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      Analysis of the prevalence and influencing factors of depression and anxiety among maintenance dialysis patients during the COVID-19 pandemic

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          Abstract

          Objective

          Currently, the COVID-19 outbreak and its spread around the globe is significantly affecting mental health and health in general, worldwide. During the COVID-19 pandemic, the general medical complications have received the most attention, whereas only a few studies address the potential direct impact of SARS-CoV-2 on mental health.

          Methods

          A total of 321 maintenance hemodialysis (MHD) patients were selected using random sampling from the hemodialysis center of the second people’s Hospital of Yibin. They completed Zung’s self-rating anxiety scale (SAS) for anxiety, Zung’s self-rating depression scale (SDS) for depression, and the activity of daily living scale (ADL) for the ability of living. Demographic data and laboratory tests were used to analyze the risk factors.

          Results

          The proportions of the prevalence of anxiety and depression symptoms were between 34.89% and 30.02%, respectively, among the MHD patients. The SAS and SDS scores of the 321 patients were 45.42(± 10.99) and 45.23(± 11.59), respectively. The results show that monthly income, medical insurance, vascular access, the duration of dialysis, complication, hemoglobin (HGB), immunoreactive parathyroid hormone (iPTH) and blood phosphorus (P) are factors that influence anxiety among patients ( p < 0.05 for all). Vascular access, monthly income, medical insurance, complication, CRP, Alb, are factors that influence depression among patients ( p < 0.05 for all).

          Conclusion

          Our results suggest that during the pandemic period, the prevalence of anxiety and depression symptoms among MHD patients increased. Some demographic and clinical variables were associated with it. We should, therefore, pay more attention to the patients’ psychology, start targeted intervention to alleviate the patients’ anxiety and further improve their quality of life.

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          Most cited references17

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          Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

          Summary Background A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.
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            Epidemic of COVID-19 in China and associated Psychological Problems

            Highlights • There are higher rate of anxiety, depression, alcohol use disorder, and lower mental wellbeing during the COVID-19 epidemic. • Depression and alcohol use disorder were higher among people from Hubei than other provinces. • Non-significant gender differences in anxiety, depression, and mental wellbeing. • Young people, aged 21–40 years old, were psychologically more vulnerable position during the COVID-19 epidemic.
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              Are we facing a crashing wave of neuropsychiatric sequelae of COVID-19? Neuropsychiatric symptoms and potential immunologic mechanisms ☆

              Highlights • The COVID-19 pandemic is a significant source of psychological distress globally. • The novel coronavirus and host immunologic response may also directly affect brain and behavior. • Acute and delayed neuropsychiatric sequelae have been associated with past viral pandemics. • Prospective monitoring of COVID-19 patients is needed to determine neuropsychiatric outcomes. • A psychoneuroimmunology perspective will aid in promoting post-pandemic public mental health.
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                Author and article information

                Contributors
                1285396756@qq.com
                Journal
                Int Urol Nephrol
                Int Urol Nephrol
                International Urology and Nephrology
                Springer Netherlands (Dordrecht )
                0301-1623
                1573-2584
                6 March 2021
                : 1-9
                Affiliations
                [1 ]GRID grid.460059.e, Department of Nephrology, , The Second People’s Hospital of Yibin, ; Yibin, 644000 Sichuan China
                [2 ]GRID grid.449525.b, ISNI 0000 0004 1798 4472, North Sichuan Medical College, ; Nanchong, Sichuan China
                Author information
                http://orcid.org/0000-0001-5923-8898
                Article
                2791
                10.1007/s11255-021-02791-0
                7936244
                33675473
                2d6ab5d6-b49d-47ac-9eb4-b1e23d85d9c6
                © The Author(s), under exclusive licence to Springer Nature B.V. part of Springer Nature 2021

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                : 20 August 2020
                : 30 January 2021
                Categories
                Nephrology - Original Paper

                Nephrology
                covid-19,anxiety,depression,maintenance hemodialysis,logistic models
                Nephrology
                covid-19, anxiety, depression, maintenance hemodialysis, logistic models

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