1
|
Gad BK, Arafa MA, Attia AF, Farahat AH, Abdou MS. Depression, anxiety, and stress among COVID-19 patients in South Sinai, Egypt: prevalence and associated predictors. Sci Rep 2023; 13:19193. [PMID: 37932329 PMCID: PMC10628151 DOI: 10.1038/s41598-023-45775-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 10/24/2023] [Indexed: 11/08/2023] Open
Abstract
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.
Collapse
Affiliation(s)
- Basma Khairy Gad
- Ministry of Health and Population, Preventive Medicine Sector, South Sinai, Egypt
| | - Mostafa Ahmed Arafa
- Department of Epidemiology, High Institute of Public Health, Alexandria University, 165 El-Horeya Road, Al Ibrahimeyah Qebli WA Al Hadrah Bahri, Bab Sharqi, Alexandria, Egypt
| | - Ashraf Farouk Attia
- Department of Epidemiology, Military Medical Academy, Heliopolis, Cairo, Egypt
| | | | - Marwa Shawky Abdou
- Department of Epidemiology, High Institute of Public Health, Alexandria University, 165 El-Horeya Road, Al Ibrahimeyah Qebli WA Al Hadrah Bahri, Bab Sharqi, Alexandria, Egypt.
| |
Collapse
|
2
|
Karkala A, Tzinas A, Kotoulas S, Zacharias A, Sourla E, Pataka A. Neuropsychiatric Outcomes and Sleep Dysfunction in COVID-19 Patients: Risk Factors and Mechanisms. Neuroimmunomodulation 2023; 30:237-249. [PMID: 37757765 DOI: 10.1159/000533722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023] Open
Abstract
The ongoing global health crisis due to the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has significantly impacted all aspects of life. While the majority of early research following the coronavirus disease caused by SARS-CoV-2 (COVID-19) has focused on the physiological effects of the virus, a substantial body of subsequent studies has shown that the psychological burden of the infection is also considerable. Patients, even without mental illness history, were at increased susceptibility to developing mental health and sleep disturbances during or after the COVID-19 infection. Viral neurotropism and inflammatory storm damaging the blood-brain barrier have been proposed as possible mechanisms for mental health manifestations, along with stressful psychological factors and indirect consequences such as thrombosis and hypoxia. The virus has been found to infect peripheral olfactory neurons and exploit axonal migration pathways, exhibiting metabolic changes in astrocytes that are detrimental to fueling neurons and building neurotransmitters. Patients with COVID-19 present dysregulated and overactive immune responses, resulting in impaired neuronal function and viability, adversely affecting sleep and emotion regulation. Additionally, several risk factors have been associated with the neuropsychiatric sequelae of the infection, such as female sex, age, preexisting neuropathologies, severity of initial disease and sociological status. This review aimed to provide an overview of mental health symptoms and sleep disturbances developed during COVID-19 and to analyze the underlying mechanisms and risk factors of psychological distress and sleep dysfunction.
