A living systematic review of the psychological problems in people suffering from COVID-19

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.

Keywords: COVID-19; Living systematic review; Mental health; Meta-analyses; Psychological problems; SARS-CoV-2 infection.

Fig. 1

Flow diagram of the selection of studies for the systematic review and meta-analyses.

Fig. 2

Forest plot of anxiety prevalence rate in patients infected with SARS-CoV-2.

Fig. 3

Forest plot of depression prevalence rate in patients infected with SARS-CoV-2.

Fig. 4

Forest plot of post-traumatic stress disorder prevalence rate in patients infected with SARS-CoV-2.

Fig. 5

Forest plot of insomnia prevalence rate in patients infected with SARS-CoV-2.

Fig. 6

Forest plot of somatization prevalence rate in patients infected with SARS-CoV-2.

Fig. 7

Forest plot of fear prevalence rate in patients infected with SARS-CoV-2.