The prevalence of psychiatric comorbidities during the SARS and COVID-19 epidemics: a systematic review and meta-analysis of observational studies

Zhao, Yan-Jie; Jin, Yu; Rao, Wen-Wang; Li, Wen; Zhao, Na; Cheung, Teris; Ng, Chee H.; Wang, Yuan-Yuan; Zhang, Qing-E; Xiang, Yu-Tao

The coronavirus disease 2019 (COVID-19) and Severe Acute Respiratory Syndrome (SARS) are associated with various psychiatric comorbidities. This is a systematic review and meta-analysis comparing the prevalence of psychiatric comorbidities in all subpopulations during the SARS and COVID-19 epidemics. A systematic literature search was conducted in major international (PubMed, EMBASE, Web of Science, PsycINFO) and Chinese (China National Knowledge Internet (CNKI) and Wanfang) databases to identify studies reporting prevalence of psychiatric comorbidities in all subpopulations during the SARS and COVID-19 epidemics. Data analyses were conducted using the Comprehensive Meta-Analysis Version 2.0 (CMA V2.0). Eighty-two studies involving 96,100 participants were included. The overall prevalence of depressive symptoms (depression hereinafter), anxiety symptoms (anxiety hereinafter), stress, distress, insomnia symptoms, post-traumatic stress symptoms (PTSS) and poor mental health were 23.9% (95% CI: 18.4%-30.3%), 23.4% (95% CI: 19.9%-27.3%), 14.2% (95% CI: 8.4%-22.9%), 16.0% (95% CI: 8.4%-28.5%), 26.5% (95% CI: 19.1%-35.5%), 24.9% (95% CI: 11.0%-46.8%), 19.9% (95% CI: 11.7%-31.9%), respectively. Prevalence of poor mental health was higher in general populations than in health professionals (29.0% vs. 11.6%; Q=10.99, p=0.001). The prevalence of depression, anxiety, PTSS and poor mental health were similar between SARS and COVID-19 epidemics (all p values>0.05). Psychiatric comorbidities were common in different subpopulations during both the SARS and COVID-19 epidemics. Considering the negative impact of psychiatric comorbidities on health and wellbeing, timely screening and appropriate interventions for psychiatric comorbidities should be conducted for subpopulations affected by such serious epidemics.