Anxiety and depressive symptoms among COVID-19 patients in Jianghan Fangcang Shelter Hospital in Wuhan, China

Social support moderates the relationship between sleep quality and mental health: A Chinese Fangcang shelter hospital-based study in asymptomatic COVID-19 carriers

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).

Prevalence of poor sleep quality in COVID-19 patients: a systematic review and meta-analysis

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.

Impact of COVID-19 on Anxiety and Depression - Biopsychosocial Factors

Anxiety and depression are prevalent mental disorders around the world. The etiology of both diseases is multifactorial, involving biological and psychological issues. The COVID-19 pandemic settled in 2020 and culminated in several changes in the routine of individuals around the world, affecting mental health. People infected with COVID-19 are at greater risk of developing anxiety and depression, and individuals previously affected by these disorders have worsened the condition. In addition, individuals diagnosed with anxiety or depression before being affected by COVID-19 developed the severe illness at higher rates than individuals without mental disorders. This harmful cycle involves several mechanisms, including systemic hyper-inflammation and neuroinflammation. Furthermore, the context of the pandemic and some previous psychosocial factors can aggravate or trigger anxiety and depression. Disorders are also risks for a more severe picture of COVID-19. This review discusses research on a scientific basis, which brings evidence on biopsychosocial factors from COVID-19 and the context of the pandemic involved in anxiety and depression disorders.

The impacts of patient mistreatment on healthcare workers' role behaviors: a study in Chinese Fangcang shelter hospitals

BACKGROUND

Fangcang shelter hospitals have played an important role in the battle against the COVID-19 epidemic in China. Patients' verbal and physical attacks on medical workforce are prone to occur in such hospitals. This study explored the impacts of patient mistreatment on healthcare workers' role behaviors (service performance and patient-oriented organizational citizenship behavior).

METHODS

We examined the influence of patient mistreatment on service performance and patient-oriented organizational citizenship behavior, as well as the mediating effect of emotional exhaustion and the moderating effect of displaced aggression by patients, using hierarchical linear regression and conditional process analysis.

RESULTS

Patient mistreatment was positively associated with emotional exhaustion among healthcare workers, while emotional exhaustion was negatively associated with service performance and patient-oriented organizational citizenship behavior. Mediation analysis revealed that emotional exhaustion mediated the association between patient mistreatment and both types of role behaviors. Moderated mediation analysis found that the mediation effect was weaker when the displaced aggression by patients was high.

CONCLUSIONS

The findings clarified the relationship among patient mistreatment, emotional exhaustion, service performance, and patient-oriented organizational citizenship behavior. Additional assistance should be provided to healthcare workers dealing with patient mistreatment. Displaced aggression by patients attenuates the positive effects of patient mistreatment on the emotional exhaustion of healthcare workers. Our findings reveal the mechanism and boundary conditions of patient mistreatment affecting healthcare workers' service performance and patient-oriented organizational citizenship behavior.

Depression, anxiety, and stress among COVID-19 patients in South Sinai, Egypt: prevalence and associated predictors

Infectious diseases trigger fear and anxiety among patients leading to disturbance in psychological health of patients. Psychological symptoms were found during SARS-COV-1 epidemic which raise the curiosity about their presence with SARS-COV-2 infection. The current study aimed to estimate the prevalence and severity of psychiatric disorders (depression, anxiety, and stress) among COVID-19 patients and their associated significant predictors. A cross-sectional study was conducted among 382 patients infected with COVID-19 in South Sinai governorate, Egypt, during the period June 2021 through January 2022. Patients with positive PCR test for COVID-19 were included if no more than 6 months have passed after being isolated in the hospital or at home. The patients were being contacted after being cured from COVID-19. The Arabic version of the Depression Anxiety Stress was used to assess the psychological status of patients. Multivariate linear regression analysis was done to detect the predictors of psychiatric symptoms among patients. A total of 382 participants with mean age of 41.5 ± 15.0 years old, of whom 72.5% were males were included in the study. 91.6% of participants had all the three studied psychological disorders; depression, anxiety and stress with most of participants had either severe or extremely severe conditions (13.9 and 75.7 for anxiety, 22.8 and 46.3% for depression, 38.5 and % 19.6 for stress, respectively). Healthcare workers had higher prevalence rates of depression, anxiety and stress. In bivariate analysis, educational level, HCWs and visiting healthcare facility were significantly affecting DASS scores. In linear regression analysis, hospital admission was the main predictor of the three psychological disorders. In Conclusion, majority of patients affected with COVID-19 suffered from symptoms of anxiety, depression and stress within six months after being infected. Hospital admission was found to be the main predictor of the presence of psychiatric disorders with prolonged recovery time from COVID-19 infection. More attention should be paid to COVID-19 patient's mental health as psychological care and presence of psychiatric in the isolation hospitals should be considered.

Correlates of anxiety and depressive symptoms in inpatients with COVID-19 in Taiwan

Objectives

Inpatients with COVID-19 may experience high levels of anxiety and depressive symptoms during the pandemic. No prior study has examined these symptoms with COVID-19 inpatients in Taiwan. Using data from a tertiary hospital in Northern Taiwan, we investigated anxiety and depressive symptoms and the associated sociodemographic or clinical characteristics in these patients.

Methods

Data of anxiety and depressive symptoms by the Hospital Anxiety and Depression Scale (HADS) as well as the sociodemographic and clinical correlates were retrospectively retrieved and analyzed for COVID-19 patients admitted to Far Eastern Memorial Hospital from June 4 to June 28, 2021.

Results

In total, 152 patients with COVID-19 were included. Among all the COVID-19 inpatients, 9.9 % (n = 15) had an HADS anxiety score of ≥8 and 7.2 % (n = 11) had an HADS depression score of ≥8. COVID-19 inpatients with HADS anxiety score ≥8 or HADS depression score ≥8 were found to have a longer length of hospital stay compared to the respective comparison group. The female patients, patients aged >55 years, and patients hospitalized for >15 days had significantly higher anxiety scores than did the corresponding comparison groups.

Conclusion

COVID-19 inpatients with either anxiety or depression were associated with longer length of hospital stay. Age, sex, and hospitalization length were found to be associated with anxiety symptoms in inpatients with COVID-19. Future studies are warranted to elucidate differential mechanisms potentially related to anxiety and depressive symptoms in patients with COVID-19.

Effect of the Online Mindfulness-Based Stress Reduction on Anxiety and Depression Status of COVID-19 Patients Treated in Fangcang Hospitals: A Randomized Controlled Trial

Background

As the focal point of epidemic prevention and control, the mental health of COVID-19 patients cannot be ignored. Online Mindfulness-Based Stress Reduction (MBSR) allows for the provision of conveniently accessible, effective and low-cost interventions on a large scale. We aim to evaluate the effectiveness of an online MBSR intervention in alleviating anxiety and depression among asymptomatic/mild patients limited by COVID-19-related restrictions.

Methods

Fifty-eight patients treated in Sanya Fangcang hospital were randomly allocated to either to the experimental group (n = 29) following daily, for 5 days, an online-based mindfulness intervention or to the control group (n = 29). Patients from both groups underwent online questionnaires including assessment of anxiety and depression status at pre- and post-tests using Self-rating Anxiety Scale and Self-Rating Depression Scale.

Results

After the online-based MBSR program, the anxiety and depression scores of the patients in the MBSR group decreased significantly in comparison to the scores of those in the control group (respectively η² = 0.175, η² = 0.215, p < 0.001). And the proportion of severe anxiety and depression patients in the MBSR group decreased to 0% which lower than the control group, and the proportion of light anxiety and depression patients was significantly more than that in the control group after the MBSR intervention.

Conclusion

The online-based MBSR intervention appears to be an effective way of alleviating anxiety and depression symptoms among COVID-19 patients with associated quarantine in Fangcang hospital. Given the seriousness of mental health threat that could be posed by this ongoing pandemic, our study provides a new idea and method for cost-effective and time-efficient interventions in the future of epidemic prevention and control.

Anxiety among hospitalized COVID-19 patients: a case-control study from a tertiary teaching hospital in Malaysia

Introduction

Anxiety has been increasingly recognized as part of the psychosocial health issues in COVID-19 patients. However, the impact of this topic may be underestimated in low- and middle-income countries. This study aimed to estimate the prevalence of and risk factors of anxiety in COVID-19 patients compared to controls in a local tertiary teaching hospital in Malaysia.

