COVID-19 is one of the main pathogens that chiefly affect the respiratory system of the human body. Earlier outbreaks of this virus include the Middle East respiratory syndrome (MERS-CoV) and the severe acute respiratory syndrome (SARS-CoV-2) which were formerly characterized as threat to public health [1]. Nevertheless, COVID-19 demonstrated some distinctive clinical features targeting respiratory tract symptoms like sneezing, sore throat and rhinorrhea [2]. Particularly dyspnea and fatigue were persistent in 87.4% of patients who had recovered from COVID-19, after negative PCR test [3].
In December 2019 five patients were admitted to the hospital having acute respiratory distress syndrome. 41 patients were hospitalized by January 2, 2020 and have been diagnosed with positive COVID-19 infection, around half of these patients had some underlying diseases which include hypertension, diabetes and cardiovascular diseases. The cumulative incidence of positive COVID-19 cases reached 5502 in China on January 29, 2020. And by January 30, 2020, almost 7734 positive cases have been identified in China and from several countries including Nepal, Sri Lanka, Japan, Republic of Korea, Singapore, Cambodia, United States of America, Canada, India, France, Germany, Finland, The Philippines, Thailand, Taiwan, and Malaysia [4]. In Pakistan, first case of COVID-19 was confirmed in February 2020. Considering the increasing number of confirmed cases in 2021 along with deficits in the healthcare delivery system, the viral disease spread just like wildfire across country.
After around an incubation period of 5 days, symptoms of COVID-19 start appearing which in few cases might lead to fatality. The time period between the onset of symptoms of COVID-19 and death ranges from 6 to 41 days. This time period depends upon many factors such as age and strength of patient’s immunity. Among older people, this period is relatively much shorter compared to people younger than 70 years of age. Cough, fever, fatigue are common occurring symptoms of COVID-19. While other symptoms include headache, hemoptysis, diarrhea and dyspnea etc. [5].
Pandemics are associated with the high level of mental stress. Fear, uncertainty, and stigma exist in any biological calamity, and they might operate as roadblocks to adequate mental therapy. Individuals are affected psychologically by the distress and uncertainty produced by the absence of proper management strategies for the COVID-19 pandemic. It has the potential to cause psychological disturbances [6]. Moreover, quarantine over an extended length of time might result in psychological stress reactions. Individuals who were confined to their homes tended to utilize social media to learn about the epidemic, exposing them to false information and unverified stories [7].
In many countries, general people reported the high level of depression, anxiety, psychological distress, post-traumatic stress disorder during a recent pandemic. Major risk factors related to mental disorders during COVID-19 pandemic are younger age, female gender, co-morbid diseases, other psychiatric disorders, and students by occupation, unemployment, more exposure to news or social media information concerning COVID-19 [8].
Emergence of COVID-19 outbreak relevant to Severe Acute Respiratory Syndrome COVID-19 2 (SARS-CoV-2) infection from China, a situation of severe psychological distress and socio-economic crisis speedily occurred worldwide. This psychological distress includes anxiety, frustration, stress and depression led to a vague situations which emerged progressively during this outbreak [9]. Many tools are available to measure different aspects of mental status or psychological well-being, among which impact of event scale (IES-R), patient health questionnaire-9(PHQ-9) and corona anxiety scale (CAS) are used in this study to measure stress, depression and anxiety.
Being a low-middle income country, Pakistan encountered lots of health care challenges in the last many decades. The country had to endure many devastating effects of epidemics on people in terms of economic loss, morbidity and mortality [10]. Economical security, fear, mental health uncertainty are a few devastating impacts of the COVID-19 pandemic and lockdown resulting from it.
Pakistan, being a developing country with limited resources lack proper surveillance systems, trained human resources and laboratory networks. Within limited resources Pakistan has made strategies sufficient to prepare for dealing this global breakout [11]. However, to prevent various negative consequences, mental and psychological strategies are required. For this purpose, this study aims to investigate mental health status of people who survived this alarming situation of the COVID-19.
