[COVID-19 effect on mental health and sleep disorders]

A cross-sectional and longitudinal study of how two intervention methods affect the anxiety, sleep quality, and physical activity of junior high school students under quarantine

Purpose

This study investigated levels of anxiety and sleep quality and their association with physical activity in junior high school students under quarantine during the COVID-19 pandemic. It also tests the effectiveness of physical activity and psychological nursing interventions in alleviating anxiety 'and improving sleep quality.

Methods

In July 2021, 14,000 home-quarantined junior high school students in Yangzhou City (China) were selected by random cluster sampling to complete an online survey. We then selected 95 junior high school students for an 8-week longitudinal experiment exploring whether the two types of intervention made positive contributions to students' anxiety, sleep quality, and physical activity.

Results

The cross-sectional study revealed that physical activity was significantly related to anxiety and sleep quality. In the longitudinal study, students who underwent the exercise intervention or the psychological nursing intervention experienced significant improvement in their anxiety levels. The exercise intervention also promoted improved sleep quality. Overall, the exercise intervention was more effective than the psychological nursing intervention in reducing levels of anxiety and sleep disorders.

Conclusion

During the epidemic period, junior high school students should be encouraged to spend more time engaging in physical activity, and their sleep quality and anxiety shouldbe focused on.

[Mental disorders associated with acute COVID-19: clinical picture, therapy approaches]

BACKGROUND

The purpose is to study the structure of clinical manifestations of mental disorders in the acute period of COVID-19 among patients, who were hospitalized with a new coronavirus infection and their relations with the severity of the immune response, to assess the efficacy and safety profile of the spectrum of used psychopharmacotherapy.

MATERIAL AND METHODS

A study was conducted of patients, hospitalized to the department of infectious diseases and repurposed for COVID-19 clinical departments with a diagnosis of COVID-19 (compliance with the criteria for ICD-10: U07.1) from September 2020 to March 2021. Study design: single center opened retrospective cohort study. The main group is consisted of 72 patients, average age - 71 [56.0; 81.0] years, the part of women - 64.0%. The control group (n=2221) was formed from those hospitalized in the same period with a diagnosis of U07.1 without mental disorders during the hospitalization period, average age 62 [51.0; 72.0] years, the part of women - 48.7%. Mental disorders were diagnosed in accordance to ICD-10 criteria, the following peripheral markers of inflammation, that were evaluated: neutrophils, lymphocytes, platelets, ESR, C-reactive protein, interleukin; also coagulogram indicators: APTT, fibrinogen, prothrombin time, D-dimers.

RESULTS

In the following range of mental disorders were identified: a depressive episode (ICD-10 F32) by 31 patients, by 22 - a disorder of adaptive reactions (ICD-10 F43.2), by 5 - delirium not caused by alcohol or other psychoactive substances (ICD-10 F05), by 14 - mild cognitive impairment caused by damage and disfunction of the brain or somatic diseases (ICD-10 F06.7). In comparison with the control group, these patients showed a statistically significant (p<0.001) increasing the level of inflammatory markers (CRP, IL-6) and changes in the coagulogram. and anxiolytic drugs were used most often. Regarding psychopharmacotherapy, drugs from the group of atypical antipsychotics - quetiapine was prescribed in 44% patients in average dose 62.5 mg per day, and Melatonin receptor type 1 and 2 agonist and antagonists of serotonin 5-HT2C receptors: agomelatine was prescribed in 11% patients in average dose 25 mg per gay.

CONCLUSION

The results of the study confirm the heterogeneity of the structure of mental disorders in the acute form of coronavirus infection, revealing the relations between the clinical picture and laboratory parameters of the immune response to systemic inflammation. Recommendations are given for the choice of psychopharmacotherapy, in conformity with the peculiarities of pharmacokinetics and interaction with somatotropic therapy.

Sleep disorders in patients with COVID-19

Sleep disorders often accompany COVID-19 and are a part of post-COVID syndrome. Some of the sleep disorders that occur in patients hospitalized for COVID-19 can be attributed to acute forms of insomnia. This type of sleep disorders is due to special conditions associated with hospitalization, and is short-term. Other sleep disorders appear as a part of anxiety-depressive symptoms diagnosed in patients with COVID-19. These symptoms can be classified as nosogenies psychogenic disorders that are associated with diagnosis of coronavirus infection; somatogenies psychopathological conditions resulting from pathological effects on the central nervous system of somatic and neurological complications of COVID-19; iatrogenies mental disorders that occur due to the intake of medication. Currently, information on the impact of sleep quality on the severity of COVID-19 and the effectiveness of treatment for post-COVID syndrome is accumulating. This review provides up-to-date information on sleep disorders in patients with COVID-19 and the principles of their therapy.