The global prevalence of depression, anxiety, and sleep disorder among patients coping with Post COVID-19 syndrome (long COVID): a systematic review and meta-analysis

BACKGROUND

Post COVID-19 syndrome, also known as "Long COVID," is a complex and multifaceted condition that affects individuals who have recovered from SARS-CoV-2 infection. This systematic review and meta-analysis aim to comprehensively assess the global prevalence of depression, anxiety, and sleep disorder in individuals coping with Post COVID-19 syndrome.

METHODS

A rigorous search of electronic databases was conducted to identify original studies until 24 January 2023. The inclusion criteria comprised studies employing previously validated assessment tools for depression, anxiety, and sleep disorders, reporting prevalence rates, and encompassing patients of all age groups and geographical regions for subgroup analysis Random effects model was utilized for the meta-analysis. Meta-regression analysis was done.

RESULTS

The pooled prevalence of depression and anxiety among patients coping with Post COVID-19 syndrome was estimated to be 23% (95% CI: 20%-26%; I2 = 99.9%) based on data from 143 studies with 7,782,124 participants and 132 studies with 9,320,687 participants, respectively. The pooled prevalence of sleep disorder among these patients, derived from 27 studies with 15,362 participants, was estimated to be 45% (95% CI: 37%-53%; I2 = 98.7%). Subgroup analyses based on geographical regions and assessment scales revealed significant variations in prevalence rates. Meta-regression analysis showed significant correlations between the prevalence and total sample size of studies, the age of participants, and the percentage of male participants. Publication bias was assessed using Doi plot visualization and the Peters test, revealing a potential source of publication bias for depression (p = 0.0085) and sleep disorder (p = 0.02). However, no evidence of publication bias was found for anxiety (p = 0.11).

CONCLUSION

This systematic review and meta-analysis demonstrate a considerable burden of mental health issues, including depression, anxiety, and sleep disorders, among individuals recovering from COVID-19. The findings emphasize the need for comprehensive mental health support and tailored interventions for patients experiencing persistent symptoms after COVID-19 recovery.

Effect of Online Balint Group and Pharmacotherapy on COVID-19 Anxiety in Iranian Healthcare Workers: A Randomized Controlled Trial

Background: Anxiety persists following coronavirus disease 2019 (COVID-19) and has caused dysfunction. Objectives: We compared the effect of the online Balint group and pharmacotherapy on COVID-19-induced anxiety in Iranian healthcare workers (HCWs). Methods: In the current clinical trial in the north of Iran in 2021, the participants were randomly assigned to two groups, including the Balint group (eight 60-minute online sessions) and the pharmacotherapy group (sertraline), following a phone screening procedure by a psychiatrist. The groups filled out two questionnaires, namely the Connor-Davidson Resilience Scale and Corona Disease Anxiety Scale, at baseline and after the intervention (fourth week). Results: Forty-five HCWs were assessed. There was a significant difference in total anxiety score and also in sub-component in each group (P ≤ 0.001). No significant differences were observed regarding the effectiveness of both interventions in anxiety (P = 0.52); however, the pharmacotherapy interventions significantly affected the resilience and related subscales (P ≤ 0.05). The domain of spiritual influences significantly increased in the pharmacotherapy group (P = 0.031). Conclusions: Balint group and pharmacotherapy can improve COVID-19-induced anxiety and boost resilience in HCWs.

Psychological consequences and the related factors among COVID‐19 survivors in southeastern Iran

Introduction

Coronavirus disease‐2019 (COVID‐19) is a new viral disease that has spread rapidly worldwide since December 2019 and there is no effective treatment for it. The current study aimed to investigate the psychological consequences and related factors among COVID‐19 survivors.

Methods

This descriptive analytical study was conducted on 152 patients with COVID‐19 referred to referral hospitals in southeastern Iran in 2020. Data collection tools were three questionnaires of demographic and background information, Depression Anxiety stress Scale (DASS‐21) and Impact of Events Scale‐Revised (IESR). Descriptive and inferential statistics and SPSS25 were used to analyze the data.

