Acute psychological impact on COVID-19 patients in Hubei: a multicenter observational study

We conducted a multicentre cross-sectional survey of COVID-19 patients to evaluate the acute psychological impact on the patients with coronavirus disease 2019 (COVID-19) during isolation treatment based on online questionnaires from 2 February to 5 March 2020. A total of 460 COVID-19 patients from 13 medical centers in Hubei province were investigated for their mental health status using online questionnaires (including Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Patient Health Questionnaire-15, and Insomnia Severity Index scales). Among all 460 COVID-19 patients, 187 (40.65%) of them were healthcare workers (HCWs). 297 (64.57%) of them were females. The most common psychological problems were somatization symptoms (66.09%, n=304), followed by depression (53.48%, n=246), anxiety (46.30%, n=213), problems of insomnia (42.01%, n=171), and then self-mutilating or suicidal thoughts (23.26%, n=107). Of all the patients, 15.65% (n=72) had severe somatization symptoms, and 2.83% (n=13) had severe (almost every day) self-mutilating or suicidal thoughts. The most common psychological problems for HCWs were somatization symptoms (67.84%, n=125), followed by depression (51.87%, n=97), anxiety (44.92%, n=84), problems of insomnia (36.18%, n=55), and then self-mutilating or suicidal thoughts (20.86%, n=39). Patients with lower education levels were found to be associated with higher incidence of self-mutilating or suicidal thoughts (odds ratio [OR], 2.68, 95% confidence interval [95% CI], 1.66-4.33 [P<0.001]). Patients with abnormal body temperature were found to be associated with higher incidence of self-mutilating or suicidal thoughts (OR, 3.97, 95% CI, 2.07-7.63 [P<0.001]), somatic symptoms (OR, 2.06, 95% CI, 1.20-3.55 [P=0.009]) and insomnia (OR, 1.66, 95% CI, 1.04-2.65 [P=0.033]). Those with suspected infected family members displayed a higher prevalence of anxiety than those without infected family members (OR, 1.61, 95% CI, 1.1-2.37 [P=0.015]). Patients at the age of 18-44 years old had fewer somatic symptoms than those aged over 45 years old (OR, 1.91, 95% CI, 1.3-2.81 [P=0.001]). In conclusion, COVID-19 patients tended to have a high prevalence of adverse psychological events. Early identification and intervention should be conducted to avoid extreme events such as self-mutilating or suicidal impulsivity for COVID-19 patients, especially for those with low education levels and females who have undergone divorce or bereavement.

Automated summary

A multicentre cross-sectional survey conducted on COVID-19 patients revealed a high prevalence of adverse psychological events, with common issues being somatization symptoms, depression, and anxiety. Early identification and intervention are crucial to prevent extreme events, especially for patients with low education levels and females who have undergone divorce or bereavement.