Collapse
Affiliation(s)
- Aliki Karkala
- Respiratory Failure Unit, G. Papanikolaou Hospital, Thessaloniki and Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Asterios Tzinas
- Respiratory Failure Unit, G. Papanikolaou Hospital, Thessaloniki and Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Athanasios Zacharias
- Respiratory Failure Unit, G. Papanikolaou Hospital, Thessaloniki and Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evdokia Sourla
- Respiratory Failure Unit, G. Papanikolaou Hospital, Thessaloniki and Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Athanasia Pataka
- Respiratory Failure Unit, G. Papanikolaou Hospital, Thessaloniki and Aristotle University of Thessaloniki, Thessaloniki, Greece
| |
Collapse
|
3
|
Wu C, Yan JR, He CY, Wu J, Zhang YJ, Du J, Lin YW, Zhang YH, Heng CN, Lang HJ. Latent profile analysis of security among patients with COVID-19 infection in mobile cabin hospitals and its relationship with psychological capital. Front Public Health 2022; 10:993831. [PMID: 36466444 PMCID: PMC9709271 DOI: 10.3389/fpubh.2022.993831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 10/28/2022] [Indexed: 11/18/2022] Open
Abstract
Aim COVID-19 patients' security is related to their mental health. However, the classification of this group's sense of security is still unclear. The aim of our research is to clarify the subtypes of security of patients infected with COVID-19, explore the factors affecting profile membership, and examine the relationship between security and psychological capital for the purpose of providing a reference for improving patients' sense of security and mental health. Methods A total of 650 COVID-19 patients in a mobile cabin hospital were selected for a cross-sectional survey from April to May 2022. They completed online self-report questionnaires that included a demographic questionnaire, security scale, and psychological capital scale. Data analysis included latent profile analysis, variance analysis, the Chi-square test, multiple comparisons, multivariate logistical regression, and hierarchical regression analysis. Results Three latent profiles were identified-low security (Class 1), moderate security (Class 2), and high security (Class 3)-accounting for 12.00, 49.51, and 38.49% of the total surveyed patients, respectively. In terms of the score of security and its two dimensions, Class 3 was higher than Class 2, and Class 2 was higher than Class 1 (all P < 0.001). Patients with difficulty falling asleep, sleep quality as usual, and lower tenacity were more likely to be grouped into Class 1 rather than Class 3; Patients from families with a per capita monthly household income <3,000 and lower self-efficacy and hope were more likely to be grouped into Classes 1 and 2 than into Class 3. Psychological capital was an important predictor of security, which could independently explain 18.70% of the variation in the patients' security. Conclusions Security has different classification features among patients with COVID-19 infection in mobile cabin hospitals. The security of over half of the patients surveyed is at the lower or middle level, and psychological capital is an important predictor of the patients' security. Medical staff should actively pay attention to patients with low security and help them to improve their security level and psychological capital.
Collapse
Affiliation(s)
- Chao Wu
- Department of Nursing, Fourth Military Medical University, Shaanxi, China
| | - Jia-ran Yan
- Department of Nursing, Fourth Military Medical University, Shaanxi, China
| | - Chun-yan He
- Department of Nursing, Fourth Military Medical University, Shaanxi, China
| | - Jing Wu
- Department of Nursing, Fourth Military Medical University, Shaanxi, China
| | - Yin-juan Zhang
- Department of Nursing, Fourth Military Medical University, Shaanxi, China
| | - Juan Du
- Department of Nursing, Fourth Military Medical University, Shaanxi, China
| | - Ya-wei Lin
- Department of Nursing, Fourth Military Medical University, Shaanxi, China
| | - Yu-hai Zhang
- Department of Health Statistics, Fourth Military Medical University, Shaanxi, China,*Correspondence: Yu-hai Zhang
| | - Chun-ni Heng
- Department of Endocrinology, Tangdu Hospital, Fourth Military Medical University, Shaanxi, China,Chun-ni Heng
| | - Hong-juan Lang
- Department of Nursing, Fourth Military Medical University, Shaanxi, China,Hong-juan Lang
| |
Collapse
|
4
|
Zürcher SJ, Banzer C, Adamus C, Lehmann AI, Richter D, Kerksieck P. Post-viral mental health sequelae in infected persons associated with COVID-19 and previous epidemics and pandemics: Systematic review and meta-analysis of prevalence estimates. J Infect Public Health 2022; 15:599-608. [PMID: 35490117 PMCID: PMC9020842 DOI: 10.1016/j.jiph.2022.04.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 03/04/2022] [Accepted: 04/13/2022] [Indexed: 12/14/2022] Open
Abstract
