Treating acute anxiety in patients with COVID-19

Khawam, Elias; Khouli, Hassan; Pozuelo, Leo

doi:10.3949/ccjm.87a.ccc016

Cited by 31 publications

(36 citation statements)

References 9 publications

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“…A 20 min single session exergame at moderate intensity were able to significantly reduce the levels of anxiety in healthy person and 8 week exergames performed 2 days per week (60 min per session ) was demonstrated to alleviate the anxiety levels in patients ( 30 – 32 ). For Covid-19 patients, relaxation techniques and breathing exercises were recommend as one of the interventions to improve acute anxiety, although more evidence is needed ( 33 ). Furthermore, a study on college students demonstrated daily physical activity confers beneficial effects in reducing Covid-19-induced stress and anxiety ( 34 ).…”

Section: Exercise As An Intervention For Anxiety and Depression Durinmentioning

confidence: 99%

Beneficial Effects of Exercise on Depression and Anxiety During the Covid-19 Pandemic: A Narrative Review

Tucker

et al. 2020

Front. Psychiatry

103

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First reported in Dec 2019, the on-going COVID-19 pandemic has become a public health emergency of international concern (PHEIC). The isolation and quarantine during the COVID-19 pandemic limited the physical and social activities of the population, which contributed to the increased prevalence of mental disorder. Depression and anxiety are the most common mental illnesses conferring a serious impact on individuals' life quality. This review summarizes the mental health consequences of COVID-19, especially for depression and anxiety. Exercise as an intervention for anxiety and depression has been demonstrated in both of the animal studies and human clinical trials. The underlying mechanism including the regulation on the production of brain-derived neurotrophic factor (BDNF), D-β-hydroxybutyrate, synaptic transmission, hypothalamic pituitary adrenal (HPA) axis, tryptophan hydroxylase, GSK3β/β-catenin pathway, neuroinflammation, oxidative stress and PGC-1α1-PPAR axis. In addition, we summarized the exercise strategies to fight against anxiety and depression according to the information from American College of Sports Medicine (ACSM), World Health Organization and recent literatures about physical exercise during COVID-19.

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Section: Exercise As An Intervention For Anxiety and Depression Durinmentioning

confidence: 99%

Beneficial Effects of Exercise on Depression and Anxiety During the Covid-19 Pandemic: A Narrative Review

Tucker

et al. 2020

Front. Psychiatry

103

View full text Add to dashboard Cite

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“…8. Psychotherapycognitive-behavioural therapy (CBT) is a first line treatment for anxiety (Bate and Malberg 2020;Fineberg, Van Ameringen et al 2020;Khawam et al 2020;Renjun et al 2020). 9.…”

Section: D)mentioning

confidence: 99%

Presentation and management of anxiety in individuals with acute symptomatic or asymptomatic COVID-19 infection, and in the post-COVID-19 recovery phase

Uzunova

Pallanti

Hollander

2021

International Journal of Psychiatry in Clinical Practice

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COVID-19 is associated with neuropsychiatric complications, the most frequent one being anxiety. Multiple biological and psychosocial factors contribute to anxiety in COVID-19. Among the biological factors, stress, genetics, gender, immune system, resilience, anosmia, hypogeusia, and central nervous system infection with SARS-CoV-2 are key. Anxiety is a complication of COVID-19 that may exacerbate the infection course, and the infection may exacerbate anxiety. We present the mechanisms of anxiety in symptomatic or asymptomatic COVID-19. We discuss the presentation of anxiety in patients without or with prior psychiatric illness, and with co-morbidities. Timely diagnosis and management of anxiety in COVID-19 patients is important. Given the frequent complication of COVID-19 with Acute Respiratory Distress Syndrome and Intensive Care Unit stay, anxiety may be a long-term complication. We review the diagnostic tools for anxiety in COVID-19, and summarise pharmacologic and non-pharmacologic treatments. We provide recommendations for diagnosis, treatment, prevention and follow up of anxiety in COVID-19. KEY POINTS Patients with COVID-19 (symptomatic or asymptomatic) exhibit a high frequency of neuropsychiatric complications with highest percentage attributed to anxiety. Multiple biological and psychosocial risk factors for anxiety exist in COVID-19-ill individuals. Biological risk factors include stress, resilience, genetics, gender, age, immune system, direct infection of the central nervous system (CNS) with SARS-CoV-2, comorbid psychiatric and general medical illnesses, ARDS and ICU stay. Anosmia and hypogeusia are COVID-19-specific anxiety risk factors. Knowledge of the anxiety risk factors is essential to focus on timely interventions, because anxiety may be a complication of and exacerbate the COVID-19 course. An inverse correlation exists between resilience and anxiety because of COVID-19, and therefore efforts should be made to increase resilience in COVID-19 patients. In COVID-19, important anxiety mechanism is neuroinflammation resulting from activation of the immune system and an ensuing cytokine storm. The general approach to management of anxiety in COVID-19 should be compassionate, similar to that during trauma or disaster, with efforts focussed on instilling a sense of hope and resilience. In selecting pharmacological treatment of anxiety, the stress response and immune system effects should be key. Medications with cardio-respiratory adverse effects should be avoided in patients with respiratory problems. Anxiety is a disorder that will require for long-term follow up at least one month after COVID-19.

