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      The psychological impact of the COVID-19 pandemic on medical students in Turkey

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          Abstract

          Objective:

          We aimed to investigate the knowledge of medical students about COVID-19, the effects of the traumatic situation they experienced, the stress they perceived and the factors affecting them. In addition, we aimed to learn the thoughts of the students about the virus due to the uncertainties.

          Methods:

          The study was carried out online between April 30, May 5, 2020 with a questionnaire prepared with googleforms. For the study, all students studying at the Faculty of Medicine of Istanbul Yeni Yüzyıl University were called through class representatives and WhatsApp class groups. The questionnaire included sociodemographic information, knowledge and sources of information about the disease, to agreement degree the proposition whether covid 19 is produced as a biological weapon. The Perceived Stress Scale (PSS) and Impact of Events Scale-Revised (IES-R) were applied.

          Results:

          The total number of participants was 275 students. No student was infected with COVID-19 at the time of the survey. The presence of chronic disease in the participants was found to be a factor that increased anxiety (p = 0.01). Majority of participants (60.40%) stated that they agree with COVID-19 is a biological weapon. The mean scores of women ‘s total PSS and IES-R were higher than men. It was found that the families of the students had a lower monthly income than the minimum monthly wage is increasing the anxiety about getting COVID-19 infection and perceived stress. One-third of the students reported that sleep and appetite were impaired than the before pandemic. The announcements and website of Ministry of Health and the social media was the main source of information of the participants.

          Conclusions:

          It was found that medical students were highly worried about being infected with COVID-19. The scores obtained from the pre-clinic students’ anxiety to become infected with COVID-19, PSS and IES-R total scores were found to be significantly higher than their clinical students.

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          Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

          Fei Zhou, Ting Yu, Ronghui Du … (2020)
          Summary Background Since December, 2019, Wuhan, China, has experienced an outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Epidemiological and clinical characteristics of patients with COVID-19 have been reported but risk factors for mortality and a detailed clinical course of illness, including viral shedding, have not been well described. Methods In this retrospective, multicentre cohort study, we included all adult inpatients (≥18 years old) with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital (Wuhan, China) who had been discharged or had died by Jan 31, 2020. Demographic, clinical, treatment, and laboratory data, including serial samples for viral RNA detection, were extracted from electronic medical records and compared between survivors and non-survivors. We used univariable and multivariable logistic regression methods to explore the risk factors associated with in-hospital death. Findings 191 patients (135 from Jinyintan Hospital and 56 from Wuhan Pulmonary Hospital) were included in this study, of whom 137 were discharged and 54 died in hospital. 91 (48%) patients had a comorbidity, with hypertension being the most common (58 [30%] patients), followed by diabetes (36 [19%] patients) and coronary heart disease (15 [8%] patients). Multivariable regression showed increasing odds of in-hospital death associated with older age (odds ratio 1·10, 95% CI 1·03–1·17, per year increase; p=0·0043), higher Sequential Organ Failure Assessment (SOFA) score (5·65, 2·61–12·23; p<0·0001), and d-dimer greater than 1 μg/mL (18·42, 2·64–128·55; p=0·0033) on admission. Median duration of viral shedding was 20·0 days (IQR 17·0–24·0) in survivors, but SARS-CoV-2 was detectable until death in non-survivors. The longest observed duration of viral shedding in survivors was 37 days. Interpretation The potential risk factors of older age, high SOFA score, and d-dimer greater than 1 μg/mL could help clinicians to identify patients with poor prognosis at an early stage. Prolonged viral shedding provides the rationale for a strategy of isolation of infected patients and optimal antiviral interventions in the future. Funding Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences; National Science Grant for Distinguished Young Scholars; National Key Research and Development Program of China; The Beijing Science and Technology Project; and Major Projects of National Science and Technology on New Drug Creation and Development.
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            Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China

