USC review: National plan needed to address COVID mental health impacts

A new USC review article catalogues both the physical toll taken by the coronavirus pandemic as well as the effects on mental health.

“The mental health and illness aspects of COVID-19 are among the most important side effects of this pandemic which requires a national plan for prevention, diagnosis and treatment,” the authors state in the article, titled “COVID-19: Review of a 21st Century Pandemic from Etiology to Neuro-Psychiatric Implications” and published Sept. 15 in the Journal of Alzheimer’s Disease.

“This is one of the most comprehensive review articles about the COVID19 at the time of the publication,” says lead author Vicky Yamamoto, PhD, a research associate from the Department of Otolaryngology-Head and Neck Surgery. “Early prediction of the risk of severe coronavirus disease as well as minimizing the risk of malnutrition, sepsis, and life-threatening conditions secondary to COVID-19 are crucial to improve the outcome, and this requires a multi-disciplinary team to treat hospitalized COVID-19 patients.”

Researchers reviewed more than 1,000 articles and cited 425 references from online databases to reach their conclusions. It’s like a biography of the virus so far, including its mechanism of infection, diagnostics, therapeutics and treatment strategies, as well as how COVID-19 patients require rehabilitation and psychological and nutritional support. Proper pain management for patients “is essential,” the authors write. “Providers need to be aware of when, and how much pain medications/sedatives to give the patient, since this could have an impact on their physiology and cognition which could potentially mask or cause metabolic encephalopathy,” a chemical imbalance in the brain that can alter behavior.

“COVID-19 has had an enormous impact on physical and mental health, as self-isolation has not only contributed to economic hardship but has possibly also led to higher morbidity and mortality rates from anxiety, suicide, depression, PTSD, and other mental illnesses,” the article states. “The fear of becoming infected may itself discourage those with underlying comorbidities requiring medical attention, such as cardiovascular events, to seek medical care thus potentially aggravating their condition and risking death.”

“The COVID-19 pandemic has affected so many facets of our society, and is a threat to the population on a global basis. It has brought together scientists from all areas of medicine, each giving their unique specialized viewpoints and expertise contributing to a group effort, such as this scientific project, in order to best disseminate valid and evidence-based data” says Jeffrey Wang, MD, professor of orthopaedic surgery (clinical scholar) at the Keck School and co-director of the USC Spine Center.

“Implementing communication, coordination, and collaboration in a timely fashion (C3T), can significantly impact the outcome of care for the COVID-19 patients,” says Babak Kateb, MD, the senior author, and a USC alumnus. He continued “ herd immunity is not an option and predicting, preventing and treating stages of COVID19 including 1) ARDS, 2) Cytokine Storm, 3) Acute Hypercoagulable state 4) Sepsis, 5) Autonomic Dysfunction will determine the patient outcome”

In conclusion, the authors “recommend facemasks, physical distancing, and personal hygiene as preventative measures, and other promising medications/therapeutic approaches listed in this paper be used for therapy.” Until the safe and effective therapies and vaccines become available, the authors stress the importance of “understand the importance of the transmission pathway of COVID-19 to inform the general population better and make practical guidelines to manage better and limit the spread.”