Impact of isolation on hospitalised patients who are infectious: systematic review with meta-analysis

Abstract

Strengths and limitations of this study► This review covers a wide variety of the literature from a range of different clinical areas. ► Data collected and the methods of collecting data on the impact of isolation is varied across studies. ► These data do not show if these effects are temporary, or in most cases if they are clinically significant. AbStrACtObjective To systematically review the literature exploring the impact of isolation on hospitalised patients who are infectious: psychological and non-psychological outcomes.Design Systematic review with meta-analysis. Data sources Embase, Medline and PsycINFO were searched from inception until December 2018. Reference lists and Google Scholar were also handsearched.results Twenty-six papers published from database inception to December 2018 were reviewed. A wide range of psychological and non-psychological outcomes were reported. There was a marked trend for isolated patients to exhibit higher levels of depression, the pooled standardised mean difference being 1.28 (95% CI 0.47 to 2.09) and anxiety 1.45 (95% CI 0.56 to 2.34), although both had high levels of heterogeneity, and worse outcomes for a range of care-related factors but with significant variation.Conclusion The review indicates that isolation to contain the risk of infection has negative consequences for segregated patients. Although strength of the evidence is weak, comprising primarily single-centre convenience samples, consistency of the effects may strengthen this conclusion. More research needs to be undertaken to examine this relationship and develop and test interventions to reduce the negative effects of isolation.

Emotional consequences of COVID-19 home confinement: The ECLB-COVID19 multicenter study

“…The present findings support previous reports suggesting several psychological perturbations and mood disturbances such as stress, depression, irritability, insomnia, fear, confusion, anger, frustration, boredom, and stigma during quarantine periods of earlier infection. 10,20,21 Regarding the COVID-19 related research, first results from Chinese studies indicate that the COVID-19 outbreak engendered anxiety, depression, sleep problems, and other psychological problems. 22,23 The significantly lower total SWEMWBS score and higher total SMFQ score "during" compared to "before" confinement support the negative effects of the current COVID-19 pandemic on mental wellbeing and emotional state in participants from Western Asian, North Africa and Europe.…”

Mental health outcomes of quarantine and isolation for infection prevention: A systematic umbrella review of the global evidence

“…Totally, 1364 citations were considered in this review and 771 unique records were screened after removing 593 duplicate records (Figure 1). At the end of full-text screening, a total of eight reviews were included in this umbrella review (Table 2) [28,29, [40][41][42][43][44][45]. These reviews have been published between 2009 and 2020, whereas most (number of reviews, n = 5) reviews were published since 2018.…”

“…Most reviews included cohort studies (n = 6; number/range of primary studies in each review, s = 1 to 12), followed by cross-sectional studies ( n = 5, s = 2 to 11), qualitative studies (n = 3, s = 2 to 10), case-control studies (n = 1, s = 6), quasi-experimental studies (n = 2, s = 2), case studies (n = 1, s = 2), mixed method studies (n = 1, s = 2), reviews (n = 1, s = 1), and psychological evaluation (n = 1, s = 1). In quality assessment (Supplementary material 1), three reviews were found to have high quality [28, 44,45], whereas most (n = 5) studies had a medium quality [29, [40][41][42][43].…”

“…among the remaining reviews, most of the primary studies were from the US, UK, and Canada, whereas fewer studies were conducted in Sweden, Australia, Netherlands, South Korea, Senegal, [44]. Both reviews evaluated studies that recruited participants from clinical settings, including healthcare providers and clinical students.…”

A Call to Arms, Not to Disarm: The Importance of Psychiatric Care in the Acute Medical Setting During the COVID-19 Pandemic

“…In addition to the aforementioned benefits regarding health-care resource management and provision of emotional support, we expect psychiatry to be essential in helping to prevent and manage the higher levels of depression and worse outcomes that have been observed in patients requiring infectious isolation in hospital settings. 3 Similar to other acutely medically ill patients, those with presentations concerning for COVID-19 are likely to be vulnerable to delirium, agitation, and decompensations of psychosis or mood disorders, necessitating psychiatric evaluation. Psychiatrists will also be needed to assist with capacity evaluations for these patients should they wish to leave against medical advice.…”