Highlights In this meta-analysis of 24 studies with 12882 confirmed COVID-19 patients, we assessed the association of comorbid liver disease, acute liver injury, and elevated liver enzymes with outcomes in COVID-19 hospitalized patients. Overall prevalence of pre-existing chronic liver disease and COVID-19-associated acute liver injury were 2.6% and 26.5%, respectively and elevated AST and ALT were 41.1% and 29.1%, respectively. In our study, COVID-19-associated acute liver injury was having 1.7 folds higher risk of poor outcomes. Elevated AST and ALT were also independently associated with higher odds of poor outcomes. These findings may help in early triage, close monitoring of the occurrence of liver injury, and careful use of drugs which can cause liver toxicity in COVID-19 patients.

Anxiety and depression have been prevalent among Healthcare Workers (HCWs) amidst the COVID-19 pandemic. This study aims to evaluate the prevalence of anxiety and depression among HCWs amid the pandemic and their association with religious coping. A cross-sectional study design was applied. The scales utilized were Malay versions of the Brief Religious Coping Scale (Brief RCOPE M) and Hospital Anxiety and Depression Scale (HADS M). In total, 200 HCWs were recruited. HCWs scored higher in positive religious coping (mean: 21.33) than negative religious coping (mean: 10.52). The prevalence of anxiety and depression was 36.5% and 29.5%. Both positive and negative religious coping were significantly associated with anxiety (p < 0.01) and depression (p < 0.05, p < 0.01). Positive coping predicted reduction in anxiety (adjusted b = −0.15, p = 0.001) and log-transformed depression score (adjusted b = −0.019, p = 0.025). Negative coping predicted increment of anxiety (adjusted b = 0.289, p < 0.001) and log-transformed depression score (adjusted b = 0.052, p < 0.001). Positive religious coping is vital in reducing anxiety and depression among HCWs amid the pandemic. Strategies which increase positive religious coping and reduce negative religious coping must be emphasized to boost mental health among HCWs.

Medical students are vulnerable to depression and anxiety due to the nature of their academic life. This study aimed to determine the prevalence of depressive and anxiety symptoms among medical students and the association between religious coping, religiosity and socio-demographic factors with anxiety and depressive symptoms. A cross sectional design was used for this study. Scales used were the Malay version of the Duke Religious Index (DUREL-M), the Malay version of the Brief Religious Coping Scale (Brief RCOPE) and the Malay version Hospital and Anxiety Depression Scale (HADS-M). 622 students participated in this study. They scored moderately on the organized (mean: 3.51) and non-organized religious (mean: 3.85) subscales of the DUREL, but had high intrinsic religiosity (mean: 12.18). The prevalence of anxiety and depressive symptoms were 4.7% and 17.4% respectively, which is lower than local as well as international data. Islam, negative religious coping and the presence of depressive symptoms were significantly associated with anxiety symptoms. Only the presence of anxiety symptoms was significantly associated with depressive symptoms. Negative religious coping, rather than positive religious coping, has significant association with depressive and anxiety symptoms. Redirecting focus towards negative religious coping is imperative to boost mental health outcomes among medical students.

Mental health disorders (MHDs) among refugees has been recognized as a major public health issue. However, to date, there is limited evidence on the prevalence of MHDs among Rohingya refugees in Malaysia. This study aimed to examine the prevalence and associated factors of major depressive disorder (MDD), generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD) among Rohingya refugees in Malaysia. A total of 220 refugees were randomly selected to participate in this cross-sectional study, conducted from June 2019 to November 2019. Perceived social support, religious orientation, food security, and sociodemographic characteristics were assessed as independent variables. The dependent variables assessed were MDD, GAD, and PTSD. The prevalence of GAD, PTSD, and MDD was reported at 92 (41.8%), 84 (38.2%), and 71 (32.3%). Several factors were significantly associated with MDD following multivariate analysis such as perceived low to moderate social support (AOR = 2.17; 95% CI 1.13, 4.19) and food insecurity (AOR = 2.77; 95% CI 1.19, 6.47). Exposure to violence (AOR = 38.46; 95% CI 16.27, 90.91) and food insecurity (AOR = 3.74; 95% CI 1.41, 9.91) were significantly associated with PTSD. Addressing these risk factors could be key in improving mental health outcomes among this vulnerable population.

The purpose of this article is to discuss the importance of addressing the psychological impact of coronavirus disease 2019 (COVID-19) on healthcare workers (HCWs) who are frontliners directly involved in mitigating the spread of the disease. This paper focuses on the utilization of a clinical practice protocol for identifying HCWs who are COVID-19-positive or under investigation and surveillance for suspected infection, in a tertiary, university teaching hospital of Malaysia. The protocol for Psychological First Aid (PFA), which is applied remotely via a mobile application and phone calls, outlines the work process in stages, with expected immediate, intermediate, and long-term goals within a “Specific, Measurable, Attainable, Relevant, and Realistic Timeframe” (SMART). This protocol is developed to provide a guideline for psychological crisis interventions that promote safety, calm, and hope in HCWs, allowing them to return to psychological functioning without being stigmatized. The unprecedented remote PFA protocol may serve as a platform for further research on the application of a goal-directed approach in a healthcare organization.