Pittsburgh Sleep Quality Index, respectively. Results A total of 48 participants with post-COVID-19 (39.2 ± 7.9 years, 54.2% women) were included in the study. Handgrip and quadriceps weakness was observed in 39.6% and 35.4% of the participants, respectively. PAL was low in 39.6%, moderate in 33.3%, and high in 27.1% of the participants. Anxiety, depression, and poor sleep quality were observed in 33.3%, 29.2%, and 50% of the participants, respectively. Conclusions Extrapulmonary features are adversely affected in a substantial proportion of post-COVID-19 patients who recovered from mild and moderate disease severity in the mid-term. Comprehensive assessment and appropriate intervention strategies should also be considered for non-severe post-COVID-19 patients.
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Affiliation(s)
- Aylin Tanriverdi
- Institute of Health Sciences, Dokuz Eylül University, Izmir, Turkey. .,School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey.
| | - Sema Savci
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Buse Ozcan Kahraman
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - Ebru Ozpelit
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
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28
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Alimoradi Z, Broström A, Tsang HW, Griffiths MD, Haghayegh S, Ohayon MM, Lin CY, Pakpour AH. Sleep problems during COVID-19 pandemic and its' association to psychological distress: A systematic review and meta-analysis. EClinicalMedicine 2021; 36:100916. [PMID: 34131640 PMCID: PMC8192091 DOI: 10.1016/j.eclinm.2021.100916] [Citation(s) in RCA: 191] [Impact Index Per Article: 63.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/29/2021] [Accepted: 05/05/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The emerging novel coronavirus disease 2019 (COVID-19) has become one of the leading cause of deaths worldwide in 2020. The present systematic review and meta-analysis estimated the magnitude of sleep problems during the COVID-19 pandemic and its relationship with psychological distress. METHODS Five academic databases (Scopus, PubMed Central, ProQuest, ISI Web of Knowledge, and Embase) were searched. Observational studies including case-control studies and cross-sectional studies were included if relevant data relationships were reported (i.e., sleep assessed utilizing the Pittsburgh Sleep Quality Index or Insomnia Severity Index). All the studies were English, peer-reviewed papers published between December 2019 and February 2021. PROSPERO registration number: CRD42020181644. FINDINGS 168 cross-sectional, four case-control, and five longitudinal design papers comprising 345,270 participants from 39 countries were identified. The corrected pooled estimated prevalence of sleep problems were 31% among healthcare professionals, 18% among the general population, and 57% among COVID-19 patients (all p-values < 0.05). Sleep problems were associated with depression among healthcare professionals, the general population, and COVID-19 patients, with Fisher's Z scores of -0.28, -0.30, and -0.36, respectively. Sleep problems were positively (and moderately) associated with anxiety among healthcare professionals, the general population, and COVID-19 patients, with Fisher's z scores of 0.55, 0.48, and 0.49, respectively. INTERPRETATION Sleep problems appear to have been common during the ongoing COVID-19 pandemic. Moreover, sleep problems were found to be associated with higher levels of psychological distress. With the use of effective programs treating sleep problems, psychological distress may be reduced. Vice versa, the use of effective programs treating psychological distress, sleep problems may be reduced. FUNDING The present study received no funding.
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Affiliation(s)
- Zainab Alimoradi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Anders Broström
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden
| | - Hector W.H. Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Shahab Haghayegh
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Maurice M. Ohayon
- Stanford Sleep Epidemiology Research Center (SSERC), School of Medicine, Stanford University, CA, USA
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University
| | - Amir H. Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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29
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Zhang L, Li T, Chen L, Wu F, Xia W, Huang M, Guo Z, Song L, Yin H, Zhang Y, Yu Y, Cai S, Lu Z, Rong S, Bao W. Association of sleep quality before and after SARS-CoV-2 infection with clinical outcomes in hospitalized patients with COVID-19 in China. EXCLI JOURNAL 2021; 20:894-906. [PMID: 34121976 PMCID: PMC8192881 DOI: 10.17179/excli2021-3451] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 04/12/2021] [Indexed: 01/08/2023]
Abstract
Sleep is believed to benefit the host defense against pathogens. We aimed to investigate the association of sleep quality with clinical outcomes among hospitalized patients with COVID-19. We conducted a prospective cohort study in 205 adult hospitalized patients with diagnosed moderate COVID-19, with follow-up until hospital discharge or death. Pittsburgh Sleep Quality Index (PSQI) assessed sleep quality before and after infection. The primary outcome was the incidence of severe or critical pneumonia, and the secondary outcomes were duration of hospital stay and laboratory measurements during the follow up. Among the 205 included hospitalized patients, 185 (90.2 %) experienced poorer sleep quality after infection than before according to the PSQI score, and 25 (12.2 %) developed severe or critical pneumonia during follow-up. In Cox regression models, the adjusted hazard ratio of developing severe or critical pneumonia associated with each 1 score increment in the PSQI score before and after infection was 1.23 (95% CI: 1.09, 1.39) and 1.35 (95 % CI: 1.08, 1.67), respectively. Poorer sleep quality was also significantly associated with a prolonged hospital stay and more serious dysregulations in immune system indicated by several laboratory markers. Poorer sleep quality, either in the daily time or after infection with SARS-CoV-2, was associated with worse clinical outcomes. These findings highlight the importance of good sleep in confronting the emerging pandemic of COVID-19.
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Affiliation(s)
- Li Zhang
- Department of Neurology, Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Wuhan 430015, China
| | - Tingting Li
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Liangkai Chen
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Feng Wu
- Department of Neurology, Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Wuhan 430015, China
| | - Wenguang Xia
- Department of Neurology, Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Wuhan 430015, China
| | - Min Huang
- Department of Neurology, Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Wuhan 430015, China
| | - Zhenli Guo
- Department of Neurology, Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Wuhan 430015, China
| | - Lin Song
- Department of Neurology, Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Wuhan 430015, China
| | - Hongxiang Yin
- Department of Neurology, Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Wuhan 430015, China
| | - Yangpu Zhang
- Department of Neurology, Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Wuhan 430015, China
| | - Yongfei Yu
- Department of Neurology, Hubei Provincial Hospital of Integrated Chinese & Western Medicine, Wuhan 430015, China
| | - Sijie Cai
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Zijian Lu
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Shuang Rong
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Wei Bao
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA 52242, USA
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Ahmet’yanov M, Reikhert L, Kicherova O, Deeva M, Makarova D. Sleep Disorders in Patients After COVID-19. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:119-122. [DOI: 10.17116/jnevro2021121121119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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