Methods

In this case-control study, we analyzed data on adult patients aged 18 years and above hospitalized for COVID-19 infection with matched hospitalized controls. The demographic, clinical data and anxiety measures using the Generalized Anxiety Disorder-7 questionnaire were analyzed using univariate and multivariate analysis.

Results

86.6% in the COVID-19 group had anxiety, significantly higher than 13.4% in the control group (p = 0.001). The COVID-19 group was significantly associated with the GAD-7 severity (p = 0.001). The number of COVID-19 patients in the mild, moderate, and severe anxiety groups was 48 (84.2%), 37 (86%), and 18 (94.7%), respectively. Multiple logistic regression showed significant predictors for anxiety, including COVID-19 diagnosis and neurological symptoms. Anxiety was found 36.92 times higher in the patients with COVID-19 compared to those without COVID-19 (OR 36.92;95% CI 17.09, 79.78, p = 0.001). Patients with neurological symptoms were at risk of having anxiety (OR 2.94; 95% CI 1.03, 8.41, p = 0.044).

Discussion

COVID-19 patients experience a significant disruption in psychosocial functioning due to hospitalization. The burden of anxiety is notably high, compounded by a diagnosis of COVID-19 itself and neurological symptomatology. Early psychiatric referrals are warranted for patients at risk of developing anxiety symptoms.

Association between tissue stress reaction and ACE2/TMPRSS2 expression in endometria of reproductive aged women before and during Covid-19 pandemic

BACKGROUND

A potential concern has been raised regarding fertility and reproductive outcome during the Covid-19 pandemic with growing stress and anxiety. However, information on the association between tissue stress reaction and expression profiles of SARS-CoV-2 viral entry proteins, ACE2 and TMPRSS2, in endometria collected from women before (pre-pandemic) and during the Covid-19 pandemic (in-pandemic) is unknown. We aim to investigate the relationship between the expression of stress-reactive proteins and of ACE2 and TMPRSS2 in endometria collected from women during these two different time frames.

METHODS

We retrospectively retrieved tissue blocks of endometrial samples from 25 women in 2019 (pre-pandemic) and 25 women in 2020 (in-pandemic) who underwent hysterectomy for different gynecological indications. Immunohistochemical analysis was performed with endometrial tissue samples that were collected before and during the pandemic, using respective antibodies targeting ACE2/TMPRSS2, ADRB2 and NK1R (stress and anxiety receptor markers, respectively). The quantification of immunoreactive cells for each marker was calculated by the immunoreactive score (IRS) analysis. This retrospective cohort study was limited to small sample size.

RESULTS

No significant differences in the IRS of ACE2 and TMPRSS2 were found between the endometria that were collected before and during the pandemic with a lack of correlation between ACE2 and TMPRSS2 expression in respective endometria (r = 0.11, pre-pandemic; r = 0.04, in-pandemic). The immunostaining levels of stress marker, ADRB2 were significantly higher in the endometria of in-pandemic group (p = 0.015) comparing to that of pre-pandemic group. Pearson's correlation coefficient analysis showed a significant correlation in the expression between ADRB2 and TMPRSS2 (r = 0.41, p = 0.042) in the endometria of in-pandemic group but not in the pre-pandemic group.

CONCLUSION

The rise in stress and anxiety among women during current pandemic may elicit substantial amount of tissue stress reaction with consequent increase in the expression of SARS-CoV-2 viral entry proteins in their endometria. A lack of correlation between ACE2 and TMPRSS2 expression in endometria may reassure women in their reproductive age that they are not more susceptible to infection by SARS-CoV-2 and suggest that stressful women during this pandemic can safely decide to conceive naturally or by artificial reproductive technology.

COVID-19 and Sleep Disturbances: A Literature Review of Clinical Evidence

The need for adequate good quality sleep to optimally function is well known. Over years, various physical, psychological, biological, and social factors have been investigated to understand their impact on sleep. However, understanding the etiological processes that are involved in causing sleep disturbances (SD) as impacted by stressful phases such as pandemics has not been well studied. Many such etiological and management strategies have surfaced during the latest "coronavirus disease of 2019 (COVID-19) pandemic. The occurrence of these SD in the infected and uninfected individuals poses a need to investigate factors linked to such occurrence during this phase. Some of such factors include stressful practices such as social distancing, masking, vaccines, and medications availability, changes in routines, and lifestyles. As the status of infection improved, a collective term for all the prolonged effects of COVID-19 after the resolution of the primary infection called the post-COVID-19 syndrome (PCS) surfaced. Apart from impacting sleep during the infectious phase, the aftereffects of this virus left an even greater impact during the PCS. Various mechanisms have been hypothesized to be linked to such SD during the PCS, but the available data are inconclusive. Further, the varied patterns of incidence of these SDs differed by many factors, such as age, gender, and geographical location, making clinical management even more challenging. This review elucidates the impact of coronavirus 2 (SARS-CoV-2) (COVID) disease on sleep health during the various phases of the COVID-19 pandemic. We also investigate different causal relationships, management strategies, and knowledge gaps related to SD during the COVID-19 pandemic.

The relationship between physical activity pre COVID-19 pandemic with mental health, depression, and anxiety in COVID-19 patients: a cross-sectional study

Purpose

Covid-19 pandemic has gained a growing trend and affected mental health in several aspects. Physical activity guidelines was strongly associated with a reduced risk for severe COVID-19 outcomes among infected adults. The purpose of this study was to evaluate the association between physical activity pre COVID-19 pandemic with mental health, depression, and anxiety in COVID-19 patients.

Methods

206 hospitalized patients diagnosed with covid-19 (140 male and 66 female, aged 34.5 ± 12) were selected and completed physical activity questionnaire (IPAQ) and hospital anxiety and depression questionnaire (HADS). For physical activity status assessment, a self-completed IPAQ questionnaire was taken and patients were divided into: (1) low active, (2) moderate active and (3) high active groups according to their physical activity experience. One-way ANOVA test was recruited and Tukey post hoc test was taken to assess difference among means. Pearson correlation was used to evaluate the association between physical activity level and mental health status (p < 0.05).

Results

The results from this study showed that anxiety and depression was significantly higher in low active patients (p = 0.001) and there was a negative correlation between physical activity level and HADS (p = 0.001). However, patients with high physical activity pre COVID-19 pandemic have a lowest levels of anxiety and depression compare to other groups (p < 0.001).

Conclusion

It seems that adequate physical activity as a part of a healthy lifestyle may have a beneficial effect on mental health during the current outbreak of covid-19. Therefore, it is suggested that we perform exercise training every day to preconditioning effects.

Strategies, challenges and opportunities in the implementation of COVID-19 field hospitals: a scoping review

OBJECTIVES

COVID-19 has strained healthcare systems, requiring the redesign of their structure, human resource management and clinical approach. Countries have adopted implementation strategies and maximise field hospital functionality to address the issue of overflow of patients with COVID-19. This scoping review was based on the main research question, 'What are the implementation strategies, challenges and opportunities in managing the field hospital during the COVID-19 pandemic?', and aimed to consolidate all recent evidence on COVID-19 field hospital implementation approaches, challenges and potentialities.

DESIGN

Scoping review, following the Arksey and O'Malley's framework, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines.

DATA SOURCES

PubMed, Web of Science and Scopus were searched from 1 January 2020 through 31 December 2021.

ELIGIBILITY CRITERIA

Original articles, reviews, case studies and reports written in English were included. Works without full article and articles that did not answer the research questions were excluded.

DATA EXTRACTION AND SYNTHESIS

Data were extracted using a standardised data extraction form in Microsoft Excel. The findings of all included articles were synthesised narratively.

RESULTS

Eighty-five records were reviewed and 25 studies were included. For the field hospital implementation strategies, 'surge capacity', namely space, human resource, supply and system, was discussed in addition to the preparation and workflow of other services such as pharmacy, rehabilitation, food and nutrition. The management of COVID-19 field hospitals is challenging with respect to staff and resource shortages, inability to anticipate patient load and poor communication. The opportunities and recommendations for improvement of management were also highlighted.

CONCLUSIONS

The compilation of lessons learnt may help improve the future management of field hospitals, administratively and clinically.