AIMS Post-viral mental health problems (MHP) in COVID-19 patients and survivors were anticipated already during early stages of this pandemic. We aimed to synthesize the prevalence of the anxiety, depression, post-traumatic and general distress domain associated with virus epidemics since 2002. METHODS In this systematic review and meta-analysis, we searched PubMed, PsycINFO, and Embase from 2002 to April 14, 2021 for peer-reviewed studies reporting prevalence of MHP in adults with laboratory-confirmed or suspected SARS-CoV-1, H1N1, MERS-CoV, H7N9, Ebolavirus, or SARS-CoV-2 infection. We included studies that assessed post-viral MHP with validated and frequently used scales. A three-level random-effects meta-analysis for dependent effect sizes was conducted to account for multiple outcome reporting. We pooled MHP across all domains and separately by severity (above mild or moderate-to-severe) and by acute (one month), ongoing (one to three months), and post-illness stages (longer than three months). A meta-regression was conducted to test for moderating effects, particularly for exploring estimate differences between SARS-Cov-2 and previous pandemics and epidemics. PROSPERO registration: CRD42020194535. RESULTS We identified 59 studies including between 14 and 1002 participants and providing 187 prevalence estimates. MHP, in general, decreased from acute to post-illness from 46.3% to 38.8% and for mild and moderate-to-severe from 22.3% to 18.8%, respectively. We found no evidence of moderating effects except for non-random sampling and H1N1 showing higher prevalence. There was a non-significant trend towards lower MHP for SARS-CoV-2 compared to previous epidemics. CONCLUSIONS MHP prevalence estimates decreased over time but were still on a substantial level at post-illness. Post-viral mental health problems caused by SARS-CoV-2 could have been expected much earlier, given the previous post-viral sequelae.
Collapse
Affiliation(s)
- Simeon Joel Zürcher
- Center for Psychiatric Rehabilitation, Universitäre Psychiatrische Dienste Bern (UPD), Bern, Switzerland; University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
| | - Céline Banzer
- Center for Psychiatric Rehabilitation, Universitäre Psychiatrische Dienste Bern (UPD), Bern, Switzerland
| | - Christine Adamus
- Center for Psychiatric Rehabilitation, Universitäre Psychiatrische Dienste Bern (UPD), Bern, Switzerland; University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Anja I Lehmann
- Epidemiology, Biostatistics and Prevention Institute, Public and Organizational Health, University of Zurich, Zurich, Switzerland
| | - Dirk Richter
- Center for Psychiatric Rehabilitation, Universitäre Psychiatrische Dienste Bern (UPD), Bern, Switzerland; University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Philipp Kerksieck
- Epidemiology, Biostatistics and Prevention Institute, Public and Organizational Health, University of Zurich, Zurich, Switzerland
| |
Collapse
|
5
|
Li Y, Chen B, Hong Z, Sun Q, Dai Y, Basta M, Tang X, Qin Q. Insomnia symptoms during the early and late stages of the COVID-19 pandemic in China: a systematic review and meta-analysis. Sleep Med 2022; 91:262-272. [PMID: 34732293 PMCID: PMC8479411 DOI: 10.1016/j.sleep.2021.09.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 09/19/2021] [Accepted: 09/19/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Evidence suggests that the outbreak of the coronavirus disease 2019 (COVID-19) and the prevention/control measures for COVID-19 may cause insomnia during the acute phase of COVID-19 pandemic in China. However, it is unclear whether insomnia sustains during the later phases of the pandemic. METHODS We searched PubMed/Medline, EMBASE, PsycINFO and China National Knowledge Infrastructure from the 27th December 2019 to the 2nd February 2021. As early stage studies on COVID-19 pandemic in China were defined as those conducted prior to April 1st, 2020, while late stage studies were those conducted after April 1st, 2020. RESULTS A total of 98 studies with 193,889 participants were included. The pooled prevalence of insomnia symptoms among all populations was 39.1% (95% CI 36.2-42.0%); the pooled prevalence of insomnia symptoms during the early and late stages of COVID-19 in China were 37.0% (95% CI 34.1-39.9%) and 41.8% (95% CI 33.6-50.0%), respectively. Importantly, there was no significant difference regarding the prevalence of insomnia symptoms between the early and late stages of COVID-19. Meta-regression showed that healthcare workers, COVID-19 patients, patients with chronic medical conditions and patients with mental disorders had a higher prevalence of insomnia symptoms compared to the general population. This association remained significant in healthcare workers and patients with chronic medical conditions after adjusting for age, gender, areas of high or low prevalence of COVID-19 cases, anxiety and depression. CONCLUSIONS Over one third of our sample present insomnia symptoms during the early stage of COVID-19 pandemic in China. Interestingly, prevalence of insomnia symptoms sustains high during the late stage of the pandemic despite the control of the disease and the amelioration of its adverse effects. Our findings suggest that insomnia symptoms related to COVID-19 appear to persist of over time.
