Mild severity COVID-19 mental health implications for patients in Greece: a qualitative study

Despoina Symintiridou, Ilias Pagkozidis, Stavroula Mystakidou, Charis Birtsou, Stella Ploukou, Stavroula Begou, Martha Andreou, Michael Dandoulakis, Elias Theodoropoulos, Chrysanthi Manolaki, Ioanna Avakian, Efthymia Makridou, Christina Avgerinou, Dimitra Iosifina Papageorgiou, Emmanouil Smyrnakis

Keywords: COVID-19, mental health, primary health care, Greece

Background:

Patients infected with COVID-19 who were quarantined and socially isolated, as well as those who were surrounded by incorrect information and misinformation, were more susceptible to unpleasant emotions such as panic and terror. The psychological repercussions of quarantine were aggravated by the detrimental effects of restricted physical activity and nutritional modifications among quarantined individuals.

Research questions:

How was the mental wellbeing of Covid-19 patients affected during the isolation?

Method:

This is a qualitative study. Adult patients with mild COVID-19 and confined at home participated in semi-structured interviews, conducted between week 2 and 3 after the diagnosis. Prior to participant enrolment, written informed consent was obtained. The interview guide focused on the illness, the management of the isolation weeks, the participants’ knowledge and perceptions and the suggestions for improvement. Interviews were audio-recorded, verbatim transcribed and analyzed with thematic analysis.

Results:

After 37 interviews data saturation was achieved. A commonly reported negative feeling is fear. Participants report fear and insecurity about their condition and possible illness consequences (short-term and long-term complications, relapse, need for hospitalization and death), the fear of infecting others especially vulnerable family members in combination with a sense of guilt, and concerns about the economic impact of their illness on their family. Feelings of loneliness caused by isolation and concerns about social stigma were also reported. In some cases fear emerges with somatic symptoms such as insomnia, panic attacks and anxiety disorders. Participants indicate that receiving timely medical evaluation and psychological assistance, as well as having access to reliable sources of information could alleviate these concerns.

Conclusions:

Fear, insecurity and manifestations such as sleep and anxiety disorders in mild Covid-19 patients are detrimental to their mental wellbeing. Primary healthcare interventions in coordination with mental health services, delivered even to mild Covid-19 patients, could significantly assist in the management of long-term psychological consequences.

Points for discussion:

Are there any examples of mental health services for homebound COVID-19 patients provided by primary healthcare?

Is the use of telemedicine services adequate to alleviate the burden COVID-19 puts on patients' mental health?

#147