Role of the MicroRNAs in the Pathogenic Mechanism of Painful Symptoms in Long COVID: Systematic Review

The ongoing pandemic of COVID-19 has caused more than 6.7 million tragic deaths, plus, a large percentage of people who survived it present a myriad of chronic symptoms that last for at least 6 months; this has been named as long COVID. Some of the most prevalent are painful symptoms like headache, joint pain, migraine, neuropathic-like pain, fatigue and myalgia. MicroRNAs are small non-coding RNAs that regulate genes, and their involvement in several pathologies has been extensively shown. A deregulation of miRNAs has been observed in patients with COVID-19. The objective of the present systematic review was to show the prevalence of chronic pain-like symptoms of patients with long COVID and based on the expression of miRNAs in patients with COVID-19, and to present a proposal on how they may be involved in the pathogenic mechanisms of chronic pain-like symptoms. A systematic review was carried out in online databases for original articles published between March 2020 to April 2022; the systematic review followed the PRISMA guidelines, and it was registered in PROSPERO with registration number CRD42022318992. A total of 22 articles were included for the evaluation of miRNAs and 20 regarding long COVID; the overall prevalence of pain-like symptoms was around 10 to 87%, plus, the miRNAs that were commonly up and downregulated were miR-21-5p, miR-29a,b,c-3p miR-92a,b-3p, miR-92b-5p, miR-126-3p, miR-150-5p, miR-155-5p, miR-200a, c-3p, miR-320a,b,c,d,e-3p, and miR-451a. The molecular pathways that we hypothesized to be modulated by these miRNAs are the IL-6/STAT3 proinflammatory axis and the compromise of the blood-nerve barrier; these two mechanisms could be associated with the prevalence of fatigue and chronic pain in the long COVID population, plus they could be novel pharmacological targets in order to reduce and prevent these symptoms.

Assessment of Level of Depression and Associated Factors among COVID-19-Recovered Patients: a Cross-Sectional Study

The coronavirus disease 2019 (COVID-19) pandemic has psychological consequences such as increased risk of depression, anxiety, and stress problems, exacerbating human health disparities. This study aimed to analyze depression and its causes in COVID-19-recovered patients in Bangladesh. A cross-sectional study was conducted on COVID-19-recovered patients who attended follow-up visits after 14 days to 3 months at Dhaka Medical College Hospital (DMCH) and Dhaka North City Corporation Hospital (DNCCH), Dhaka, Bangladesh, from 1 January to 31 December 2021. Respondents were face-to-face interviewed with a semistructured questionnaire after written agreement. The Patient Health Questionnaire (PHQ-9) was used to assess respondents' depression, and data were analyzed using SPSS version 23, with a P value of <0.05 indicating statistical significance. A total of 325 COVID-19-recovered patients aged from 15 to 65 years (mean, 44.34 ± 13.87 years) were included in this study, the highest proportion (23.1%) of them were aged 46 to 55 years, and the majority (61.5%) of them were male. There were 69.5% of respondents who had no signs of depression while 31% of them did have signs, with 26.7% being mildly depressed, 2.5% being extremely depressed, and 1.2% being severely depressed. Diabetes mellitus, hospitalization duration, social distancing, social media posts on COVID-19, loss of employment, family damage, and fear of reinfection were significantly associated with depression level of respondents. This study gives us a glimpse into the psychological health of COVID-19-recovered patients, and its findings highlight the imperative of alleviating their psychological anguish in Bangladesh. IMPORTANCE The COVID-19 pandemic had a significant psychological impact on healthy populations, with increased depression, perceived stress, posttraumatic stress disorder, and insomnia reported. The COVID-19 pandemic affects people's mental health by instilling fear of infection and depression. In the post-COVID-19 syndrome, depressive symptoms and clinically significant depression may have serious consequences for quality-of-life outcomes. To combat the spread of COVID-19, the Bangladesh government has implemented a number of measures, including lockdown, social distancing, self-isolation, and quarantine. Given the negative consequences, it is critical to investigate potential factors and mechanisms that may shed light on mental health improvement. The purpose of the study is to determine the level of depression in patients 3 months after recovering from acute COVID-19. The study's findings highlight the need for COVID-19-infected people in Bangladesh to receive health education and interventions.

Medical implementation practice and its medical performance evaluation of a giant makeshift hospital during the COVID-19 pandemic: An innovative model response to a public health emergency in Shanghai, China

Introduction

In confronting the sudden COVID-19 epidemic, China and other countries have been under great pressure to block virus transmission and reduce fatalities. Converting large-scale public venues into makeshift hospitals is a popular response. This addresses the outbreak and can maintain smooth operation of a country or region's healthcare system during a pandemic. However, large makeshift hospitals, such as the Shanghai New International Expo Center (SNIEC) makeshift hospital, which was one of the largest makeshift hospitals in the world, face two major problems: Effective and precise transfer of patients and heterogeneity of the medical care teams.

Methods

To solve these problems, this study presents the medical practices of the SNIEC makeshift hospital in Shanghai, China. The experiences include constructing two groups, developing a medical management protocol, implementing a multi-dimensional management mode to screen patients, transferring them effectively, and achieving homogeneous quality of medical care. To evaluate the medical practice performance of the SNIEC makeshift hospital, 41,941 infected patients were retrospectively reviewed from March 31 to May 23, 2022. Multivariate logistic regression method and a tree-augmented naive (TAN) Bayesian network mode were used.

Results

We identified that the three most important variables were chronic disease, age, and type of cabin, with importance values of 0.63, 0.15, and 0.11, respectively. The constructed TAN Bayesian network model had good predictive values; the overall correct rates of the model-training dataset partition and test dataset partition were 99.19 and 99.05%, respectively, and the respective values for the area under the receiver operating characteristic curve were 0.939 and 0.957.

Conclusion

The medical practice in the SNIEC makeshift hospital was implemented well, had good medical care performance, and could be copied worldwide as a practical intervention to fight the epidemic in China and other developing countries.

Effects of dysfunctional beliefs about sleep on sleep quality and mental health among patients with COVID-19 treated in Fangcang shelter hospitals

Introduction

With the COVID-19 pandemic in China, a large number of mild or ordinary confirmed cases have been sent to Fangcang shelter hospitals for treatment. We aimed to investigate the mental health condition of Fangcang patients 2 years after the pandemic when patients knew more about COVID-19 and the virus was less virulent. We focused on the effect of dysfunctional beliefs and attitudes about sleep on depression, anxiety, and insomnia.

Methods

A total of 1,014 patients from two large Fangcang shelter hospitals in Shanghai between 22 April and 8 May 2022 completed a set of questionnaires comprising: the Dysfunctional Beliefs and Attitudes about Sleep scale, the Generalized Anxiety Disorder scale, the Patient Health Questionnaire, and the Insomnia Severity Index scale.

Results

Results show that the positive screening rates for anxiety, depression, and insomnia among tested patients were 55.3, 27.0, and 47.8%, respectively. Patients were more likely to report higher anxiety, depression, and insomnia, and to endorse affective and sleep disorders if they were: female, aged 18-40 years, with undergraduate course or above, white-collar employees, or those who thought the pandemic would have severe economic effects. About 51.4% of the participants had dysfunctional beliefs about sleep to varying degrees. Compared with patients who had accurate beliefs about sleep, the ratios of insomnia, anxiety, and depression were significantly higher among patients with dysfunctional beliefs about sleep.

Discussion

Attention should be paid to the mental health problems of patients in Fangcang shelter hospitals. The results indicate that dysfunctional beliefs about sleep significantly increased anxiety, depression, and insomnia of Fangcang patients.

Prevalence and Predictors of Anxiety among Stable Hospitalized COVID-19 Patients in Malaysia

The COVID-19 pandemic has created anxiety among hospitalized SARS-CoV-2 patients. Therefore, this study aimed to determine the prevalence of anxiety and its associated factors among stable inpatient COVID-19 patients in Malaysia. Method: A cross-sectional study was conducted using a web-based online survey involving 401 patients from Malaysia’s leading COVID-19 hospitals from 15th April until 30th June 2020, who were chosen using quota sampling. The General Anxiety Disorders 7 items (GAD-7) scale, the Coping Orientation to Problems Experienced Inventory (Brief-COPE) and a socio-demographic profile questionnaire were used. Descriptive analysis and multiple logistic regression were performed using SPSS v23 to determine the prevalence of anxiety and its associated factors. Result: The results showed that the prevalence of anxiety was 7.0%. Multiple logistic regression analysis revealed that female gender (p < 0.05), a fear of infection (p < 0.05), a lack of information (p < 0.05), a maladaptive coping mechanism of behavioral disengagement (p < 0.001) and self-blame (p < 0.001) were significantly associated with anxiety. Meanwhile, adaptive coping mechanisms via instrumental support (p < 0.001) were a significant protective predictor of anxiety. Conclusions: COVID-19 infection has had a significant influence on the mental health of patients. Findings in our study provide baseline data on the prevalence of anxiety among stabilized COVID-19 inpatients in Malaysia. Despite the relatively low prevalence, the data have the potential to improve the present mental health monitoring system and the deployment of suitable treatments in dealing with similar circumstances.