Collapse
Affiliation(s)
- Yun Li
- Department of Sleep Medicine, Mental Health Center of Shantou University, Shantou, China
- Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Baixin Chen
- Department of Sleep Medicine, Mental Health Center of Shantou University, Shantou, China; Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Zhuoting Hong
- Department of Sleep Medicine, Mental Health Center of Shantou University, Shantou, China; Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Qimeng Sun
- Department of Sleep Medicine, Mental Health Center of Shantou University, Shantou, China; Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Yanyuan Dai
- Department of Sleep Medicine, Mental Health Center of Shantou University, Shantou, China; Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Maria Basta
- Department of Psychiatry, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - Xiangdong Tang
- Sleep Medicine Center, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qingsong Qin
- Laboratory of Human Virology and Oncology, Shantou University Medical College, Shantou, China
| |
Collapse
|
6
|
Dong F, Liu HL, Dai N, Yang M, Liu JP. A living systematic review of the psychological problems in people suffering from COVID-19. J Affect Disord 2021; 292:172-188. [PMID: 34126309 PMCID: PMC8169237 DOI: 10.1016/j.jad.2021.05.060] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 05/26/2021] [Accepted: 05/28/2021] [Indexed: 12/23/2022]
Abstract
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.
Collapse
Affiliation(s)
- Fei Dong
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China; School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Hong-Liang Liu
- Gastroenterology Department, Guang'anmen Hospital, China Academy of Chinese Medicine Sciences, Beijing, China
| | - Ning Dai
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China; School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Ming Yang
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China; School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Jian-Ping Liu
- Center for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China; Institute for Excellence in Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
| |
Collapse
|
7
|
Liu C, Pan W, Li L, Li B, Ren Y, Ma X. Prevalence of depression, anxiety, and insomnia symptoms among patients with COVID-19: A meta-analysis of quality effects model. J Psychosom Res 2021; 147:110516. [PMID: 34023580 PMCID: PMC8129994 DOI: 10.1016/j.jpsychores.2021.110516] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/11/2021] [Accepted: 05/13/2021] [Indexed: 12/09/2022]
Abstract
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.
Collapse
Affiliation(s)
- Chaomeng Liu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Weigang Pan
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Li Li
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Bing Li
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Yanping Ren
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xin Ma
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China..
