Anxiety and depression among home-quarantined COVID-19 patients: findings from a North African population

Abstract

The psychological impact of COVID-19 has been widely reported. Although quarantine limited viral spread, it was associated with increased mental health problems. The aim of our study was to estimate the prevalence of anxiety and depression during the COVID-19 quarantine in Monastir and identify their associated factors to better prevent these disorders in future epidemics. We conducted a cross-sectional study among COVID-19 patients recruited from the COVID-19 triage unit at Fattouma Bourguiba Hospital in Monastir between February and June 2021. Patients aged 18 years or older diagnosed with COVID-19 and quarantined at home were included. Patients unreachable by phone or unable to complete the telephone questionnaire were excluded. Demographic and clinical data were collected at the triage unit. Ten days after diagnosis, patients were contacted by telephone to assess anxiety and depressive symptoms using the Hospital Anxiety and Depression Scale (HADS) and to report symptom duration and complications. A total of 383 patients were included in the current study. For anxiety, 6.5% of participants had borderline symptoms, and 13.3% had significant anxiety symptoms. For depression, 8.4% of participants had borderline symptoms, and 16.4% had significant depressive symptoms. Significant anxiety (HADS-A score ≥ 11) was independently associated with female gender (OR = 3.58; 95% CI: 1.42–9.00), persistent symptoms at day 10 (OR = 2.70; 95% CI: 1.25–5.87), fever (OR = 2.64; 95% CI: 1.25–5.57), history of anxiety (OR = 3.32; 95% CI: 1.46–7.53), and oxygen requirement (OR = 5.22; 95% CI: 1.57–17.44). Significant depression (HADS-D score ≥ 11) was independently associated with persistent symptoms at day 10 (OR = 3.26; 95% CI: 1.62–6.58), fever (OR = 2.38; 95% CI: 1.22–4.66), history of depression (OR = 3.97; 95% CI: 1.99–7.91), oxygen requirement (OR = 3.51; 95% CI: 1.07–11.52), health professional status (OR = 2.28; 95% CI: 1.02–5.12), and quarantine with family (OR = 3.16; 95% CI: 1.28–7.82). Whether during the COVID-19 pandemic or future infectious outbreaks, strict quarantine measures contribute to an increased risk of mental health issues. Multiple risk factors play a role in this phenomenon. These findings highlight the importance of considering mental health in epidemic response strategies to enable early intervention and protect the psychological well-being of quarantined patients.