Systematic Reviews
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 6, 2021; 9(25): 7433-7444
Published online Sep 6, 2021. doi: 10.12998/wjcc.v9.i25.7433
Association between COVID-19 and anxiety during social isolation: A systematic review
Erlene Roberta Ribeiro dos Santos, Jose Lucas Silva de Paula, Felipe Maia Tardieux, Vânia Nazaré Costa-e-Silva, Amos Lal, Antonio Flaudiano Bem Leite
Erlene Roberta Ribeiro dos Santos, Department of Neuropsychiatry and Behavioral Science-Neurosciences, Research Circle on Technologies, Strategies and Instruments Applied to Collective Health, Vitória de Santo Antão 55608680, Brazil
Jose Lucas Silva de Paula, Felipe Maia Tardieux, Department of Collective Health, Research Circle on Technologies, Strategies and Instruments Applied to Collective Health, Vitória de Santo Antão 55608680, Brazil
Vânia Nazaré Costa-e-Silva, State Audit Component of the Unified Health System, State Health Secretariat, Recife 50751530, Brazil
Amos Lal, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, United States
Antonio Flaudiano Bem Leite, Department of Epidemiological Surveillance, Henrique de Holanda, Municipal Health Secretariat, Vitória de Santo Antão 55608680, Brazil
Author contributions: Santos ERRD and Costa-e-Silva VN designed the research; Santos ERRD, Tardieux FM and Silva de Paula JL performed the research; Santos ERRD, Tardieux FM and Silva de Paula JL analyzed the data; Santos ERRD, Costa-e-Silva VN, Silva de Paula JL and Leite AFB wrote the paper; Santos ERRD, Silva de Paula JL, Tardieux FM, Costa-e-Silva VN, Lal A and Leite AFB supervised the paper; all authors read and approved the final manuscript.
Conflict-of-interest statement: No conflict of interests.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Amos Lal, FACP, MBBS, Assistant Professor, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, 1st Street, Rochester, MN 55905, United States. manavamos@gmail.com
Received: February 5, 2021
Peer-review started: February 5, 2021
First decision: March 7, 2021
Revised: March 17, 2021
Accepted: August 13, 2021
Article in press: August 13, 2021
Published online: September 6, 2021
Processing time: 206 Days and 11.6 Hours
ARTICLE HIGHLIGHTS
Research background

The uncertainties about coronavirus disease 2019 (COVID-19), the change in routine, lifestyles and the reduction of physical contact can cause stress, anxiety, emotional overload, poor sleep and even physical health complications.

Research motivation

We are more than 1 year into the pandemic and more and more literature is evolving around the psychosocial effects of social isolation during this period. We were motivated to do a deep literature review of the scientific literature available and provide pragmatic insight to the problem.

Research objectives

Our objective was to evaluate the scientific publications available on the relationship between COVID-19 and anxiety experienced in the general population, during the period of social isolation, adopted by governmental organizations and public health policymakers as a measure to contain the spread of cases.

Research methods

A literature search was performed systematically exploring the Pubmed and Medline databases using the following terms classified as MeSH descriptors: (“anxiety” AND “pandemic” AND “COVID-19”). For the search, in the Biblioteca Virtual em Saúde – BVS, Science.gov, Web of Science and National Library platforms, the following keywords were used: ("anxiety" AND "coronavirus" AND "social isolation"). Thirty-seven peer-reviewed articles were found. PRISMA and the Downs & Black checklist were used for qualitative evaluation.

Research results

The collated evidence demonstrated increased levels of symptoms of anxiety and depression during the period of social isolation. The population between the ages of 21 to 40 years was most affected. The risk of severe depression was twice as high at the epicenter of the pandemic. Sleep quality was significantly impaired. Questions about politics, religion, and consumption of products from China were found to generate fear and anticipate probable changes in the pattern of post-pandemic consumption. Social isolation exacerbated feelings of extreme hopelessness, sadness, loneliness and suicidal ideation.

Research conclusions

We conclude that there is a potential relationship between social isolation during the COVID-19 pandemic and symptoms of anxiety. It is important to note that the direct and indirect costs of not identifying the detrimental effects of this phenomenon and neglecting strategies for intervention could lead to a significant psychological burden on society in several aspects after social isolation. This study represents a first approximation on this important theme, which needs to be revisited from future studies, considering longer reference periods.

Research perspectives

Direction of the future research: We aim to maintain this as a live systematic review and provide timely updates on the evolving literature concerning to this very relevant issue.