Eyelid Myokymia—a Presumed Manifestation of Coronavirus Disease 2019 (COVID-19)

The purpose of this study is to report eyelid myokymia in patients recently recovered from COVID-19 disease. A cohort of 15 patients who developed eyelid myokymia during or immediate post-recovery of systemic disease were evaluated. Demographic, clinical characteristics, effect of age, and hospitalization on the disease course were studied. The disease course was evaluated every month for 3 months period. All, except 2, patients had complete resolution of lid myokymia within 3 months of onset. Median [IQR] myokymia recovery time was 42 [31,60] days. Age and duration of hospitalization had a significant linear relationship with myokymia recovery time. Recovery was delayed by 2.64 days with every 1-year increment in age and by 6.19 days with every additional day of hospital stay. Recovery time was independent of severity of systemic disease (P = .055) and gender (P = 0.2). Eyelid myokymia can be a possible manifestation of COVID-19 recovery phase. While myokymia recovers gradually in all these patients, older age and a longer duration of hospitalization are associated with slower recovery.

Acute and long‑term psychiatric symptoms associated with COVID‑19 (Review)

Coronavirus disease 2019 (COVID-19) started spreading at the end of 2019 and despite the immediate actions of various governments with strict control, more and more individuals became infected daily. Due to the uncertainty and insecurity that still exists around this pandemic, there is an acute need for information and knowledge of what severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection entails. Respiratory and other physical symptoms received most of the medical attention, however, infected patients were also at risk for developing psychiatric and mental health disorders, such as depression, anxiety, and sleep disturbances. Available research reports a so-called 'post-COVID-19 syndrome', which refers to new and/or persistent signs and symptoms for over 12 weeks, following SARS. The aim of the present review was to provide a general overview of the psychiatric symptoms developed during SARS-CoV-2 infection and their long-term outcome, highlighting that, through follow-up with surviving patients it was revealed that some of the psychiatric symptoms of COVID-19 persisted for a long time after discharge and were also associated with negative effects on global functioning and lower quality of life.

The impact of COVID-19 pandemic on depression and anxiety symptoms: Findings from the United Arab Emirates Healthy Future (UAEHFS) cohort study

BACKGROUND

Significant concerns about mental health were raised during the COVID-19 pandemic. We investigated the prevalence of depression and anxiety symptoms among the participants of the United Arab Emirates Healthy Future Study (UAEHFS); a national cohort study. We further explored the change in the prevalence of depression symptoms among those with comparable pre-pandemic data.

METHODS

A sample of UAEHFS participants were invited to complete a COVID-19 online questionnaire during the first wave of the pandemic. Depression and anxiety symptoms were assessed using the Patient Health Questionnaire Depression Scale (PHQ-8) and the Generalized Anxiety Disorder-7 Scale (GAD-7) respectively. Unpaired analyses were done to examine the effect of COVID-19 on depression and anxiety symptoms during the pandemic. Paired analysis was conducted to examine the change in depression symptoms.

RESULTS

During the pandemic, we reported a prevalence of 32.8% (95% CI: 27.0, 39.1) for depression and 26.4% (95% CI: 21.0, 32.6) for anxiety symptoms. Younger people reported higher levels of depression (40.4%) and anxiety (34.5%) symptoms. Females reported higher levels of depression (36.5%) and anxiety (32.7%) symptoms. In paired analysis, the prevalence of depression symptoms during the pandemic was 34% (95% CI: 26.5, 42.4) compared to 29.9% (95% CI: 22.7, 38.1) before the pandemic. No statistically significant difference was observed, p-value = 0.440. Adjusted multivariate logistic regression models for PHQ-8 and GAD-7 during the pandemic showed that participants, who were experiencing flu-like symptoms, had higher odds of reporting depression symptoms compared to those without symptoms. Additionally, age was significantly negatively associated with anxiety symptoms.

CONCLUSIONS

Overall, we found that depression and anxiety symptoms were more prevalent among young people and females. However, we did not find a significant change in the prevalence of depression symptoms among those with comparable pre-pandemic data. Identifying vulnerable groups and understanding trajectories through longitudinal studies would help with planning for effective mental health interventions for the current and future pandemics.

Establishment of hospital resilience framework in urban China: insight from Wuhan City

Since the Corona Virus Disease 2019 (COVID-19) swept the world, many countries face a problem that is a shortage of medical resources. The role of emergency medical facilities in response to the epidemic is beginning to arouse public attention, and the construction of the urban resilient emergency response framework has become the critical way to resist the epidemic. Today, China has controlled the domestically transmitted COVID-19 cases through multiple emergency medical facilities and inclusive patient admission criteria. Most of the existing literature focuses on case studies or characterizations of individual facilities. This paper constructs an evaluation system to measure urban hospital resilience from the spatial perspective and deciphered the layout patterns and regularities of emergency medical facilities in Wuhan, the city most affected by the epidemic in China. Findings indicate that the pattern of one center and two circles are a more compelling layout structure for urban emergency medical facilities in terms of accessibility and service coverage for residents. Meanwhile, the Fangcang shelter hospital has an extraordinary performance in terms of emergency response time, and it is a sustainable facility utilization approach in the post-epidemic era. This study bolsters areas of the research on the urban resilient emergency response framework. Moreover, the paper summarizes new medical facilities’ planning and location characteristics and hopes to provide policy-makers and urban planners with valuable empirical evidence.

Experiences of COVID-19 patients in a Fangcang shelter hospital in China during the first wave of the COVID-19 pandemic: a qualitative descriptive study

OBJECTIVES

This study aimed to examine COVID-19 patients' experiences in a Fangcang shelter hospital in China, to provide insights into the effectiveness of this centralised isolation strategy as a novel solution to patient management during emerging infectious disease outbreaks.

DESIGN

This study adopted a qualitative descriptive design. Data were collected by individual semistructured interviews and analysed using thematic analysis.

SETTING

This study was undertaken in 1 of the 16 Fangcang shelter hospitals in Wuhan, China between 28 February 2020 and 7 March 2020. Fangcang shelter hospitals were temporary healthcare facilities intended for large-scale centralised isolation, treatment and disease monitoring of mild-to-moderate COVID-19 cases. These hospitals were an essential component of China's response to the first wave of the COVID-19 pandemic.

PARTICIPANTS

A total of 27 COVID-19 patients were recruited by purposive sampling. Eligible participants were (1) COVID-19 patients; (2) above 18 years of age and (3) able to communicate effectively. Exclusion criteria were (1) being clinically or emotionally unstable and (2) experiencing communication difficulties.

RESULTS

Three themes and nine subthemes were identified. First, COVID-19 patients experienced a range of psychological reactions during hospitalisation, including fear, uncertainty, helplessness and concerns. Second, there were positive and negative experiences associated with communal living. While COVID-19 patients' evaluation of essential services in the hospital was overall positive, privacy and hygiene issues were highlighted as stressors during their hospital stay. Third, positive peer support and a trusting patient-healthcare professional relationship served as a birthplace for resilience, trust and gratitude in COVID-19 patients.

CONCLUSIONS

Our findings suggest that, while sacrificing privacy, centralised isolation has the potential to mitigate negative psychological impacts of social isolation in COVID-19 patients by promoting meaningful peer connections, companionship and support within the shared living space. To our knowledge, this is the first study bringing patients' perspectives into healthcare service appraisal in emergency shelter hospitals.

Experiences of COVID-19 survivors: A qualitative study based on Watson's Theory of Human Caring

This study aims to investigate the experiences of survivors of COVID‐19 in Turkey. The research questions and results are structured according to Watson’s Theory of Human Caring. The study was conducted using a descriptive qualitative research design. The phenomenological method was used to explore the experiences of survivors of COVID‐19. A total of 34 survivors of COVID‐19 were included in the study. Data were collected using semi‐structured and open‐ended questions online and via telephone interviews between February and March 2020. Data were evaluated using thematic analysis and descriptive analysis. Six main themes and twenty‐five sub‐themes were defined that describe the experiences of survivors of COVID‐19 regarding the illness: (a) Denial and adaptation, (b) Fear, (c) Feeling of hopelessness, (d) Preventions (e) Meaning attribution, and (f) Metaphors about COVID‐19. Information from this research may be used by healthcare professionals to develop new strategies for the care of survivors of COVID‐19. Moreover, it can be said that Watson’s Theory of Human Caring is suitable for monitoring the psychosocial development of patients with COVID‐19.

