Depression, anxiety, and stress among COVID-19 patients in South … – Nature.com

Reducing psychological stress is an essential aspect of COVID-19 treatment strategies. Since its appearance, COVID-19 has had a significant impact on people'shealth and quality of life worldwide14. Both the infected and non-infected could be at risk of mental health problems as a result of issues such as widespread anxiety, social isolation, healthcare, and other essential workers stress, and unemployment and financial difficulties15,16,17. Other experiences might be specific to individuals infected with the virus, such as concern over the outcome of their illness18.

While many studies have examined the physical and financial effects of the coronavirus, few have examined the mental health care needs of COVID-19 patients18. Thus, this study was conducted to determine the prevalence of emotional disturbance mental health symptoms as well as the probable correlates of these symptoms among COVID-19 patients in the South Sinai governorate of Egypt. The results revealed a high prevalence of anxiety, depression, and stress among COVID-19-infected patients, with 75.7% having extremely severe anxiety, 46.3% having extremely severe depression, and 19.6% having extremely severe stress.

A cross-sectional study conducted by Li et al.19 in China investigated the prevalence ofanxiety and depression among COVID-19 hospitalized patients during the pandemic and found a mean anxiety score of 6.695.01 and a mean depression score of 8.275.35. Healthcare workers (HCWs) were found to be most likely to experience depression, anxiety, or stress as COVID-19 patients, with 80.2% having extremely severe or severe depression, 86.8% having extremely severe or severe anxiety, and 64.9% having extremely severe or severe stress.

A cross-sectional study in a university hospital in Egypt examined a sample of 270 HCWs employed in COVID-19 isolation units; the DASS revealed a significant frequency of depression disorders, with 28.1% of the HCWs having mild to moderate depressive symptoms and 64.8% having severe symptoms20. Another study conducted in Egypt found a high prevalence of severedepressive symptoms among Egyptian physicians, with 63% having severe or extremely severe depressive symptoms, 77.6% having extremely severe anxiety, and 72% experiencing stress21. In Jordan, a study conducted by Naser et al.22 found a high prevalence of depressive (78.1%) and anxiety (70.8%) symptoms among healthcare professionals. In 2003, a study using the DASS-21 during the SARS outbreak found that 93% of patients had experienced depressive symptoms, with 65% having severe or extremely severe symptoms. Nearly 90% of HCWs who had dealt with SARS patients during the outbreak experienced psychological symptoms. Thus, viruses similar to COVID-19 can be linked to the presence of mental health symptoms among patients and their caregivers23.

HCWs are the first line of defense against highly infectious diseases with unclear outcomes. With a lack of infection control measures and protective equipment, HCWs face a significant amount of stress that may cause them to have a higher prevalence of psychological disorders than ordinary patients24. Li et al. conducted a study in China that demonstrated a substantial positive correlation between depression and anxiety scores using the Hospital Anxiety and Depression Scale (HADS); these findings were similar to ours in which the presence of depressive symptoms increased the risk of anxiety and stress symptoms among COVID-19 patients19.

Our linear regression results revealed that hospital admission was the main predictor of depression, anxiety and stress and the duration of hospital stay with extended recovery time from COVID-19 symptoms were significantly affecting appearance of depression after infection. Previous studies have also found psychological problems to be linked to prolonged hospitalization for multiple diseases18,25. Others have linked longer hospital stays with higher levels of anxiety and depression in COVID-19 patients26,27. Elgohary et al.20 identified other predictors affecting the presence and severity of psychological disorders among COVID-19 patients, including young age, decreased sleep hours, being female, a past history of a psychiatric disease, fear of COVID-19 infection in themselves or their relatives, and fear of death from COVID-19 for themselves or their relatives. Similarly, Khanal et al.24 reported that females, divorced people and university students with history of chronic disease and high-income earners (1500 JD) were at greater risk of developing anxiety during their infection with COVID-19.

Patients with longer disease duration were shown to have a more depressive attitude about their condition. Effect of steroid use and grade of dyspnea on development of moderate or severe post-COVID depression and showed that higher grades of dyspnea were associated with higher probability of development of moderate or severe post-COVID depression28.

The present study faced some limitations including being single-centered which affect the representation and generalization of results among all patients infected with COVID-19. Other limitations included the fear of patients to admit having problems during COVID-19 infection and Arabic version of DASS has a lot of similar questions which confuse the patients upon answering.

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Depression, anxiety, and stress among COVID-19 patients in South ... - Nature.com