| |
Collapse
|
8
|
Alimoradi Z, Broström A, Tsang HW, Griffiths MD, Haghayegh S, Ohayon MM, Lin CY, Pakpour AH. Sleep problems during COVID-19 pandemic and its' association to psychological distress: A systematic review and meta-analysis. EClinicalMedicine 2021; 36:100916. [PMID: 34131640 PMCID: PMC8192091 DOI: 10.1016/j.eclinm.2021.100916] [Citation(s) in RCA: 185] [Impact Index Per Article: 61.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/29/2021] [Accepted: 05/05/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The emerging novel coronavirus disease 2019 (COVID-19) has become one of the leading cause of deaths worldwide in 2020. The present systematic review and meta-analysis estimated the magnitude of sleep problems during the COVID-19 pandemic and its relationship with psychological distress. METHODS Five academic databases (Scopus, PubMed Central, ProQuest, ISI Web of Knowledge, and Embase) were searched. Observational studies including case-control studies and cross-sectional studies were included if relevant data relationships were reported (i.e., sleep assessed utilizing the Pittsburgh Sleep Quality Index or Insomnia Severity Index). All the studies were English, peer-reviewed papers published between December 2019 and February 2021. PROSPERO registration number: CRD42020181644. FINDINGS 168 cross-sectional, four case-control, and five longitudinal design papers comprising 345,270 participants from 39 countries were identified. The corrected pooled estimated prevalence of sleep problems were 31% among healthcare professionals, 18% among the general population, and 57% among COVID-19 patients (all p-values < 0.05). Sleep problems were associated with depression among healthcare professionals, the general population, and COVID-19 patients, with Fisher's Z scores of -0.28, -0.30, and -0.36, respectively. Sleep problems were positively (and moderately) associated with anxiety among healthcare professionals, the general population, and COVID-19 patients, with Fisher's z scores of 0.55, 0.48, and 0.49, respectively. INTERPRETATION Sleep problems appear to have been common during the ongoing COVID-19 pandemic. Moreover, sleep problems were found to be associated with higher levels of psychological distress. With the use of effective programs treating sleep problems, psychological distress may be reduced. Vice versa, the use of effective programs treating psychological distress, sleep problems may be reduced. FUNDING The present study received no funding.
Collapse
Affiliation(s)
- Zainab Alimoradi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Anders Broström
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden
| | - Hector W.H. Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Shahab Haghayegh
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Maurice M. Ohayon
- Stanford Sleep Epidemiology Research Center (SSERC), School of Medicine, Stanford University, CA, USA
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University
| | - Amir H. Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| |
Collapse
|
9
|
Phiri P, Ramakrishnan R, Rathod S, Elliot K, Thayanandan T, Sandle N, Haque N, Chau SWH, Wong OWH, Chan SSM, Wong EKY, Raymont V, Au-Yeung SK, Kingdon D, Delanerolle G. An evaluation of the mental health impact of SARS-CoV-2 on patients, general public and healthcare professionals: A systematic review and meta-analysis. EClinicalMedicine 2021; 34:100806. [PMID: 33842872 PMCID: PMC8022621 DOI: 10.1016/j.eclinm.2021.100806] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/05/2021] [Accepted: 03/05/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The global impact of COVID-19 pandemic continues to affect the lives of billions of people with recurrent waves. Healthcare systems are struggling to manage pre-existing patient care and recurring covid-19 demands. As a result, we evaluated the mental health impact using systematic review and meta-analysis. METHODS A comprehensive search was undertaken from April 2020 to 22nd January 2021 using multiple electronic databases. A systematic review protocol was developed and published on PROSPERO registration; CRD42020181481. A random-effects model was used to compute pooled estimates of anxiety, depression, PTSD, insomnia and suicidal thoughts. FINDINGS Our search yielded 11,295 studies and of those 287 met the inclusion criteria. The meta-analysis of 206 studies revealed minimal differences in prevalence of anxiety, depression, and PTSD among HCPs compared with the public during the pandemic but higher prevalence of suicidal thoughts/ideation or self-harm (11% vs 5.8%) and lower prevalence of wellbeing (28.2% vs 52.6%) among the public compared to HCPs. INTERPRETATION The pandemic has led to a high mental health burden especially amongst HCPs and higher suicidal ideation and lower wellbeing in general public which warrants further investigation and management globally. These findings highlight an emerging critical public health issue that requires urgent solutions.
