Global occurrence of depressive symptoms during the COVID-19 pandemic.

OBJECTIVE: This study aimed to estimate the occurrence of depressive symptoms in a global population of young, middle-aged and older adults amid the COVID-19 pandemic. Study data also assessed the impact of the social restrictions caused by the pandemic on depressive symptomatology. METHODS: A self-administered internet-based survey was completed by 111,225 individuals residing in 176 countries (March-April 2020). We retained: demographic data, depressive symptoms (PHQ8), anxieties specific to the COVID-19, personality traits (Big-Five Personality Questionnaire), comorbidity frequency, health quality, behavioral variables (i,e., staying at home, avoiding social gatherings, social distancing in the past week). Occurrence of depressive symptoms was estimated using standard cut-offs (total PHQ8 score ≥ 10). Hierarchical regression modeling examined correlates of depressive symptoms (PHQ8 score) in three groups stratified by age, i.e., 18-34, 35-54 and 55+ years. RESULTS: Moderate to severe depressive symptoms were present in 27% of young, 15% middle-aged and 9% older adults. Younger age, female gender, not partnered, higher anxiety, and poorer health were associated with elevated depressive symptoms. Staying at home/not attending social gatherings were minor contributors to depressive symptoms in young and middle-aged adults. These were not significant in older adults. Social distancing was a marginal contributor in middle-aged and near significant in older adults, but not significant in young adults. CONCLUSIONS: The occurrence of depressive symptoms is decreasing with advancing age. Increased risk of depressive symptoms was associated with being a younger adult, females, single/divorced, poorer health and higher anxiety. In all age groups, the presence of depressive symptoms was greater than global estimates preceding the COVID-19 pandemic. Social restrictions amid the COVID-19 pandemic were marginal risks for depressive symptoms.

Brain abnormalities in COVID-19 acute/subacute phase: A rapid systematic review.

OBJECTIVE: This systematic review aimed to synthesize early data on typology and topography of brain abnormalities in adults with COVID-19 in acute/subacute phase. METHODS: We performed systematic literature search via PubMed, Google Scholar and ScienceDirect on articles published between January 1 and July 05, 2020, using the following strategy and key words: ((covid[Title/Abstract]) OR (sars-cov-2[Title/Abstract]) OR (coronavirus[Title/Abstract])) AND (brain[Title/Abstract]). A total of 286 non-duplicate matches were screened for original contributions reporting brain imaging data related to SARS-Cov-2 presentation in adults. RESULTS: The selection criteria were met by 26 articles (including 21 case reports, and 5 cohort studies). The data analysis in a total of 361 patients revealed that brain abnormalities were noted in 124/361 (34%) reviewed cases. Neurologic symptoms were the primary reason for referral for neuroimaging across the studies. Modalities included CT (-angiogram, -perfusion, -venogram), EEG, MRI (-angiogram, functional), and PET. The most frequently reported brain abnormalities were brain white matter (WM) hyperintensities on MRI 66/124 (53% affected cases) and hypodensities on CT (additional 23% affected cases), followed by microhemorrhages, hemorrhages and infarcts, while other types were found in <5% affected cases. WM abnormalities were most frequently noted in bilateral anterior and posterior cerebral WM (50% affected cases). CONCLUSION: About a third of acute/subacute COVID-19 patients referred for neuroimaging show brain abnormalities suggestive of COVID-19-related etiology. The predominant neuroimaging features were diffuse cerebral WM hypodensities / hyperintensities attributable to leukoencephalopathy, leukoaraiosis or rarefield WM.