Psychological Resilience, Coping, and Distress in Admitted Patients With COVID-19 Infection.

Objective: To assess psychological resilience, coping, and related psychological distress in admitted COVID-19 patients. Predictors of subsequent development of posttraumatic stress symptoms (PTSS) and disability were also studied.Methods: Stable inpatients with COVID-19 (aged > 18 years with mild symptoms) admitted to a tertiary care hospital from April 2020 to December 2020 were recruited for the study. During admission, the patients were assessed for resilience, coping, and psychological distress using the 10-item Connor-Davidson Resilience Scale (CD-RISC-10), Brief COPE (Coping Orientation to Problems Experienced), and 4-item Patient Health Questionnaire (PHQ-4). Similarly, they were assessed at 4 weeks after discharge using the PTSD Checklist for DSM-5 and World Health Organization Disability Assessment Schedule.Results: A total of 176 patients were recruited for the study and assessed during their admission, and 102 were reassessed during follow-up. Of the patients, 17.6% during admission and 58.8% at follow-up had significant psychological distress (PHQ-4 score > 2). The mean ± SD CD-RISC-10 score was 27.94 ± 5.82. The most used coping strategies were emotional support, religion, and acceptance. Increased resilience was associated with better education (rs[100] = 0.265, P = .007), less psychological distress (r[100] = -0.596, P = .001), and healthy coping strategies. PHQ-4, PCL-5, and disability scores at follow-up were positively correlated (Pearson correlation). The multiple regression model statistically significantly predicted PTSS (F7, 94 = 2.660, P < .015, adjusted R2 = 0.103).Conclusions: COVID-19 patients with better resilience are associated with reduced psychological distress. Better resilient traits and reduced psychological distress may prevent ensuing PTSS and disability.

Loneliness and Social Isolation: Determinants of Cardiovascular Outcomes.

One in three Americans report experiencing loneliness in everyday life, a number that has grown exponentially over the last few decades. As we respond to the SARS-COV2 pandemic with quarantine and social distancing, social isolation and feelings of loneliness are increasing among people of all ages. This presents as an opportune time to recognize the public health impact of these important psychosocial determinants. Loneliness and social isolation are associated with a higher incidence of CVD, higher healthcare utilization and worse outcomes even after controlling for conventional risk factors of CVD. In this review, we discuss loneliness and social isolation as determinants of cardiovascular outcomes, the pathophysiology of this association, and its implications in clinical practice. We discuss some of the shortcomings in the assessment of loneliness and social isolation while identifying the most commonly used rating scales for the same. Finally, we suggest modifications to interventions for loneliness and social isolation during the COVID-19 pandemic.

Smoking Doubles the Mortality Risk in COVID-19: A Meta-Analysis of Recent Reports and Potential Mechanisms.

Introduction Studies have reported conflicting results regarding the effect of smoking on outcome in coronavirus disease 2019 (COVID-19) patients, but the results have been conflicting. In this meta-analysis, we systematically examined the association between smoking and mortality in COVID-19. Methods PubMed database was searched to look for relevant articles. Inclusion criteria were as follows: (1) cohort studies or case series studies; (2) study population included individuals with a confirmed COVID-19 infection; (3) the status of smoking was reported, regardless if it was current or in the past; and (4) mortality among smokers was reported in the study or could be calculated and compared to non-smokers. Mortality rates were pooled using a random effects model. Risk ratio (RR) and its 95% confidence interval (CI) were also calculated using the same model. Another meta-analysis was then performed to assess the difference in mortality between current and former smokers. Results Ten studies with a total of 11,189 patients were included. Mortality among smokers was 29.4% compared to 17.0% among non-smokers. RR was 2.07 (95% CI: 1.59, 2.69). Based on analysis of four studies (532 patients), there was no difference in mortality risk between current and former smokers (RR: 1.03; 95% CI: 0.75, 1.40). Conclusions Smoking, current or past, is associated with higher mortality in COVID-19 patients. Mortality among current smokers was about 50% greater than former smokers, but the difference was not statistically significant.