Introduction The COVID-19 pandemic has impacted biopsychosocial health and wellbeing globally. Pre-pandemic studies suggest a high prevalence of common mental disorders, including anxiety and depression in South Asian countries, which may aggravate during this pandemic. This systematic meta-analytic review was conducted to estimate the pooled prevalence of anxiety and depression in South Asian countries during the COVID-19 pandemic. Method We systematically searched for cross-sectional studies on eight major bibliographic databases and additional sources up to October 12, 2020, that reported the prevalence of anxiety or depression in any of the eight South Asian countries. A random-effects model was used to calculate the pooled proportion of anxiety and depression. Results A total of 35 studies representing 41,402 participants were included in this review. The pooled prevalence of anxiety in 31 studies with a pooled sample of 28,877 was 41.3% (95% confidence interval [CI]: 34.7–48.1, I 2 = 99.18%). Moreover, the pooled prevalence of depression was 34.1% (95% CI: 28.9–39.4, I 2 = 99%) among 37,437 participants in 28 studies. Among the South Asian countries, India had a higher number of studies, whereas Bangladesh and Pakistan had a higher pooled prevalence of anxiety and depression. No studies were identified from Afghanistan, Bhutan, and Maldives. Studies in this review had high heterogeneity, high publication bias confirmed by Egger's test, and varying prevalence rates across sub-groups. Conclusion South Asian countries have high prevalence rates of anxiety and depression, suggesting a heavy psychosocial burden during this pandemic. Clinical and public mental health interventions should be prioritized alongside improving the social determinants of mental health in these countries. Lastly, a low number of studies with high heterogeneity requires further research exploring the psychosocial epidemiology during COVID-19, which may inform better mental health policymaking and practice in South Asia.

Background: The coronavirus disease (COVID-19) pandemic has caused a significant burden of mortality and morbidity. A vaccine will be the most effective global preventive strategy to end the pandemic. Studies have maintained that exposure to negative sentiments related to vaccination on social media increase vaccine hesitancy and refusal. Despite the influence social media has on vaccination behavior, there is a lack of studies exploring the public's exposure to misinformation, conspiracy theories, and concerns on Twitter regarding a potential COVID-19 vaccination. Objective: The study aims to identify the major thematic areas about a potential COVID-19 vaccination based on the contents of Twitter data. Method: We retrieved 1,286,659 publicly available tweets posted within the timeline of July 19, 2020, to August 19, 2020, leveraging the Twint package. Following the extraction, we used Latent Dirichlet Allocation for topic modelling and identified 20 topics discussed in the tweets. We selected 4,868 tweets with the highest probability of belonging in the specific cluster and manually labeled as positive, negative, neutral, or irrelevant. The negative tweets were further assigned to a theme and subtheme based on the contentResult: The negative tweets were further categorized into 7 major themes: "safety and effectiveness,” "misinformation,” "conspiracy theories,” "mistrust of scientists and governments,” "lack of intent to get a COVID-19 vaccine,” "freedom of choice," and "religious beliefs. Negative tweets predominantly consisted of misleading statements (n=424) that immunization against coronavirus is unnecessary as the survival rate is high. The second most prevalent theme to emerge was tweets constituting safety and effectiveness related concerns (n=276) regarding the side effects of a potential vaccine developed at an unprecedented speed. Conclusion: Our findings suggest a need to formulate a large-scale vaccine communication plan that will address the safety concerns and debunk the misinformation and conspiracy theories spreading across social media platforms, increasing the public's acceptance of a COVID-19 vaccination.

Introduction: The COVID-19 pandemic has impacted biopsychosocial health and wellbeing globally. Pre-pandemic studies suggest a high prevalence of common mental disorders, including anxiety and depression in South Asian countries, which may aggravate during this pandemic. This systematic meta-analytic review was conducted to estimate the pooled prevalence of anxiety and depression in South Asian countries during the COVID-19 pandemic. Method: We systematically searched for cross-sectional studies on eight major bibliographic databases and additional sources up to October 12, 2020, that reported the prevalence of anxiety or depression in any of the eight South Asian countries. A random-effects model was used to calculate the pooled proportion of anxiety and depression. Results: A total of 35 studies representing 41,402 participants were included in this review. The pooled prevalence of anxiety in 31 studies with a pooled sample of 28,877 was 41.3% (95% confidence interval [CI]: 34.7-48.1, I2 = 99.18%). Moreover, the pooled prevalence of depression was 34.1% (95% CI: 28.9-39.4, I2 = 99%) among 37,437 participants in 28 studies. Among the South Asian countries, India had a higher number of studies, whereas Bangladesh and Pakistan had a higher pooled prevalence of anxiety and depression. No studies were identified from Afghanistan, Bhutan, and Maldives. Studies in this review had high heterogeneity and varying prevalence across sub-groups. Conclusion: South Asian countries have high prevalence rates of anxiety and depression, suggesting a heavy psychosocial burden during this pandemic. Clinical and public mental health interventions should be prioritized alongside improving the social determinants of mental health in these countries. Lastly, a low number of studies with high heterogeneity requires further research exploring the psychosocial epidemiology during COVID-19, which may inform better mental health policymaking and practice in South Asia.

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