مقاله انگلیسی رایگان در مورد بررسی سیستماتیک پیامدهای سلامت روان بزرگسالان بستری در بیمارستان برای COVID-19 – الزویر 2022

Abstarct

Introduction

Methods

Results

Discussion

Conclusions

Declaration of Competing Interest

Acknowledgments

Supplementary materials

References

Abstract

Background

     Patients hospitalized for COVID-19 may be at high risk of mental health (MH) disorders. This systematic review assesses MH outcomes among adults during and after hospitalization for COVID-19 and ascertains MH care utilization and resource needs.

Methods

     We searched multiple medical literature databases for studies published December 2019 to March 2021. Studies of ≥ 200 participants were synthesized. One reviewer completed article selection, data abstraction and assessed study quality and strength of evidence, with verification by a second.

Results

     Fifty articles met preliminary inclusion criteria; 19 articles that included ≥ 200 participants were synthesized. Evidence from these primarily fair-quality studies suggests many patients experience symptoms of depression (9–66%), anxiety (30–39%), and insomnia (24–40%) during and 3 months after hospitalization for COVID-19. However, patients infrequently receive a new MH disorder diagnosis 6 months after hospitalization (5% are diagnosed with a new mood disorder, 7% anxiety disorder, and 3% insomnia). Some hospitalized patients – including women and those with more severe COVID-19 – may be at higher risk of poor MH outcomes. Data on MH care utilization and resource needs are currently limited.

Limitations

     Most included studies were small, did not report the proportion of participants with preexisting MH disorders, and did not use comparison groups.

Conclusions

     While many patients experience MH symptoms after hospitalization for COVID-19, most do not go on to develop a new MH disorder. Future studies should report whether participants have preexisting MH disorders and compare patients hospitalized for COVID-19 to patients hospitalized for other causes.

Introduction

     As of August 2021, 210 million people have been confirmed to have had COVID-19 and 4 million have died from Coronavirus Disease 2019 (COVID-19) worldwide (Johns Hopkins University, 2021). Despite rapid advancements in the diagnosis and treatment of COVID-19 in the past year, it remains uncertain what patients who have been hospitalized with COVID-19 should expect during their recovery. In particular, experts have warned these patients may be at high risk of exacerbating existing mental health (MH) conditions or developing new MH conditions such as major depression, anxiety disorders, or post-traumatic stress disorder (PTSD) (de Girolamo et al., 2020; Huff, 2020; Kahl and Correll, 2020).

     Hospitalization for COVID-19 might worsen MH symptoms or conditions through complex and interrelated mechanisms. First, being hospitalized for a serious illness can negatively affect MH. Research from Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) epidemics has found that many patients with serious SARS and MERS infections experienced symptoms of anxiety (36%) and insomnia (42%) during the acute phase of their illness, and some developed PTSD (32%), depressive disorders (15%), and anxiety disorders (15%) after recovery (Rogers et al., 2020). Research has also found patients treated in the intensive care unit (ICU) for any illness are at high risk of MH issues, with one-third developing symptoms of anxiety and depressive disorders, and one-fifth developing PTSD symptoms within a year of their ICU stay (Tingey et al., 2020). Second, addressing complications of COVID-19 may require invasive procedures, including the administration of sedation and/or paralytic agents and intensive intravascular monitoring. These interventions interfere with a patient’s ability to respond to and understand their providers, environment, and treatment, which may affect MH outcomes after recovery from COVID-19 (Tingey et al., 2020). Finally, stress associated with isolation from family and friends and financial hardship due to medical costs and disruption to work are additional factors that could contribute to poor MH among those hospitalized for COVID-19.

Results

Search results

     The literature flow diagram (Fig. 1) summarizes the results of the search and study selection processes. Among 4866 potentially relevant citations, we included 50 articles; 19 of these articles enroled ≥ 200 participants and were retained in our best-available evidence synthesis. These 19 articles presented data from 17 studies, including 2 prospective cohort studies (Mazza et al., 2020, 2021; Turan et al., 2021), 2 retrospective cohort studies (Atalla et al., 2020; Taquet et al., 2021a, 2021b) and 13 cross-sectional studies (Chamberlain et al., 2021; Chen et al., 2021; Einvik et al., 2021; Islam et al., 2021; Jiang et al., 2020; Li et al., 2020; Liu et al., 2020; Ma et al., 2020; Mandal et al., 2020; Moayed et al., 2021; Moradian et al., 2020; Sahan et al., 2021; Wang et al., 2021). Appendix C presents limited data extraction of the 31 studies that enroled < 200 participants. Appendix D presents detailed data extraction, and Appendix E presents quality assessment outcomes, for the 19 articles that enroled ≥ 200 participants.