            Cuiyan Wang, Riyu Pan, Xiaoyang Wan … (2020)
            Background: The 2019 coronavirus disease (COVID-19) epidemic is a public health emergency of international concern and poses a challenge to psychological resilience. Research data are needed to develop evidence-driven strategies to reduce adverse psychological impacts and psychiatric symptoms during the epidemic. The aim of this study was to survey the general public in China to better understand their levels of psychological impact, anxiety, depression, and stress during the initial stage of the COVID-19 outbreak. The data will be used for future reference. Methods: From 31 January to 2 February 2020, we conducted an online survey using snowball sampling techniques. The online survey collected information on demographic data, physical symptoms in the past 14 days, contact history with COVID-19, knowledge and concerns about COVID-19, precautionary measures against COVID-19, and additional information required with respect to COVID-19. Psychological impact was assessed by the Impact of Event Scale-Revised (IES-R), and mental health status was assessed by the Depression, Anxiety and Stress Scale (DASS-21). Results: This study included 1210 respondents from 194 cities in China. In total, 53.8% of respondents rated the psychological impact of the outbreak as moderate or severe; 16.5% reported moderate to severe depressive symptoms; 28.8% reported moderate to severe anxiety symptoms; and 8.1% reported moderate to severe stress levels. Most respondents spent 20–24 h per day at home (84.7%); were worried about their family members contracting COVID-19 (75.2%); and were satisfied with the amount of health information available (75.1%). Female gender, student status, specific physical symptoms (e.g., myalgia, dizziness, coryza), and poor self-rated health status were significantly associated with a greater psychological impact of the outbreak and higher levels of stress, anxiety, and depression (p < 0.05). Specific up-to-date and accurate health information (e.g., treatment, local outbreak situation) and particular precautionary measures (e.g., hand hygiene, wearing a mask) were associated with a lower psychological impact of the outbreak and lower levels of stress, anxiety, and depression (p < 0.05). Conclusions: During the initial phase of the COVID-19 outbreak in China, more than half of the respondents rated the psychological impact as moderate-to-severe, and about one-third reported moderate-to-severe anxiety. Our findings identify factors associated with a lower level of psychological impact and better mental health status that can be used to formulate psychological interventions to improve the mental health of vulnerable groups during the COVID-19 epidemic.
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              Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019

              Jianbo Lai, Simeng Ma, Ying Wang … (2020)
              Key Points Question What factors are associated with mental health outcomes among health care workers in China who are treating patients with coronavirus disease 2019 (COVID-19)? Findings In this cross-sectional study of 1257 health care workers in 34 hospitals equipped with fever clinics or wards for patients with COVID-19 in multiple regions of China, a considerable proportion of health care workers reported experiencing symptoms of depression, anxiety, insomnia, and distress, especially women, nurses, those in Wuhan, and front-line health care workers directly engaged in diagnosing, treating, or providing nursing care to patients with suspected or confirmed COVID-19. Meaning These findings suggest that, among Chinese health care workers exposed to COVID-19, women, nurses, those in Wuhan, and front-line health care workers have a high risk of developing unfavorable mental health outcomes and may need psychological support or interventions.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Pak J Med Sci
                Journal ID (iso-abbrev): Pak J Med Sci
                Title: Pakistan Journal of Medical Sciences
                Publisher: Professional Medical Publications (Pakistan )
                ISSN (Print): 1682-024X
                ISSN (Electronic): 1681-715X
                Publication date (Print): Sep-Oct 2020
                Volume: 36
                Issue: 6
                Pages: 1355-1359
                Affiliations
                [1 ]Prof. Dr. Fuat Torun, Department of Psychiatry, Istanbul Yeni Yuzyil University Medical Faculty, Istanbul, Turkey
                [2 ]Dr. Sebahat Dilek Torun, Associate Professor, Department of Public Health, Bahcesehir University Medical Faculty, Istanbul, Turkey
                Author notes
                Correspondence: Prof. Dr. Fuat Torun Istanbul Yeni Yuzyil University, Medical Faculty, Psychiatry Department/ Gaziosmanpasa, Istanbul, Turkey. E-mail. fuattorun@ 123456hotmail.com
                Article
                Publisher ID: PJMS-36-1355
                DOI: 10.12669/pjms.36.6.2985
                PMC ID: 7501012
                PubMed ID: 32968408
                SO-VID: bb14acd2-3723-4b1e-95e3-eba7f7790ce9
                Copyright © Copyright: © Pakistan Journal of Medical Sciences
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 30 May 2020
                Date revision received : 08 June 2020
                Date revision received : 25 June 2020
                Date accepted : 05 July 2020
                Categories
                Subject: Original Article

                Keywords: novel coronavirus,medical students,perceived stress,impact of events,anxiety
                Data availability:
                Keywords: novel coronavirus, medical students, perceived stress, impact of events, anxiety

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