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

Wang, Minghuan; Hu, Caihong; Zhao, Qian; Feng, Renjie; Wang, Qing; Cai, Hongbin; Guo, Zhenli; Xu, Kang; Luo, Wenjing; Guo, Canshou; Zhang, Sheng; Chen, Chunfa; Zhu, Chunli; Wang, Hongmin; Chen, Yu; Ma, Li; Zhan, Peiyan; Cao, Jie; Huang, Shanshan; Yang, Mia Jiming; Fang, Yuxin; Zhu, Suiqiang; Yang, Yuan

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.