Basic and Clinical Neuroscience
Volume:11 Issue: 2, Mar-Apr 2020

Coronavirus disease 2019 (COVID-19) is escalating all over the world and has higher morbidities and mortalities in certain vulnerable populations.  People Who Use Drugs (PWUD) are a marginalized and stigmatized group with weaker immunity responses, vulnerability to stress, poor health conditions, high-risk behaviors, and lower access to health care services. These conditions put them at a higher risk of COVID-19 infection and its complications. In this paper, an international group of experts on addiction medicine, infectious diseases, and disaster psychiatry explore the possible raised concerns in this issue and provide recommendations to manage the comorbidity of COVID-19 and Substance Use Disorder (SUD).

The new coronavirus virus 2019 (COVID-19) has affected many routine medical activities, including medical education and clinical activities. The social isolation has led to highlighting virtual learning and telemedicine. We present a report of our adoptive procedures taken during the outbreak of COVID-19 in our tertiary healthcare center and compare the current educational and clinical issues with these issues one month before the outbreak. Virtual learning is a useful replacement in this critical situation.

As one of the major health problems in the present century, the COVID-19 pandemic affected all parts of the global communities and the health of substance users are potentially at a greater risk of harm. This global study has been designed and conducted by the International Society of Addiction Medicine Practice and Policy Interest Group (ISAM-PPIG) to understand better the health related issues of people with Substance Use Disorders (SUD) as well as responses of the relevant health care systems during the pandemic.

This is a cross-sectional study using convenient sampling. The data gathering was carried out with two follow-up stages each two months apart through an online conducted survey prepared using Google platform. The survey started by emergence of COVID-19 as a pandemic in March 2020 and respondents were followed till September 2020 when most of the initial lockdowns by most countries are supposed to be reopened.

The study was approved by the ethics committee of University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. The results will be published in relevant peer reviewing journals and communicated with different international stakeholders.

In the Coronavirus Disease 2019 (COVID-19) pandemic, medical staff Are  in direct contact with the patients and experience high work pressure. Direct contact with the patients could create some psychological problems in this group. Thus, the prevalence of such problems must be investigated in them. The present study aimed to determine the level of stress, anxiety, and depression among the healthcare staff in Zanjan City, Iran, during the COVID-19 epidemic.

This descriptive study has a cross-sectional design. The Sample of the study population consisted of 535 Staff healthcare members of Vali-e-Asr Hospital in Zanjan City, Iran. A sample of 200 of medical staff was randomly selected to participate in the present study. The required data were collected using the electronic version of Depression, Anxiety, Stress Scale (DASS) tool. Descriptive statistics, as well as the inferential statistics (the Pearson correlation coefficient, Spearman correlation coefficient, Phi, and Cramer’s correlation tests), were used to analyze the obtained data in SPSS.

The mean age of the study participants was 40.60 years. The mean values of depression, anxiety, and stress in study samples were 6.27, 5.38, and 8.41, respectively. There was a significant relation between gender and variables of depression, anxiety, and stress. There was also an inverse relationship between stress and variables of educational level and age (P<0/05).

We found that our sample reported a normal degree of Depression, anxiety, and stress. The extent of stress induced by direct contact with patients was higher in female employees. Furthermore, with the increase in the education and age of the employees, their stress level decreased.

During the Coronavirus Disease 2019 (COVID-19) outbreak, news media has played an important role in informing people to satisfy their curiosity about this stressful condition. Regular exposure to such stressful news may elicit different emotions in people and engage them in using strategies to control their emotions. In the present study, we aimed at exploring the most common negative emotion(s) experienced by individuals, as well as the most frequent Emotion Regulation (ER) strategies used facing the COVID-19-related news. We also examined whether the variable of personal relevance can moderate these emotional responses.  

617 individuals living in Tehran who regularly read the news about the COVID-19 from the early stages of spread completed an online survey. After excluding the participants with high scores from the Beck Depression Inventory (>18), data obtained from 443 participants were analyzed in terms of the experienced negative emotions and ER strategies.

Anxiety (55.8%) was the most common negative emotion reported by participants facing COVID-19-related news and problem-solving was the most frequent strategy used to control negative emotions. Both groups with high and low personal relevance indicated a similar pattern in experiencing high and low arousal emotions, as well as using ER strategies, and no significant differences were found (X2=0.006, p=0.51; X2=0.14, p=0.39, respectively). We also found that participants with high scores in the resilience scale used an integrative rather than a single approach of the ER strategies (rbp=0.15, p=0.01). 

We found that during the COVID-19 outbreak, news media may have important role in triggering anxiety in people who regularly read the relevant news, and problem-solving was the most frequent strategy among them. Being directly involved with COVID-19 in personal life did not make any differences in the way that individuals emotionally respond to the news. While using an integrative approach in regulating emotion was found in more resilient individuals..

The outbreak due to Coronavirus Disease 2019 (COVID-19) is n global public health emergency and challenges psychological resilience. The central nervous system, endocrine system, and immune system are complex interacting systems. Cortisol has been implicated as the cause of a wide range of mental and physical health disorders; however, the impact of cortisol on outcomes in patients with COVID-19 is not clear.

The current study enrolled patients with COVID-19 (onset of disease within 7 days of the first symptom) to evaluate the serum concentration of cortisol and levels of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS) to investigate a possible relationship between cortisol, depression, and anxiety levels and outcomes of patients with COVID-19. 

A total of 30 patients with COVID-19 were studied. The levels of cortisol and HADS score in patients who died of Covid-19 were significantly higher in comparison with surviving patients (P<0.017 and P<0.001 respectively). We also found that the HADS score was positively correlated with serum cortisol levels (r= 0.842, P=0.004). 