Results

The mean age of patients was 39.52 ± 13.16 years. The patients were mostly female (63.8%). Seventy‐three percent of the patients had severe posttraumatic stress disorder, 26.3% had moderate depression and 26.3% had severe anxiety. The mean scores of posttraumatic stress, depression, and anxiety among patients with COVID‐19 were 41.59 ± 17.28, 12.13 ± 9.16, and 12.45 ± 10.71, respectively. Intensive care unit (ICU) admission, divorce, illiteracy, and retirement were all associated with higher psychological load among patients.

Discussion and Conclusion

The results showed that patients with COVID‐19 had different levels of anxiety, depression, and posttraumatic stress. These results may direct the attention of the medical staff to the mental health of COVID‐19 patients, necessitating timely psychological care and intervention during an epidemic.

Grief Experience After Deaths: Comparison of Covid-19 and non-Covid-19 Causes

The grief caused by loved ones’ death causes grief is a global phenomenon. The Covid-19 pandemic caused significant changes in human lifestyles and the experience of grief. The purpose of the present study was to compare grief experiences in the deceased's relatives caused by Covid-19 and non-Covid-19. Seventy-five first- and second-degree relatives of the deceased infected with Covid-19 (n = 33) and non-Covid-19 (n = 42) in a Gorgan hospital in northern Iran were included cross-sectional study using convenience sampling. Data were collected using the GEQ-34 grief experience questionnaire and demographic variables and questions related to funeral and burial. The results revealed that the deceased's burial quality caused by the Covid-19 group was significantly lower (p = 0.035). However, the feeling of the Covid-19 label is significantly higher (p <0.001). There was no significant variation in grief's broad experience between the two groups (P > 0.05). Nevertheless, the experience of grief was significantly different in the group of relatives of the deceased infected by Covid-19 in terms of notoriety (P = 0.040) and physical reactions (p = 0.002). Educational interventions to reduce stigma and discrimination due to death caused by Covid-19 and clinical and psychological support of relatives of the deceased due to Covid-19 are recommended by compiling appropriate messages from different channels.

Evaluation of the COVID-19 pandemic effect on the development of somatic symptoms in patients with mood disorders: a case-control study

Somatic symptoms are one of the most common complaints among patients with psychiatric disorders and are considered as one of the most common psychiatric disorders in the new coronavirus pandemic. This study aimed to evaluate the effect of the COVID-19 pandemic on the physical symptoms in patients with mood disorders and compare it with healthy individuals. In this case-control study, 67 patients with mood disorders were referred to the psychiatric clinic of 5 Azar Hospital in Gorgan, who met the inclusion criteria, and 68 healthy individuals as control group were entered into the study. For all participants after informed consent, a demographic information questionnaire was completed along with Screening for Somatic Symptoms-7 (SOMS7) and Patient Health Questionnaire-15 (PHQ-15), and the data were analysed by SPSS software version 25. The mean score obtained for the SOMS-7 questionnaire for the group of patients with mood disorders and the control group was 32.37 ± 8.19 and 35.42 ± 11.3, respectively. The mean obtained for the PHQ-15 questionnaire for the mood disorders group and the control group was 8.56 ± 5.93 and 5.86 ± 4.63, respectively. In the mood disorder group, 26.9% of patients had no risk for physical symptoms, 31.3% of patients had a low risk, 25.4% of patients had a moderate risk, and 16.4% of patients had a high risk for physical symptoms. The statistical test showed that although the risk of physical symptoms was high in both groups, this rate was higher in the group with mood disorders, and there is a significant difference between the two groups (P < 0.05). The results also showed a significant and direct relationship between the two questionnaires (P < 0.05). According to the results, although the prevalence of somatic symptoms increased in both groups, the prevalence of somatic symptoms is significantly higher in the mood disorder group.