The Impact of Gender and Age Differences and Infectious Disease Symptoms on Psychological Distress in Quarantined Asymptomatic or Mildly Ill COVID-19 Patients in Japan

Quarantine imposed due to COVID-19 infection can exacerbate psychological distress, and it is important for a public mental health agency to identify factors that are predictive of high psychological distress in such situation. The aim of this study was to investigate whether gender, age, and the presence or absence of infectious disease symptoms affected psychological distress among asymptomatic or mildly ill COVID-19 patients who were quarantined. Participants were 436 asymptomatic or mildly symptomatic COVID-19-infected patients who were quarantined in a treatment facility between 1 May 2020 and 30 September 2021. We used Quantification Theory I analysis to investigate the effects of gender, age, and the nature of infectious disease symptoms on psychological distress. The results of the analysis showed that the contribution rate was 0.06. Among gender, age, presence of symptoms, and the nature of symptoms, age had the greatest effect on psychological distress, and being in one’s teens to thirties was considered to exacerbate psychological distress the most. According to the results, the psychological distress of asymptomatic and mildly symptomatic COVID-19 patients isolated was affected by gender, age, and symptomology, especially due to age differences. However, the impact of these items on psychological distress was not considered significant.

Characterization of serotonin as a candidate biomarker of severity and prognosis of COVID-19 using LC/MS analysis

The coronavirus disease 2019 (COVID-19) pandemic has been associated with high mortality worldwide. Owing to its complicated pathophysiology, diagnostic and prognostic biomarkers for effective patient management remain scarce. We analyzed kynurenine, tryptophan, and serotonin levels in the serum of patients with COVID-19 via liquid chromatography/mass spectrometry analysis. Serum serotonin levels were decreased in patients with more severe COVID-19, along with increased kynurenine and decreased tryptophan concentrations. Patients with moderate disease who subsequently worsened showed significantly lower serotonin concentrations compared with those who did not experience severe disease. Serum serotonin levels may represent a valuable biomarker for COVID-19 severity and prognosis.

A Study on the Effect of the Pre-Go-Live Training in Anxiety and Depression of Medical Staff Based on the Data of Wuhan Fangcang Shelter Hospital During COVID-19 in the Era of Big Data

Coronavirus disease 2019 (COVID-19) broke out in 2019. In the past 4 years, China has adopted many measures to control the epidemic, including building Fangcang shelter hospitals to isolate confirmed positive cases. Therefore, we aim to explore the mental health status of medical staff in the Wuhan Fangcang shelter hospital and discuss the relevant factors that affect the medical staff's mental status. The subjects of the research were staff from several Fangcang shelter hospitals in Wuhan during the epidemic of COVID-19. Patient Health Questionnaire−9 items Scale (PHQ-9) was used to assess the severity of the participants' depressive symptoms, and Generalized Anxiety Disorder−7 items Scale (GAD-7) was used to evaluate the severity of the participants' anxiety symptoms. The demographic information and health adjustment methods were collected in a self-made questionnaire, and regression analysis on related factors that affect mental health was performed. The three most frequently used methods of psychological adjustment for the staff in the Fangcang shelter hospital are common recreational activities, such as reading, streaming videos, listening to music, and playing games. (93.8%), communicating with colleagues in the Fangcang shelter hospital (92.5%), and communicating with family members and friends (78.3%). Binary logistic regression analysis showed that developing depression symptoms has relation to 2 factors, which are having not participated in medical emergency rescue missions (odds ratio = 2.610; 95% confidence interval 1.398–4.872, P = 0.003) and inadequate training before entering the shelter hospital (odds ratio = 2.804, 95% confidence interval 1.293–6.08, P = 0.009). Compared with adequate pre-job training, insufficient training increases the risk of anxiety symptoms (odds ratio = 2.692; 95% confidence interval 1.3–5.575, P = 0.008). Lack of experience and inadequate training in medical emergency rescue missions exposed the medical staff to a higher risk of developing symptoms of depression and anxiety. Psychological adjustment methods that are helpful to adjust their mental state are most commonly used.

Post-traumatic stress disorder, anxiety, depression and related factors among COVID-19 patients during the fourth wave of the pandemic in Vietnam

Background

This study investigated post-traumatic stress disorder (PTSD), anxiety, depression and their related factors among coronavirus disease 2019 (COVID-19) patients during the fourth wave of the pandemic in Vietnam.

Methods

Vietnamese-fluent confirmed COVID-19 patients for at least 3 d were recruited in this online cross-sectional study to answer a three-part questionnaire including participants’ sociodemographic characteristics, PTSD (Impact of Event Scale-Revised) and anxiety and depression (Hospital Anxiety and Depression Scale). Associated factors were determined using multivariable binary logistic regression models.

Results

Of 1544 responses, the majority were female (53.0%), ages 18–39 y (74.8%) and were isolated and treated at field hospitals (72.2%). Family or friends were the greatest sources of mental support (68.2%), followed by healthcare providers (51.1%). The overall prevalence rates of PTSD, anxiety and depression among COVID-19 patients were 22.9%, 11.2% and 17.4%, respectively. Risk factors included older age, higher education, getting infected from the public, knowing someone who died from COVID-19 and high perception of life threat. Meanwhile, mental assistance from family or friends, a greater number of supporters, living with someone not vulnerable and higher salaries were significantly protective factors.

Conclusions

The psychological responses associated with some sociodemographic details. Family or friends should be the first line of mental interventions for COVID-19 patients.

Depression among COVID-19 survivors in Colombia

The COVID-19 survivors are at high risk of meeting the criteria for depression. However, few studies have explored its prevalence and associated factors. The study aimed to know the frequency and variables associated with depression among COVID-19 survivors in Santa Marta, Colombia. A sample of COVID-19 survivors was included. Depression was quantified with the Patient Health Questionnaire (PHQ-9, α = 0.85). Three hundred and thirty survivors participated in the research. They were aged between 18 and 89 years, 61.5% were women, and 49.7% of participants scored above the cut-off point for depression. Depression was associated with female gender, younger age, COVID moderate or severe, and having presented symptoms for more than three weeks. In conclusion, depression occurs in half of the COVID-19 survivors and is higher in younger, women and who report more severe symptoms. Longitudinal studies can provide further information on the long-term impact on the mental health of COVID-19 survivors.

Neurological involvement associated with COVID-19 disease: a study on psychosocial factors

Background

Objective

Methods

Results

Conclusion

Supplementary Information

Sleep disturbances during the COVID-19 pandemic: A systematic review, meta-analysis, and meta-regression

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.

The global png health workers during the COVID-19 pandemic: A systematic review and meta-analysis

BACKGROUND

This study was designed to conduct a systematic review and meta-analysis of existing literature examining the prevalence of depression among hospital staff and the impact of various factors with a view to organize related programs for reducing the complications of this mental disorder.

METHOD

A total of 24 studies were extracted from a literature search conducted through electronic databases including PubMed, EMBASE, Scopus, and Web of Science from January 2019 to February 2021.

FINDINGS

Following the extraction of data, the total number of hospital staff was reported to be 42,010. Based on the results, depression prevalence among them was 26% (95% Cl, 0.18-0.35). Furthermore correlation coefficients revealed a significant relationship between the rate of depression and variables including type of career, age, and gender (P-value < 0.05). The highest and lowest prevalence of depressive disorder among hospital staff was in Africa 82% (95% Cl, 0.35-0.97) and Asia 19% (95% Cl, 0.11-0.29).

CONCLUSION

Our findings affirmed that female workers who aged between 29 and 35 and worked as administrative and support staff in hospitals were among the population being at higher risk of developing mental health problems during the COVID-19 pandemic.

Practices, awareness, and perception towards home-based COVID-19 management among the general population in Mangalore city in south India

Background: Most patients with COVID-19 experience mild illness, which can be managed in a home environment. This study was done to assess the perception, awareness, and practices regarding home-based management of COVID-19 among the general population in India.