Collapse
Affiliation(s)
- Peter Phiri
- Southern Health NHS Foundation Trust, Research and Development Dept., Clinical Trials Facility, Moorgreen Hospital, Southampton SO30 3JB, UK
- Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Aldermoor Health Centre, Southampton SO16 5ST, UK
| | - Rema Ramakrishnan
- Nuffield Department of Women's and Reproductive Health, University of Oxford, UK
| | - Shanaya Rathod
- Southern Health NHS Foundation Trust, Research and Development Dept., Clinical Trials Facility, Moorgreen Hospital, Southampton SO30 3JB, UK
| | - Kathryn Elliot
- Southern Health NHS Foundation Trust, Research and Development Dept., Clinical Trials Facility, Moorgreen Hospital, Southampton SO30 3JB, UK
| | - Tony Thayanandan
- Oxford Brain Health Clinical Trials Unit, Department of Psychiatry, Warneford Hospital,University of Oxford, Oxford OX3 7JX, UK
| | - Natasha Sandle
- Oxford Brain Health Clinical Trials Unit, Department of Psychiatry, Warneford Hospital,University of Oxford, Oxford OX3 7JX, UK
| | - Nyla Haque
- Oxford Brain Health Clinical Trials Unit, Department of Psychiatry, Warneford Hospital,University of Oxford, Oxford OX3 7JX, UK
| | - Steven WH Chau
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong
| | - Oscar WH Wong
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong
| | - Sandra SM Chan
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong
| | - Evelyn KY Wong
- Department of Psychiatry, North District Hospital, Hong Kong
| | - Vanessa Raymont
- Oxford Brain Health Clinical Trials Unit, Department of Psychiatry, Warneford Hospital,University of Oxford, Oxford OX3 7JX, UK
| | - Sheena K Au-Yeung
- Oxford Brain Health Clinical Trials Unit, Department of Psychiatry, Warneford Hospital,University of Oxford, Oxford OX3 7JX, UK
| | - David Kingdon
- University Department of Psychiatry, Academic Centre, College Keep, University of Southampton, UK
| | - Gayathri Delanerolle
- Oxford Brain Health Clinical Trials Unit, Department of Psychiatry, Warneford Hospital,University of Oxford, Oxford OX3 7JX, UK
| |
Collapse
|
10
|
Lin YN, Liu ZR, Li SQ, Li CX, Zhang L, Li N, Sun XW, Li HP, Zhou JP, Li QY. Burden of Sleep Disturbance During COVID-19 Pandemic: A Systematic Review. Nat Sci Sleep 2021; 13:933-966. [PMID: 34234598 PMCID: PMC8253893 DOI: 10.2147/nss.s312037] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 05/30/2021] [Indexed: 02/06/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) pandemic may exert adverse impacts on sleep among populations, which may raise awareness of the burden of sleep disturbance, and the demand of intervention strategies for different populations. We aimed to summarize the current evidence for the impacts of COVID-19 on sleep in patients with COVID-19, healthcare workers (HWs), and the general population. We searched PubMed and Embase for studies on the prevalence of sleep disturbance. Totally, 86 studies were included in the review, including 16 studies for COVID-19 patients, 34 studies for HWs, and 36 studies for the general population. The prevalence of sleep disturbance was 33.3%-84.7%, and 29.5-40% in hospitalized COVID-19 patients and discharged COVID-19 survivors, respectively. Physiologic and psychological traumatic effects of the infection may interact with environmental factors to increase the risk of sleep disturbance in COVID-19 patients. The prevalence of sleep disturbance was 18.4-84.7% in HWs, and the contributors mainly included high workloads and shift work, occupation-related factors, and psychological factors. The prevalence of sleep disturbance was 17.65-81% in the general population. Physiologic and social-psychological factors contributed to sleep disturbance of the general population during COVID-19 pandemic. In summary, the sleep disturbance was highly prevalent during COVID-19 pandemic. Specific health strategies should be implemented to tackle sleep disturbance.
Collapse
Affiliation(s)
- Ying Ni Lin
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Zhuo Ran Liu
- Department of Thyroid and Vascular Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Shi Qi Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Chuan Xiang Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Department of Respiratory Medicine, Wuhan No.3 Hospital, Wuhan, 430000, People's Republic of China
| | - Liu Zhang
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Ning Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Xian Wen Sun
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Hong Peng Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Jian Ping Zhou
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Qing Yun Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| |
Collapse
|