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©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Mental health impact of the Middle East respiratory syndrome, SARS, and COVID-19: A comparative systematic review and meta-analysis
Gayathri Delanerolle, Yutian Zeng, Jian-Qing Shi, Xuzhi Yeng, Will Goodison, Ashish Shetty, Suchith Shetty, Nyla Haque, Kathryn Elliot, Sandali Ranaweera, Rema Ramakrishnan, Vanessa Raymont, Shanaya Rathod, Peter Phiri
Gayathri Delanerolle, Nuffield Department of Primary Health Care Science, University of Oxford, Oxford OX2 6ED, United Kingdom
Yutian Zeng, Jian-Qing Shi, Xuzhi Yeng, Southern University of Science and Technology, Shenzhen 518055, Guangdong Province, China
Jian-Qing Shi, The Alan Turing Institute, London NW1 2DB, United Kingdom
Will Goodison, Ashish Shetty, University College London Hospital NHS Foundation Trust, London NW1 2PG, United Kingdom
Ashish Shetty, University College London, London WC1E 6BT, United Kingdom
Suchith Shetty, Kathryn Elliot, Shanaya Rathod, Peter Phiri, Department of Research and Innovation, Southern Health NHS Foundation Trust, Southampton SO30 3JB, United Kingdom
Nyla Haque, Vanessa Raymont, Department of Psychiatry, University of Oxford, Oxford OX2 6ED, United Kingdom
Sandali Ranaweera, Department of BioSystems Technology, University of Sri Jayewardenepura, Nugegoda 10100, Sri Lanka
Rema Ramakrishnan, National Perinatal Epidemiology Unit, University of Oxford, Oxford OX3 7JX, United Kingdom
Peter Phiri, Faculty of Environmental and Life Sciences, Psychology Department, University of Southampton, Southampton SO17 1PS, United Kingdom
Author contributions: Delanerolle G and Phiri P developed the systematic review protocol and embedded this within the EPIC project’s evidence synthesis phase; Delanerolle G and Goodison W wrote the first draft of the manuscript; The statistical analysis plan was developed by Delanerolle G and was conducted by Shi JQ, Yeng X and Zeng Y; The data was critically appraised by Shetty A, Phiri P, Zeng Y, Yeng X, Shi JQ, Goodison W, Ramakrishnan R, Ranaweera S and Raymont V; The SARS-CoV data was extracted by Chau SWH and his team; The SARS-CoV-2 data was extracted by Phiri P/Delanerolle G and their team; Yeng X and Zeng Y extracted the MERS dataset which was reviewed by Delanerolle G, Phiri P, Shetty S, Shi JQ and Shetty A; Yeng X, Zeng Y and Shi JQ conducted the analysis; Shetty S designed and developed the original illustration; Delanerolle G, Phiri P, Shetty A, Zeng Y, Yeng X, Shetty S, Shi JQ, Goodison W, Ramakrishnan R, Elliot K, Ranaweera S and Raymont V critically appraised and finalised the manuscript; All authors approved the final version of the manuscript.
Supported by Southern Health NHS Foundation Trust.
Conflict-of-interest statement: Dr Phiri has received research grant from Novo Nordisk, and other, educational from Queen Mary University of London, other from John Wiley & Sons, other from Otsuka, outside the submitted work. Dr Rathod reports other from Janssen, Boehringer outside the submitted work. All other authors report no conflict of interest. The views expressed are those of the authors and not necessarily those of the NHS, the National Institute for Health Research, the Department of Health and Social Care or the Academic institutions. The study sponsor had no further role in the study design, data collection, analysis and interpretation of data, in the writing of the report and in the decision to submit the paper for publication.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Peter Phiri, BSc, PhD, RN, Academic Fellow, Department of Research and Innovation, Southern Health NHS Foundation Trust, Clinical Trials Facility, Moorgreen Hospital Botley Road, West End, Southampton SO30 3JB, United Kingdom.
peter.phiri@southernhealth.nhs.uk
Received: October 28, 2021
Peer-review started: October 28, 2021
First decision: December 12, 2021
Revised: December 24, 2021
Accepted: April 9, 2022
Article in press: April 9, 2022
Published online: May 19, 2022
Processing time: 201 Days and 7.2 Hours
BACKGROUND
Over the last few decades, 3 pathogenic pandemics have impacted the global population; severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV) and SARS-CoV-2. The global disease burden has attributed to millions of deaths and morbidities, with the majority being attributed to SARS-CoV-2. As such, the evaluation of the mental health (MH) impact across healthcare professionals (HCPs), patients and the general public would be an important facet to evaluate to better understand short, medium and long-term exposures.
AIM
To identify and report: (1) MH conditions commonly observed across all 3 pandemics; (2) Impact of MH outcomes across HCPs, patients and the general public associated with all 3 pandemics; and (3) The prevalence of the MH impact and clinical epidemiological significance.
METHODS
A systematic methodology was developed and published on PROSPERO (CRD42021228697). The databases PubMed, EMBASE, ScienceDirect and the Cochrane Central Register of Controlled Trials were used as part of the data extraction process, and publications from January 1, 1990 to August 1, 2021 were searched. MeSH terms and keywords used included Mood disorders, PTSD, Anxiety, Depression, Psychological stress, Psychosis, Bipolar, Mental Health, Unipolar, Self-harm, BAME, Psychiatry disorders and Psychological distress. The terms were expanded with a ‘snowballing’ method. Cox-regression and the Monte-Carlo simulation method was used in addition to I2 and Egger’s tests to determine heterogeneity and publication bias.
RESULTS
In comparison to MERS and SARS-CoV, it is evident SAR-CoV-2 has an ongoing MH impact, with emphasis on depression, anxiety and post-traumatic stress disorder.
CONCLUSION
It was evident MH studies during MERS and SARS-CoV was limited in comparison to SARS-CoV-2, with much emphasis on reporting symptoms of depression, anxiety, stress and sleep disturbances. The lack of comprehensive studies conducted during previous pandemics have introduced limitations to the “know-how” for clinicians and researchers to better support patients and deliver care with limited healthcare resources.
Core Tip: Global research into exploring pandemics have been conducted for several decades. However, clinical research associated with mental health (MH) impact of Middle East respiratory syndrome, severe acute respiratory syndrome coronavirus (SARS-CoV) and SARS-CoV-2 was limited. This systematic review and meta-analysis is a comparison of the MH impact across, healthcare professionals, patients and the general public using the Monte-Carlo simulation method. Evaluated prevalence of multiple MH variables have been conducted using randomised controlled trials and cross-sectional studies. The study demonstrates the need to conduct comprehensive and longitudinal multi-morbid research to evaluate the true MH impact to aid better future pandemic preparedness. This systematic review and meta-analysis indicate a complex MH impact across all cohorts with the requirement for mechanistic relationships between physical and MH to be explored further.