Methods: This cross-sectional study was done in May and June 2021. Data were collected using a Google Form.

Results: Mean age of the 294 participants was 36.6 ± 12.1 years. Of these participants, 45 (15.3%) were diagnosed with COVID-19 anytime in the past. Among them, 37 (82.2%) underwent home-based management for COVID-19. Monitoring body temperature and oxygen saturation were performed just once a day by 15.2% and 5.9% of COVID-19 patients respectively. Self-medication was practiced by 11 (29.7%) patients.

Disposable face masks were worn by 23 (62.2%) patients beyond eight hours of continuous usage. The disposable type of face mask was not discarded despite becoming wet, and cloth masks were worn by eight (21.6%) patients. Disposable gloves were only worn by 14 (37.8%) caregivers of COVID-19 patients. As many as 10 (27%) patients were tested for COVID-19 after completion of home isolation.

Awareness of all mild symptoms and signs of the disease was known to only 19 (6.5%) participants. Normal oxygen saturation in the blood was known to 40 (13.6%) participants. Just six (2%) participants were aware of the correct duration of home isolation in a symptomatic patient with COVID-19. The recommended duration of handwashing with soap and water was known to 102 (34.7%) participants.

As many as 17.4% and 32.7% of participants were not confident in using thermometer and pulse oximeter respectively.

Conclusion: Practices, awareness, and perception regarding certain essential measures in COVID-19 home management were found lacking among several participants. These need to be addressed by suitable training programs among the general population.

Prevalence of depressive and anxiety symptoms among Chinese older adults during the COVID-19 pandemic: A systematic review and meta-analysis

Background: Estimating the prevalence of depressive and anxiety symptoms among older adults with different health conditions can inform mental health services for this population during the corona virus disease-2019 (COVID-19) pandemic. Method: A search of 12 scientific databases identified 17 studies with 11,237 Chinese older adults who were infected by COVID-19, were generally healthy, or had chronic illnesses. Meta-analysis was used to estimate the overall prevalence of depressive and anxiety symptoms in these three groups. Assessment criteria, region, and time phase of the pandemic were tested as sources of heterogeneity. Results: With an average risk of bias score of 6.71 (range = 6-8), the majority of included studies employed appropriate statistical methods, used validated measurement tools, and had adequate response rates; however, they might have deficiencies in sample frame, sampling method, and sample size. Within the COVID-19, general, and chronic illness groups, the prevalence of depressive symptoms was 27%, 26%, and 61%, respectively, and the prevalence of anxiety symptoms was 14%, 23%, and 85%, respectively. Among generally healthy older adults, anxiety was more prevalent during the Phase 2 (March-April 2020) of the pandemic compared with other time phases. Conclusions: The results have implications for addressing the mental health problems of Chinese older adults, especially those with chronic illnesses, during the COVID-19 pandemic.

A Qualitative Study Regarding COVID-19 Inpatient Family Caregivers' Need for Supportive Care

Background:

Family caregivers of COVID-19 inpatients are exposed to multiple sources of distress. These include not only losing friends, colleagues and members of the family, but also the fear of possible losses in sociality, finances and, impoverished communication with sick family members and health care providers.

Objective:

This study describes the psychological experience of COVID-19 inpatient family caregivers to highlight the main sources of distress, issues, concerns and unmet needs.

Methods:

Two focus groups were independently organized with COVID-19 inpatient family caregivers and health care personnel of COVID-19 wards in order to highlight family caregivers’ practical and psychological burden and related needs. A thematic analysis was conducted to analyze the data.

Results:

Family caregivers mentioned they needed more information about the patient’s condition with more attention being paid to their own emotional state. Feelings of impotence, concerns about how to deal with patient’s discharge, significant psychological distress, and anxiety were frequently reported by study participants.

Conclusion:

Study findings suggest the need to strengthen the assistance of COVID-19 patient family caregivers. In the pandemic scenario, family caregivers might represent a crucial resource, which can guarantee rapid discharges, support home health care and thus relieve pressure on hospital systems.

A Predictive Model of Pandemic Disaster Fear Caused by Coronavirus (COVID-19): Implications for Decision-Makers

This paper presents quantitative research results regarding a predictive model of pandemic disaster fear caused by the coronavirus disease (COVİD-19). The aim of this paper was to establish the level and impact of certain demographic and socioeconomic characteristics on pandemic disaster fear caused by the coronavirus (COVID-19). The research was conducted using a questionnaire that was provided and then collected online for 1226 respondents during May 2021. A closed, five-point Likert scale was used to create the structured questionnaire. The first section of the questionnaire included research questions about the participants' socioeconomic and demographic characteristics, while the second section included issue questions about fear caused by COVID-19. The results of multivariate regression analyses showed the most important predictor for fear of COVID-19 to be gender, followed by age and education level. Furthermore, the results of t-tests showed statistically significant differences between men and women in terms of different aspects of pandemic disaster fear caused by the coronavirus disease. Our results have several significant public health implications. Women who were more educated and knowledgeable, married, and older, reported a greater fear of the outbreak at various levels. Decision-makers can use these findings to identify better strategic opportunities for pandemic disaster risk management.

Evaluation of symptoms along with depression, anxiety and stress levels of Sars-CoV-2 positive patients during the second wave in the city of Indore, Central India - a cross sectional study

INTRODUCTION

The consequences of the second wave hitting India have drastically laid a huge impact on the mental state of patients. The second wave had proven to be far more dangerous and hence the psychological evaluation needed to be conducted to know the scenario of patients suffering from SARS-CoV-2.

OBJECTIVE

This study was undertaken to evaluate the symptoms of SARS-CoV-2 patients along with the existing depression, anxiety and stress levels amongst them.

MATERIAL AND METHODS

An observational, cross-sectional questionnaire-based survey was conducted among 351 patients infected with SARS-CoV-2 during the second wave in Indore, Central India. The questionnaire consisted of questions pertaining to socio-demographic characteristics, clinical signs and symptoms. Evaluation of depression, anxiety and stress levels were done by use of 21 item Depression, Anxiety, Stress Scale (DASS-21).

RESULTS

The most common symptom amongst patients was cough (42.2%) followed by fever (40.2%). Sixty-nine (19.6%) patients were asymptomatic. Depression score was found to have significant, positive weak correlation with age (ρ-0.124, p-0.020, p value <.05). No significant difference was observed between the depression, anxiety and stress score of males and females. Based on the scores assigned to the responses, patients who tested positive were belonging to normal category with no diagnosed depression, anxiety or stress.

CONCLUSION

The present study showed fever, cough, headache, weakness, and chest pain as the common sign and symptoms of COVID-19 during the second wave. There was a prevalence of low levels of anxiety, stress and depression amongst patients in Radha Saomi Covid Care Centre, Indore during the second wave.

Quality of Life of People with Cancer in the Era of the COVID-19 Pandemic in India: A Systematic Review

Background:

The recent pandemic of COVID-19 caused havoc on the health system globally and raised a lot of questions and issues. Treatment for cancer is an emergency that cannot be taken back, particularly in an era of global pandemics. Cancer treatment mainly includes chemotherapy, surgery, radiotherapy, and palliative care, and because of the pandemic, all of these treatments are affected. The COVID-19 pandemic also had a potential effect on the quality of life and mental health of patients as well as health workers.

Objective:

This systematic review was intended to discuss the quality of life of people with cancer in the era of the COVID-19 pandemic in India in the light of the best available facts.

Methods:

An extensive literature search was done on PubMed, Medline, Embase, Clinical Key and Google Scholar databases till 3rd Feb 2021. Out of 1455 research articles, 06 research articles were included in this systematic review.

Results:

The results showed that cancer treatment delivery was as per standard safety protocol and the best treatment decisions were made by scheduling and setting priority. Till data, no direct research was conducted on the Indian continent to assess the quality of life of cancer patients in the COVID-19 era. The effect on the quality of life of cancer patients is very large and needs to be explored more by further research. Issues to be discussed with health care administrators and policy makers further. The tele-oncology method of cancer care delivery to patients is another rational option which is applicable as well.

Conclusion:

This systematic review demonstrated up-to-date evidence regarding the quality of life of cancer patients in the COVID-19 era in India. No research has been done to assess the quality of life of cancer patients. Still, the area is unrevealed, but evidence from other global studies indicates an altered quality of life for cancer patients. To maintain quality of life, cancer physicians should make evidence-based decisions and incorporate multidisciplinary management into decision making.

