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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Cross-sectional survey following a longitudinal study on mental health and insomnia of people with sporadic COVID-19
Xiao-Jun Li, Tian-Ze Guo, Yan Xie, Yan-Ping Bao, Jia-Yue Si, Zhe Li, Yi-Ting Xiong, Hui Li, Su-Xia Li, Lin Lu, Xue-Qin Wang
Xiao-Jun Li, Department of Psychiatry, Peking University International Hospital, Beijing 102206, China
Tian-Ze Guo, Department of Bioengineering, University of California San Diego, San Diego, CA 92093, United States
Yan Xie, Department of Psychology, Peking University International Hospital, Beijing 102206, China
Yan-Ping Bao, Department of Epidemiology, National Institute on Drug Dependence and Beijing Key laboratory of Drug Dependence, Peking University, Beijing 100191, China
Jia-Yue Si, University of California Davis, Davis, CA 95616, United States
Zhe Li, Department of History, University College London, London WC1E 6BT, United Kingdom
Yi-Ting Xiong, Hui Li, Lin Lu, Xue-Qin Wang, Department of Psychiatry, Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing 100191, China
Su-Xia Li, Department of Clinical Pharmacology, National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
Lin Lu, Peking-Tsinghua Centre for Life Sciences and Peking University-International Development Group/McGovern Institute for Brain Research, Peking University, Beijing 100091, China
Author contributions: All authors contributed to the study concept; Wang XQ, Li SX, Li XJ and Guo TZ designed the study; Li XJ, Guo TZ, Xie Y, Si JY, Xiong YT and Li H performed data acquisition and interpretation; Guo TZ, Bao YP, Wang XQ and Li SX performed the statistical analysis; Li XJ, Guo TZ, Li Z, Wang XQ and Li SX wrote the manuscript; Lu L revised the manuscript for important intellectual content. All the authors reviewed and approved the final manuscript.
Supported by the Beijing Municipal Science & Technology Commission, No. Z191107006619091; National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), No. NCRC2020M07; and National Natural Science Foundation of China, No. 81871071.
Institutional review board statement: The study was reviewed and approved by the Peking University International Hospital Ethical Committee and Medical Ethics Committee of Peking University Sixth Hospital, Approval No. 2020-021BMR.
Informed consent statement: Informed consent was waived by the ethics committee.
Conflict-of-interest statement: All authors declare no competing interests.
Data sharing statement: In order to protect the privacy of the subjects, we do not share the data generated in this study publicly, but the datasets are available from the corresponding authors with the approval of the ethics committee of the study hospitals.
STROBE statement: The authors have read the STROBE statement, and the manuscript was prepared and revised according to the STROBE statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Xue-Qin Wang, MD, Associate Professor, Department of Psychiatry, Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, No. 51 Huayuanbei Road, Beijing 100191, China. wangxueqin@bjmu.edu.cn
Received: March 19, 2022
Peer-review started: March 19, 2022
First decision: April 18, 2022
Revised: April 20, 2022
Accepted: July 6, 2022
Article in press: July 6, 2022
Published online: August 19, 2022
BACKGROUND
In the post-pandemic era, the emergence of sporadic cases of coronavirus disease 2019 (COVID-19) and the scale of the pandemic are unpredictable. Therefore, the impact of sporadic cases of COVID-19 and isolation measures on mental health and sleep in different groups of people need to be analyzed.
AIM
To clarify the severity of psychological problems and insomnia of staff and community residents around a hospital with sporadic cases of COVID-19, and their relationship with quarantine location and long-term changes.
METHODS
A cross-sectional survey was conducted on community residents and medical staff. Many of these medical staff had been subjected to different places of quarantine. Community residents did not experience quarantine. Hospital anxiety and depression scale (HADS), acute stress disorder scale (ASDS) and insomnia severity index (ISI) were used to evaluate anxiety and depression, acute stress disorder symptoms, and the severity of insomnia. Additionally, we conducted a 1-year follow-up study on medical staff, with related scales measurement immediately after and one year after the 2-wk quarantine period.
RESULTS
We included 406 medical staff and 226 community residents. The total scores of ISI and subscale in HADS of community residents were significantly higher than that of medical staff. Further analysis of medical staff who experienced quarantine showed that 134 were quarantined in hotels, 70 in hospitals and 48 at home. Among all subjects, the proportions of HADS, ASDS and ISI scores above normal cutoff value were 51.94%, 19.17% and 31.11%, respectively. Multivariable logistic regression analysis found that subjects with higher total ASDS scores had a greater risk to develop anxiety and depression. The total ISI score for medical staff in hotel quarantine was significantly higher than those in home quarantine. Total 199 doctors and nurses who completed the 1-year follow-up study. Compared with baseline, HADS and ASDS scores decreased significantly one year after the end of quarantine, while ISI scores did not change significantly.
CONCLUSION
Sporadic COVID-19 cases had a greater psychological impact on residents in surrounding communities, mainly manifested as insomnia and depressive symptoms. Hotel quarantine aggravated the severity of insomnia in medical staff, whose symptoms lasted ≥ 1 year.
Core Tip: This is the first study to research the severity of psychological problems and insomnia of medical staff and community residents around a hospital with sporadic coronavirus disease 2019 (COVID-19) cases, along with long-term changes in the post-pandemic era. We found that sporadic COVID-19 cases had a greater impact on mental health and sleep for community residents, and hotel quarantine had a higher risk for insomnia in doctors and nurses. The insomnia symptoms of doctors and nurses could last for ≥ 1 year. Therefore, our results indicate psychological and sleep problems after sporadic COVID-19 might need long-term mental and psychological intervention, especially for insomnia in doctors and nurses.