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“…Although research has provided a description of the psychological impact of COVID-19 [ 16 ], the literature regarding interventions or guidelines for managing the mental health impacts of the virus is limited [ 17 ]. Countries that were impacted initially by the COVID-19 pandemic identified several problems that increased the difficulty of providing psychological interventions during the pandemic, including barriers to participation, limited efficiency of outreach, and limited capacity of frontline workers to provide support due to competing demands on their time and energy [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Changes in Stress, Anxiety, and Depression Levels of Subscribers to a Daily Supportive Text Message Program (Text4Hope) During the COVID-19 Pandemic: Cross-Sectional Survey Study

Agyapong¹,

Hrabok²,

Vuong³

et al. 2020

JMIR Ment Health

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Background In addition to the obvious physical medical impact of COVID-19, the disease poses evident threats to people’s mental health, psychological safety, and well-being. Provision of support for these challenges is complicated by the high number of people requiring support and the need to maintain physical distancing. Text4Hope, a daily supportive SMS text messaging program, was launched in Canada to mitigate the negative mental health impacts of the pandemic among Canadians. Objective This paper describes the changes in the stress, anxiety, and depression levels of subscribers to the Text4Hope program after 6 weeks of exposure to daily supportive SMS text messages. Methods We used self-administered, empirically supported web-based questionnaires to assess the demographic and clinical characteristics of Text4Hope subscribers. Perceived stress, anxiety, and depression were measured with the 10-Item Perceived Stress Scale (PSS-10), the Generalized Anxiety Disorder–7 (GAD-7) scale, and the Patient Health Questionnaire–9 (PHQ-9) scale at baseline and sixth week time points. Moderate or high perceived stress, likely generalized anxiety disorder, and likely major depressive disorder were assessed using cutoff scores of ≥14 for the PSS-10, ≥10 for the GAD-7, and ≥10 for the PHQ-9, respectively. At 6 weeks into the program, 766 participants had completed the questionnaires at both time points. Results At the 6-week time point, there were statistically significant reductions in mean scores on the PSS-10 and GAD-7 scales but not on the PHQ-9 scale. Effect sizes were small overall. There were statistically significant reductions in the prevalence rates of moderate or high stress and likely generalized anxiety disorder but not likely major depressive disorder for the group that completed both the baseline and 6-week assessments. The largest reductions in mean scores and prevalence rates were for anxiety (18.7% and 13.5%, respectively). Conclusions Text4Hope is a convenient, cost-effective, and accessible means of implementing a population-level psychological intervention. This service demonstrated significant reductions in anxiety and stress levels during the COVID-19 pandemic and could be used as a population-level mental health intervention during natural disasters and other emergencies. International Registered Report Identifier (IRRID) RR2-10.2196/19292

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Treating acute anxiety in patients with COVID-19

Cited by 31 publications

References 9 publications

Beneficial Effects of Exercise on Depression and Anxiety During the Covid-19 Pandemic: A Narrative Review

Beneficial Effects of Exercise on Depression and Anxiety During the Covid-19 Pandemic: A Narrative Review

Presentation and management of anxiety in individuals with acute symptomatic or asymptomatic COVID-19 infection, and in the post-COVID-19 recovery phase

Changes in Stress, Anxiety, and Depression Levels of Subscribers to a Daily Supportive Text Message Program (Text4Hope) During the COVID-19 Pandemic: Cross-Sectional Survey Study

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