Prevalence and factors associated with anxiety and depression amongst hospitalised COVID-19 patients in Laquintinie Hospital Douala, Cameroon

Studies assessing the mental health of patients with COVID-19 infection remain limited. Disasters and major emergencies, not just COVID-19, undoubtedly lead to greater incidence of mental health problems. Previous studies indicate that the novel Coronavirus disease can cause panic and stress in patients. Our literature search didn't reveal any previous published data from Cameroon and the Central African sub-region. In order to bridge this gap, we assessed the prevalence and factors associated with depression and anxiety in COVID-19 patients. We carried out a cross-sectional study in a secondary hospital in the Littoral Region of Cameroon. We recruited hospitalised COVID-19 patients during a 4-month period. We collected data on sociodemographic characteristics. The HADS score was used to assess levels of anxiety and depression. All analysis were done using Stata 14. A P value of <0.05 was used as the cut-off for statistical significance. A total number of 285 patients took part in this study with a mean age of 48.47 years. The prevalence of anxiety in COVID-19 patients was 60.35% while the prevalence of depression was 81.40%. At multivariate logistic regression male gender (OR: 1.89, P = 0.04), hypoxaemia (OR: 2.20, P = 0.01), presence of COVID-19 complications (OR: 1.61, P = 0.02) and current episode of depression (OR: 4.14, P<0.01) were independently associated with anxiety. Similarly, age > 35 years (OR:2.03, P = 0.02), presence of comorbidity (OR: 1.68, P = 0.01), BMI > = 30kg/m2 (OR: 1.78, P = 0.02), presence of COVID-19 complications (OR: 1.28, P = 0.01) and anxiety (OR: 4.60, P<0.001) were independently associated with depression. Hospitalised patients with COVID-19 experienced high levels of anxiety and depression. Treatment of hospitalised patients with COVID-19 should therefore include psychotherapy and psychiatric support.

Prevalence of depression and anxiety among male patients with COVID-19 in Lebsayyer Field Hospital, Qatar

BACKGROUND

Depression and anxiety are major health problems found to be associated with various conditions. COVID-19 is a global pandemic that has a substantial effect on the worldwide population. This study aimed to assess the prevalence of depression and anxiety among male patients with COVID-19 and explore their relationship with participants' characteristics.

METHODS

This cross-sectional study was conducted among expatriate male patients with COVID-19 admitted to Lebsayyer Field Hospital in Qatar with mild COVID-19 (according to World Health Organization classification) from July till August 2020. The sample size was calculated using Cochran's formula based on disease prevalence. All eligible patients were invited to participate until reaching 400 participants, who then completed an anonymous survey of sociodemographic questions, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7 questionnaire, which are validated screening tools for depression and anxiety, respectively.

RESULTS

Of the 400 participants, 148 (37.0%) and 77 (19.3%) reported depressive and anxiety symptoms, respectively. Depression was more prevalent among those 40-49 years old (p = 0.029), while anxiety was more prevalent among people aged  ≥ 50 (p = 0.456). Both depression (p = 0.009) and anxiety (p = 0.042) were more prevalent among Bangladeshi, followed by Filipino participants. Depression was more prevalent among those with the highest income (> 15,000 QR; p = 0.004), in contrast to anxiety, which was more prevalent among those with the lowest monthly income ( <  2,000 QR; p = 0.039).

CONCLUSION

The prevalence of depressive and anxiety symptoms is high among the study participants. Associated factors identified by the study were unsteady income, poor self-rated health, living with family, Southeast Asian ethnicity, and age group of 40-49 years.

Sleep Dysfunction in COVID-19 Patients: Prevalence, Risk Factors, Mechanisms, and Management

During the COVID-19 pandemic, the need to establish the prevalence of sleep dysfunction and psychological distress, identify predisposing and protective factors, and explore effective management strategies remains an important priority. Evidence to date suggests that a considerable proportion of COVID-19 patients experience significant sleep disturbances (estimated to afflict up to 50-75%) as well as psychological distress such as depression, anxiety, and traumatic stress. Duration of hospitalization, pre-existing mental health concerns, lower absolute lymphocyte count, and increased neutrophil-to-lymphocyte ratio have been all associated with a greater risk of sleep dysfunction in infected and hospitalized patients. Furthermore, in this review, we discuss the link between sleep deprivation, susceptibility to viral infections, and psychosocial wellbeing in relevance to COVID-19 and summarize the existing evidence regarding the presence and role of sleep apnea in infected individuals. Finally, we highlight the importance of suitable interventions in order to prevent and manage sleep dysfunction and avoid long-term physical and psychological implications. Future research should aim to provide high-quality information including in high risk, underserved, or difficult to reach populations and on the long-term consequences and effectiveness of applied interventions.

Prevalence and risk factors of anxiety, depression and sleeping disturbances in china during the COVID-19 outbreak: a web-based cross-sectional study

The rapid development of the coronavirus disease 2019 (COVID-19) outbreak has brought great harm to physical and mental health of the public. This study aims to investigate the psychological status and sleep quality of the Chinese public during the outbreak of the COVID-19 and its related factors. The survey was conducted from February 17^th to February 26^th, 2020 in southwestern China. The snowball sampling method was used to invite subjects. Demographic data were collected, and mental status and sleep quality were assessed by the Generalized Anxiety Disorder-7 Scale (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the Pittsburgh Sleep Quality Index (PSQI). Descriptive, univariate, and correlation analyses were used to investigate risk factors for psychological status and sleep patterns. A total of 1509 adults (713 males and 796 females) were enrolled in this study. The overall prevalence of anxiety, depression, and decreased sleep quality were 22.3%, 32.2% and 35.4%, respectively. Compared with females, male population has witnessed a higher prevalence of anxiety symptoms (25.1% vs 20.4%, P= 0.007) and depressive symptoms (34.6% vs 30.0%, P= 0.027). In addition, age, marital status, living situation, involvement in anti-pandemic work, basic health status and work status were significant risk factors for anxiety or depression (P< 0.05). During the COVID-19 outbreak, psychological problems and sleep disorders were prevalent among the Chinese public. More attention should be paid to males, the elderly, the solitary, the unemployed, front-line workers in pandemic prevention, and patients with chronic diseases.

Mental Health in Hospitalised COVID 19 Patients in Quarantine During Second Wave in a South Indian Private Teaching Hospital

BACKGROUND

Covid 19 lockdown measures were taken all of a sudden during the devastating second wave in India, when there was a considerable loss and suffering in the country. The coronavirus disease 2019 (COVID 19) pandemic has led to unprecedented hazards to mental well-being globally.

PURPOSE

To assess the prevalence and evaluate risk factors of depression, insomnia or sleep disturbances and suicidal ideation among covid 19 positive patients admitted in covid wards with mild-to-moderate disease.

MATERIALS AND METHODS

A total of 635 hospitalised patients who were covid-19 positive were requested to fill an online quality of life pre-validated questionnaire comprising of 4 sections - the sociodemographic information section, health care assessment related to depression symptoms, insomnia assessment and assessment of suicidal ideation. The survey comprised of pre-validated questions on sociodemographics, knowledge of covid 19, fear of covid 19, insomnia, feeling of sadness, depression, feeling of rejection and suicidal ideation among the covid 19 positive inpatients in quarantine due to mild or moderate covid 19 disease.

RESULTS

The prevalence of depression and insomnia or sleep disturbances after being diagnosed as covid 19 positive and hospitalized was nearly 40% and 28.8%, respectively, among the inpatients. Depression was significantly observed in female group (p < 0.001), unmarried or separated individuals (p < 0.001), housewives (p < 0.001) and patients with comorbidities (p < 0.001). Insomnia was more likely to be present in elderly covid positive patients (p < 0.001) and separated or divorced group of participants (p < 0.001). The prevalence of suicidal ideation was 5% of the total covid 19 positive patients participated in this study, and it was significantly observed among separated or divorced patients, cancer patients, patients from suburban residence and among graduates (p < 0.001).

CONCLUSION

Covid 19 is associated with major psychological impact among the patients suffering from thus warrants counselling.

A living systematic review of the psychological problems in people suffering from COVID-19

OBJECTIVES

We aimed to investigate the psychological problems on people infected with SARS-CoV-2 during the pandemic.

