Mental health of individuals infected with SARS-CoV-2 during mandated isolation and compliance with recommendations-A population-based cohort study

PLoS One. 2022 Mar 16;17(3):e0264655. doi: 10.1371/journal.pone.0264655. eCollection 2022.

Abstract

Background: Isolation is an indispensable measure to contain the SARS-CoV-2 virus, but it may have a negative impact on mental health and overall wellbeing. Evidence on the isolation experience, facilitating and complicating factors is needed to mitigate negative effects.

Methods and findings: This observational, population-based cohort study enrolled 1547 adults from the general population with SARS-CoV-2 infection reported to authorities between 27 February 2020 and 19 January 2021 in Zurich, Switzerland. We assessed the proportion of individuals reporting symptoms of depression and anxiety before, during and after isolation (by DASS-21), and queried worries, positive experiences, and difficulties. We analyzed the association of these outcomes with socio-demographics using ordinal regression. Additionally, we report free-text statements by participants to capture most important aspects of isolation. The proportion of participants affected by depression or anxiety increased during isolation from 10·0% to 17·1% and 9·1% to 17·6%, respectively. Ordinal regression showed that taking care of children increased the difficulty of isolation (OR 2·10, CI 1·43-3·08) and risk of non-compliance (OR 1·63, CI 1·05-2·53), especially in younger participants. A facilitating factor that individuals commonly expressed was receiving more support during isolation.

Conclusion: Isolation due to SARS-CoV-2 presents a mental burden, especially for younger individuals and those taking care of children. Public health authorities need to train personnel and draw from community-based resources to provide targeted support, information, and guidance to individuals during isolation. Such efforts could alleviate the negative impact isolation has on the mental and physical health of individuals and ensure compliance of the population with recommendations.

Publication types

  • Clinical Trial
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anxiety Disorders / epidemiology*
  • Anxiety Disorders / psychology
  • COVID-19 / psychology*
  • Cohort Studies
  • Depression / epidemiology*
  • Depression / psychology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance / psychology
  • Patient Compliance / statistics & numerical data
  • Regression Analysis
  • Social Isolation / psychology*
  • Switzerland / epidemiology
  • Young Adult

Grants and funding

The Zurich SARS-CoV-2 Cohort study is funded through the Health Directorate of the Canton of Zurich and the Pandemic Fund of the University of Zurich. The study is also part of the Corona Immunitas research program, coordinated by the Swiss School of Public Health (SSPH+) and funded through SSPH+ fundraising, including funding by the Swiss Federal Office of Public Health, the Cantons of Switzerland (Basel, Vaud, and Zurich), private funders (ethical guidelines for funding stated by SSPH+ were respected) and institutional funds of the participating universities. HEA was also supported by an SNSF Early Postdoc. Mobility Fellowship (nccr – on the move). TB received funding from the European Union’s Horizon 2020 research and innovation program under the Marie Skłodowska-Curie grant agreement No 801076, through the SSPH+ Global PhD Fellowship Program in Public Health Sciences (GlobalP3HS) of the Swiss School of Public Health. Study funders had no role in the study design, data collection, analysis, interpretation, or writing of this report.