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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
ARTICLE HIGHLIGHTS
Research background
Coronavirus disease 2019 (COVID-19) is highly contagious and has a wide-ranging and serious impact on mental health. Although vaccination in some countries and regions has gradually restored people’s lives, the emergence of virus mutations and sporadic cases might persist in the long term and affect mental health and sleep.
Research motivation
There is a higher risk in general hospitals for COVID-19. The severity of psychological problems and insomnia of medical staff and community residents around a hospital with sporadic COVID-19 cases, and long-term changes in the post-pandemic period remain ambiguous. Additionally, the risk of COVID-19 and different quarantine locations among medical staff may affect doctors’ and nurses’ mental health and sleep. There have been few long-term follow-up studies about mental health and sleep in the post-pandemic era.
Research objectives
This study aimed 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 in the post-pandemic era.
Research methods
Medical staff from the hospital where patients with COVID-19 were found, and residents from the community surrounding the hospital were included in the study. Rating scales were provided by wenjuanxing on the internet. SPSS version 18.0 was used to perform statistical analysis. The significance level was set at α = 0.05 and all tests were two-tailed.
Research results
In the cross-sectional study, 632 subjects were recruited, including 406 medical staff in the hospital that reported sporadic COVID-19 cases and 226 community residents in the surrounding area. The total insomnia severity index (ISI) scores and hospital anxiety and depression scale (HADS) scores were significantly higher in the community residents than in the medical staff. Among medical staff, there were 360 doctors and nurses and 252 of them were quarantined in different locations according to contact level with the patient. The total ISI score for medical staff in hotel quarantine was significantly higher than that in home quarantine. One year later, 199 doctors and nurses completed the follow-up study. The total HADS and acute stress disorder scale scores of doctors and nurses were decreased, but there was little change in ISI total score.
Research conclusions
Our findings indicated that in the post-pandemic period, sporadic COVID-19 cases had a greater psychological impact on residents in the surrounding community than in hospital staff, and mainly manifested as insomnia and depressive symptoms. Doctors and nurses exposed to sporadic COVID-19 cases experienced anxiety and depression, stress, and insomnia in the early stage. Hotel quarantine means a higher risk of infection, and has a greater impact on doctors and nurses’ insomnia than home quarantine. One year later, the anxiety and depression of doctors and nurses significantly improved. However, the long-term mental and psychological problems should not be ignored, especially their insomnia symptoms.
Research perspectives
Sporadic COVID-19 has a greater psychological effect on surrounding community residents than on hospital staff. Government officials should give them relevant support, such as health education. A psychological and sleep rating hotline for people living in surrounding communities and those quarantined in hotels should help. We suggest that effective measures should also be implemented to treat the long-term insomnia in doctors and nurses.