METHODS

In this living systematic review and meta-analyses, we searched seven electronic databases for cross-sectional studies and longitudinal studies on psychological problems on COVID-19 patients from Jan 1, 2020 to Oct 7, 2020. The primary outcome was prevalence of various psychological problems such as anxiety, depression, stress, insomnia, somatization, and fear. We pooled data for prevalence with their 95% confidence interval (CI) using random effect models and assessed the study quality based on the 11-item checklist recommended by the Agency for Healthcare Research and Quality.

RESULTS

Fourty-four studies, including studies from China(35), Italy(2), Iran(2), India(1), Korea(1), Ecuador(1), Switzerland(1), Germany(1), were identified by comprising a total of 8587 completed questionnaires and 38 studies for meta-analyses. The prevalence of anxiety, depression, post-traumatic stress disorder(PTSD), insomnia, somatization, and fear in patients with COVID-19 was 16.6% (10.1%-23.1%), 37.7% (29.3%-46.2%), 41.5% (9.3%-73.7%), 68.3% (48.6%-88.0%), 36.5% (20.2%-52.8%), 47.6% (9.4%-85.7%), respectively. The prevalence of anxiety, depression, and insomnia in severe COVID-19 patients (intensive care unit inpatients) was higher than mild or clinically stable COVID-19 patients.

LIMITATIONS

A significant degree of heterogeneity in terms of populations, sampling methods, scales was noted across studies.

CONCLUSIONS

There existed high proportions of COVID-19 patients with psychological problem. The prevalence of psychological problems was closely related to the patients themselves, their surroundings and social support. It is imperative to provide ontime psychological care service for COVID-19 patients and to follow-up them for a longer period.

Prevalence of depression, anxiety, and insomnia symptoms among patients with COVID-19: A meta-analysis of quality effects model

BACKGROUND

Evidence from previous virus epidemics has shown that infected patients are at risk for developing psychiatric and mental health disorders, such as depression, anxiety, and insomnia. Hence, to collect high-quality data on the impact of COVID-19 pandemic on the prevalence of depression, anxiety, and insomnia symptoms among patients infected with SARS-CoV-2 should be the immediate priority.

METHODS

A comprehensive search of Medline, Embase, Web of Science, and PsycINFO databases was conducted from January 1, 2020 to December 26, 2020 for eligible studies reporting on the prevalence of depression, anxiety, and insomnia symptoms in patients with COVID-19. Studies meeting the following criteria were included in the analysis: (1) included patients with COVD-19; (2) recorded the prevalence of depression, anxiety, or insomnia symptom; (3) sample size ≥30; (4) with validated screening tools; and (5) passed through the international peer-review process. Data extraction and quality assessment was independently performed by two reviewers. The quality effects meta-analysis was conducted further to calculate the pooled prevalence.

RESULTS

Twenty-two studies were included for analysis with a total of 4318 patients. The pooled prevalence of depression, anxiety and insomnia symptoms was 38% (95% CI = 25-51), 38% (95% CI = 24-52), and 48% (95% CI = 11-85), respectively. Neither subgroup analysis nor sensitivity analysis can explain the source of high heterogeneity. In addition, the prevalence estimates of depression, anxiety and insomnia symptoms varied based on different screening tools.

CONCLUSIONS

The present systematic review and meta-analysis suggest that depression, anxiety, and insomnia symptoms are prevalent in a considerable proportion of patients with COVID-19. Thus, early detection and properly intervention for mental illness in this population are of great significance. Additionally, the quality of included studies to date has been variable, and ongoing surveillance is essential.

Assessment of depression, anxiety and stress in COVID-19 infected individuals and their families

Background

Pandemics have been associated with widespread psychological distress in the normal population due to quarantine and lockdown, however there are only few studies on psychiatric symptoms in COVID infected patients and their families. This study was planned to assess the depressive, anxiety and stress symptoms in individuals and their families infected with COVID19, during current pandemic.

Methods

A cross-sectional, observational study was conducted on hospitalised, COVID infected patients and their immediate family members. Ninety-three, COVID patients and fifty-four family members were studied through Google forms which contained socio-demographic proforma and Depression Anxiety Stress Scale-21 (DASS21). Collected data was tabulated to assess depression, anxiety and stress symptoms in the given population and study their relation with various sociodemographic variables.

Results

Almost one-third of the sample showed increased score on depression and anxiety subscales and one-fifth on stress subscales. 30–45% of the family members studied had higher score on either of the subset. There was also a high correlation between the scores of depression, anxiety and stress subset in the study sample.

Conclusion

This study, reflects high magnitude of depression, anxiety and stress symptoms in these patients and their families which alert us to the need for definitive interventions in these affected individuals.

Anxiety and depressive symptoms among COVID-19 patients admitted to three isolation facilities in Bangladesh

The COVID-19 pandemic can impose a profound impact on the mental health of hospitalised patients infected with SARS-CoV-2. However, there have been no studies that explored the psychological distress of the COVID-19 inpatients in Bangladesh. Therefore, this study aimed to assess the prevalence of anxiety and depressive symptoms and explore the associated factors among inpatients with COVID-19. A cross-sectional study was conducted among 138 COVID-19 patients admitted to three isolation facilities in Dhaka, Bangladesh, from September to October 2020. Participants' sociodemographic and clinical data were obtained. Mental health symptoms were evaluated with the Hospital Anxiety and Depression Scale (HADS). Descriptive statistics, bivariate and multivariate logistic regression models were performed to analyse the data. The prevalence of anxiety and depressive symptoms were 57.2% (95% CI: 48.2-65.2) and 52.2% (95% CI: 43.8-62.7), respectively. Presence of comorbidity (aOR: 5.64, 95% CI: 2.21-14.35) and having ≥3 COVID-19 physical symptoms (aOR: 6.90, 95% CI: 2.71-17.56) were associated with anxiety symptoms. Besides, presence of comorbidity (aOR: 2.73, 95% CI: 1.07-6.99), having ≥3 COVID-19 physical symptoms (aOR: 4.46, 95% CI: 1.78-11.20) and patient with ≤93% oxygen saturation (aOR: 2.33, 95% CI: 1.01-5.36) were associated with depressive symptoms. Considerable numbers of COVID-19 patients in Bangladesh experienced psychological distress during hospitalisation, requiring more attention and timely mental health interventions.

Predictors of mental health during the COVID-19 pandemic in older adults: the role of socio-demographic variables and COVID-19 anxiety

The objective of this study was to evaluate factors related to the mental health of Peruvian older adults during the COVID-19 pandemic. The study had a cross-sectional and observational design. A total of 274 older adults in Lima, Peru (M_age = 67.86) filled out a sociodemographic survey, the Coronavirus Anxiety Scale, Mental Health Inventory-5, Patient Health Questionnaire-2 item, and Generalized Anxiety Disorder Scale. A Structural Equation Model (SEM) was estimated to test an a priori model that relates the sociodemographic variables, COVID-19 Anxiety, psychological well-being, anxiety and depression. The model fit indices indicated a good fit to the data. The socio-demographic variables explained 23.8% of the variance of the COVID-19 Anxiety (R² = .238). Socio-demographic variables explained 50.5% of psychological well-being variance, 52% of anxiety and 46.9% of depression. Also, sex, work; being diagnosed with COVID-19; family member with COVID-19 diagnosis; and time of exposure to COVID-19 information had statistically significant effects psychological well-being, anxiety and depression. In conclusion, some sociodemographic characteristics and COVID-19 anxiety affect the psychological well-being, anxiety and depression. The findings may allow for a better understanding of the mental health of older adults during the COVID-19 pandemic and guide government responses to detect, anticipate and minimize its impact on the mental health of this population.

A Qualitative Investigation of the Psychological Experiences of COVID-19 Patients Receiving Inpatient Care in Isolation

Coronavirus disease 2019 (COVID-19) has spread rapidly throughout the world. Still, little is known about the psychological experiences of patients who received inpatient isolation treatment in order to improve the well-being of these patients. We randomly recruited 10 COVID-19 patients who received inpatient isolation treatment at a designated hospital in Wuhan from February to March 2020 and were discharged after recovery. The data were collected via a semi-structured interview over WeChat video and analyzed them using Calaizzi's descriptive phenomenological method. COVID-19 patients experienced significant psychological stress during hospitalization that continued after recovery and discharge. This can be categorized into three themes: (1) negative emotions experienced; (2) uncertainty of treatment provided; and (3) worries about readjusting to daily life. The insight into a patient's psychological experiences can support the timely implementation of personalized nursing interventions within hospitals and the community to improve the patient's mental well-being and recovery trajectory.