Abstract
Background: The twenty-first century viral respiratory epidemics have taught us valuable lessons. Our systematic review examined the impact of these epidemics, including coronavirus disease 2019 (COVID-19), on mental health among different population groups, drawing on their insights for recommendations for the current COVID-19 pandemic.Methods: Searches were performed on PubMed, Embase, PsycINFO, Web of Science, Scopus, CINAHL, and Cochrane on April 4, 2020. Studies that had undefined mental health outcomes or did not use a validated scale for measure were excluded. Quality assessment was carried out via the Newcastle–Ottawa Scale.Results: We included 95 studies, most of which were conducted in Hong Kong (31.6%) and China (21.4%). A total of 30 (30.9%) studies are on the general public, 41 (42.2%) on healthcare workers, and 26 (26.6%) on patients and quarantined individuals. Furthermore, 36 (37.1%) of the studies are of high quality, 48 (49.5%) are of moderate quality, and 13 (13.4%) are of low quality. The most significant mental health outcomes reported include anxiety, depression, and post-traumatic stress disorder symptoms. The subgroups identified to have a higher risk of psychiatric symptoms among the general public include females, the elderly, individuals with chronic illness, migrant workers, and students. Long-term mental health impact was reported in some healthcare workers and epidemic patients, even up to 3 years in the former. Interestingly, when compared to non-quarantined groups, quarantine was not significantly associated with worse mental health outcomes.Conclusion: Important implications for the COVID-19 pandemic were highlighted. Respiratory epidemics pose a significant psychological morbidity onto many population groups. Psychological support for vulnerable groups, including healthcare workers and patients, should be implemented to prevent them from spiraling into clinical psychiatric conditions.
Highlights
Respiratory epidemics erupted around the world at an unprecedented level in recent years
We explore the relationship between viral respiratory epidemics in the 21st century and their impact on mental health in populations around the world— the general public, healthcare workers and students, patients of the epidemics, and quarantined individuals
We identified 270 potential articles and excluded 175 papers after examination of full text
Summary
Respiratory epidemics erupted around the world at an unprecedented level in recent years. In 2002, severe acute respiratory syndrome coronavirus (SARS-CoV) resulted in an epidemic involving 26 countries and more than 8,000 people [1]. This was soon followed by the influenza A/H1N1 pandemic, the Middle East Respiratory Syndrome (MERS) epidemic, and the influenza A/H7N9 epidemic. Patients who were impacted with the novel respiratory illness had to face the risk of mortality and long-term functional impairment [8]. Our systematic review examined the impact of these epidemics, including coronavirus disease 2019 (COVID-19), on mental health among different population groups, drawing on their insights for recommendations for the current COVID-19 pandemic
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