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Cited by 175COVID-19 and Mental HealthLong-Term Effects of COVID-19COVID-19 Clinical Research Studies

Factors related to mental health of inpatients with COVID-19 in Wuhan, China

Open access
Hu, Yanyu, Chen, Yingying, Zheng, Yixiong, You, Ciping, Tan, Jing, Hu, Lan, Zhang, Zhenqing, Ding, Lijun·2020·Brain, Behavior, and Immunity
DOI 10.1016/j.bbi.2020.07.016PMC PMC7362867
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Abstract

Objective To evaluate the mental health status of hospitalized patients with coronavirus disease 2019 (COVID-19) and to explore the related factors.Method This was a cross-sectional survey among COVID-19 inpatients in two isolation wards of a designated hospital in Wuhan, China, from March 7, 2020, to March 24, 2020. Participants' demographic data, clinical data and levels of circulating inflammatory markers were collated. Mental health symptoms were evaluated with questionnaires, which included the Insomnia Severity Index (ISI) scale, the 9-item Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder (GAD-7) scale, and questions about patients' self-perceived illness severity. Multivariate linear regression analysis was performed to explore factors that associated with mental symptoms, and a structural equation model (SEM) was used to assess the possible relationships between those factors and the patients' mental health.Results Among the 85 participants, 45.9% had symptoms of depression (PHQ-9 ≥ 5), 38.8% had anxiety (GAD-7 ≥ 5), and 54.1% had insomnia (ISI ≥ 8). According to multivariate regression analysis, female sex, a higher level of interleukin (IL)-1β and greater self-perceived illness severity were all significantly associated with a higher PHQ-9 score, higher GAD-7 score and higher ISI score. In addition, the disease duration and the neutrophil to lymphocyte ratio (NLR) were positively related to patients' self-perceived illness severity. The results of the SEM analyses suggested that sex (β = 0.313, P < 0.001), self-perceived illness severity (β = 0.411, P < 0.001) and levels of inflammatory markers (β = 0.358, P = 0.002) had direct effects on patients' mental health. The disease duration (β = 0.163, P = 0.003) and levels of inflammatory markers (β = 0.101, P = 0.016) also indirectly affected patients' mental health, with self-perceived illness severity acting as a mediator.Conclusion A majority of COVID-19 infected inpatients reported experiencing mental health disturbances. Female sex, disease duration, levels of inflammatory markers and self-perceived illness severity are factors that could be used to predict the severity of patients' mental symptoms.

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  • COVID-19 can cause increased psychological symptoms such as PTSD, depression, and anxiety in patients.

    “Evidence suggests that this disease has psychological consequences on healthcare workers, students, psychiatric patients and general workers, especially for COVID-19 patients [4–13].”

    From Mindfulness-based online intervention on mental health and quality of life among COVID-19 patients in China: an intervention design (2021) · cites this paper as [10]

    The Discussion reports depression (45.9%) and anxiety (38.8%) among COVID-19 inpatients, supporting psychological consequences for patients. It does not report PTSD in those patients; its PTSD figure concerns SARS survivors. The study also does not establish that COVID-19 caused an increase in symptoms. (LLM, conf=0.88)

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  • As of March 22, 2021, there are 97,716 COVID-19 survivors cured and discharged in China, about one-third (32,572) may be suffering from mental illness as reported by survey results in Wuhan.

    “As of March 22, 2021, there are 97 716 COVID-19 survivors cured and discharged from hospital in China, about one-third of them (i.e. 32 572 patients) may be suffering from mental illness as reported by the survey results in Wuhan, China [3, 10].”

    From Mindfulness-based online intervention on mental health and quality of life among COVID-19 patients in China: an intervention design (2021) · cites this paper as [10]

    The Discussion reports substantial depression, anxiety and insomnia symptoms among COVID-19 inpatients in Wuhan, supporting concern about their mental health. But the survey assessed 85 patients before discharge, not survivors after discharge; the approximately one-third post-discharge figure in the Discussion concerns SARS survivors. This paper does not establish that 32,572 of the 97,716 discharged COVID-19 patients in China had mental illness. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • In Wuhan, China, a March 2020 survey found 45.9% of patients had depression symptoms, 38.8% anxiety, and 54.1% insomnia.

    “In addition, a survey conducted in March, 2020 showed that 45.9% of patients had symptoms of depression, 38.8% had anxiety and 54.1% had insomnia in Wuhan, China [10].”

    From Mindfulness-based online intervention on mental health and quality of life among COVID-19 patients in China: an intervention design (2021) · cites this paper as [10]

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Authors
Hu, Y., Chen, Y., Zheng, Y., You, C., Tan, J., Hu, L., Zhang, Z., & Ding, L.
Affiliations
Tongji Hospital (CN)
Corresponding author
Ding, Lijun
ORCID
Venue
Brain, Behavior, and Immunity
Publisher
Elsevier BV
Published
2020-10
Volume
89
Pages
587-593
ISSN
0889-1591 (ISSN-L)
DOI
10.1016/j.bbi.2020.07.016
PMC
PMC7362867
OpenAlex
W3042823213
Cited by
175
References
32
Citations by year
2026: 1 · 2025: 11 · 2024: 20 · 2023: 36 · 2022: 48 · 2021: 46 · 2020: 13
FWCI
14.27
Type
journal article
Language
en
Open access
Licence
Locations
  • Brain Behavior and Immunity (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
  • Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
Keywords
COVID-19 pandemic, mental health, depression, anxiety, insomnia, inflammatory markers, IL-1β, neutrophil-to-lymphocyte ratio, disease duration, sex differences, hospitalized patients, Wuhan, isolation wards, COVID-19 treatment
MeSH terms
Patient Health Questionnaire, Betacoronavirus, COVID-19, SARS-CoV-2, Adult, Anxiety, China, Cross-Sectional Studies, Depression, Female, Hospitalization, Humans, Inflammation, Sleep Initiation and Maintenance Disorders, Leukocyte Count, Male, Mental Health, Middle Aged, Neutrophils, Pneumonia, Viral, Severity of Illness Index, Sex Factors, Time Factors, Coronavirus Infections, Lymphocyte Count, Pandemics

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