Our findings showed that stress and anxiety are associated with patients’ outcomes. Psychological interventions can improve the mental health of vulnerable groups during the COVID-19 epidemic.

Coronavirus disease 2019 (COVID-19) has become a pandemic with 1771514 cases identified in the world and 70029 cases in Iran until April 12, 2020. The co-prescription of psychotropics with COVID-19 medication is not uncommon. Healthcare providers should be familiar with many Potential Drug-Drug Interactions (DDIs) between COVID-19 therapeutic agents and psychotropic drugs based on cytochrome P450 metabolism. This review comprehensively summarizes the current literature on DDIs between antiretroviral drugs and chloroquine/hydroxychloroquine, and psychotropics, including antidepressants, antipsychotics, mood stabilizers, and anxiolytics.

Medical databases, including Google Scholar, PubMed, Web of Science, and Scopus were searched to identify studies in English with keywords related to psychiatric disorders, medications used in the treatment of psychiatric disorders and COVID-19 medications.

There is a great potential for DDIs between psychiatric and COVID-19 medications ranging from interactions that are not clinically apparent (minor) to those that produce life-threatening adverse drug reactions, or loss of treatment efficacy. The majority of interactions are pharmacokinetic interactions via the cytochrome P450 enzyme system.

DDIs are a major concern in the comorbidity of psychiatric disorders and COVID-19 infection resulting in the alteration of expected therapeutic outcomes. The risk of toxicity or lack of efficacy may occur due to a higher or lower plasma concentration of medications. However, psychiatric medication can be safely used in combination with COVID-19 pharmacotherapy with either a wise selection of medication with the least possibility of interaction or careful patient monitoring and management.

To assess the opinion of patients with Multiple Sclerosis (MS) on the outcomes of COVID-19 (coronavirus disease 2019) and its effects on MS symptoms if they catch coronavirus. A cross-sectional study was performed. 

Considering the study objectives, a questionnaire was designed and prepared as a Google Form for MS patients for one week. 

A total of 148 MS patients with an average age of 35.73 years completed the questionnaire. The most important concern of the participants was “a high prevalence of COVID-19” following by the “MS symptoms worsening”. Many participants (35%) believed that, if they catch COVID-19 they will be cured. However, the treatment will take more time for them in comparison with the general population. About 39.8% of the patients stated that COVID-19 infection does not affect the MS symptom, but others noted that, it can cause relapse (30.8%) or worsen MS symptoms (29.3%).

This study revealed that MS patients are more anxious about the effects of COVID-19 on their underlying disease rather than the infection itself.

Coronavirus disease 2019 (COVID-19) results from Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). it is now a pandemic that affects us all. For patients referring to the addiction care systems, this pandemic can create additional vulnerabilities. A great deal of effort has made to re-organize the care systems for patients with addiction.  Our study focuses on the voice of our patients, on clues to adapt treatment, and on the impact of the pandemic on the therapeutic alliance.

A qualitative design was used to develop a description and understanding of general and clinically relevant aspects of the impact of the COVID-19 pandemic.  Fifteen addicted patients (11 under treatment and 4 in recovery) were interviewed by 4 interviewers according to the COREQ (consolidated criteria for reporting qualitative research).

COVID-19 has had a serious impact on thoughts, feelings, and behaviors. Interviewees shared their anxieties about their health and the health of their relatives. Frightening thoughts were associated with a range of negative feelings and behaviors, such as stress, anger, avoidance, and isolation. The use of psychoactive substances differed between the patients in treatment with those who are in stable recovery. In the former, all succeeded in staying abstinent. They have experienced that solidarity and connectedness were essential in sustaining their recovery. Those still in treatment were fighting against the temptation to start using again; they felt emotionally isolated and sometimes patronized by health care workers.

The elaboration of the interviewees on the therapeutic relationship provides promising clues to optimize that relationship.  Remembering this common expression, “we are all in this together,” shared decision making could very well be used to shape effective and receptive treatment interventions during the different challenges faced at different stages of the COVID-19 epidemic.

Awareness of the current outbreak of Coronavirus Disease - 2019 (COVID-19) affecting the nervous system and identifying its possible ways to enter the Central Nervous System (CNS) are critical for the prevention and treatment of the disease. Hence, the CNS implications of the COVID-19 since the spread of the virus were reviewed in this study.

The experience of the loss of the relatives, which is naturally one of the most stressful events in a person’s life, has turned into a new concept and challenge for survivors and mental health professionals during the coronavirus era. We discussed how restrictions caused by social distancing potentially increase the likelihood of a phenomenon called complicated grief or prolonged bereavement disorder and multilayer response by case finding to increase the access to public education to manage this complicated situation.

The bidirectional association between the circadian system and innate-adaptive immune functions has been highlighted in many investigations. Viruses are a submicroscopic infectious agent that activate the immune system after entering the human host cell. A novel virus, socalled Coronavirus Disease 2019 (COVID-19), which has recently emerged, is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Previous investigations show that the factors that are strongly controlled by circadian rhythms, such as clock genes and melatonin, modulate the immune response and may, therefore, influence the healing processes of COVID-19. Moreover, the mechanism of COVID-19 shows that some host cell factors, such as an angiotensin-converting enzyme, exhibit daily rhythms. In this review, we explore key findings that show a link between circadian rhythms and viral infection. The results of these findings could be helpful for clinical and preclinical studies to discover a useful and highly effective treatment for eradicating the COVID-19 disease.