Effects of mental health interventions among people hospitalized with COVID-19 infection: A systematic review of randomized controlled trials

Amina Tasleem; Yutong Wang; Kexin Li; Xiaowen Jiang; Ankur Krishnan; Chen He; Ying Sun; Yin Wu; Suiqiong Fan; Jill T Boruff; Sarah Markham; Danielle B Rice; Olivia Bonardi; Tiffany Dal Santo; Letong Li; Ian Thombs-Vite; Branka Agic; Christine Fahim; Michael S Martin; Sanjeev Sockalingam; Andrea Benedetti; Brett D Thombs

doi:10.1016/j.genhosppsych.2022.04.002

Effects of mental health interventions among people hospitalized with COVID-19 infection: A systematic review of randomized controlled trials

Gen Hosp Psychiatry. 2022 Jul-Aug:77:40-68. doi: 10.1016/j.genhosppsych.2022.04.002. Epub 2022 Apr 9.

Authors

Amina Tasleem¹, Yutong Wang¹, Kexin Li¹, Xiaowen Jiang¹, Ankur Krishnan¹, Chen He¹, Ying Sun¹, Yin Wu², Suiqiong Fan¹, Jill T Boruff³, Sarah Markham⁴, Danielle B Rice⁵, Olivia Bonardi¹, Tiffany Dal Santo¹, Letong Li¹, Ian Thombs-Vite¹, Branka Agic⁶, Christine Fahim⁷, Michael S Martin⁸, Sanjeev Sockalingam⁹, Andrea Benedetti¹⁰, Brett D Thombs¹¹

Affiliations

¹ Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.
² Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
³ Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, Quebec, Canada.
⁴ Department of Biostatistics and Health Informatics, King's College London, London, UK.
⁵ Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychology, McGill University, Montreal, Quebec, Canada.
⁶ Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
⁷ Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada.
⁸ School of Epidemiology and Public Health, University of Ottawa, Ontario, Canada; Correctional Service of Canada, Ottawa, Ontario, Canada.
⁹ Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
¹⁰ Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec, Canada.
¹¹ Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Department of Psychology, McGill University, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada; Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada. Electronic address: brett.thombs@mcgill.ca.

Abstract

Objective: We evaluated the effects of mental health interventions among people hospitalized with COVID-19.

Methods: We conducted a systematic review and searched 9 databases (2 Chinese-language) from December 31, 2019 to June 28, 2021. Eligible randomized controlled trials assessed interventions among hospitalized COVID-19 patients that targeted mental health symptoms. Due to the poor quality of trials, we sought to verify accuracy of trial reports including results.

Results: We identified 47 randomized controlled trials from China (N = 42), Iran (N = 4) and Turkey (N = 1) of which 21 tested the efficacy of psychological interventions, 5 physical and breathing exercises, and 21 a combination of interventions. Trial information could only be verified for 3 trials of psychological interventions (cognitive behavioral, guided imagery, multicomponent online), and these were the only trials with low risk of bias on at least 4 of 7 domains. Results could not be pooled or interpreted with confidence due to the degree of poor reporting and trial quality, the frequency of what were deemed implausibly large effects, and heterogeneity.

Conclusion: Trials of interventions to address mental health in hospitalized COVID-19 patients, collectively, are not of sufficient quality to inform practice. Health care providers should refer to existing expert recommendations and standard hospital-based practices.

Registration: PROSPERO (CRD42020179703); registered on April 17, 2020.

Keywords: COVID-19; Interventions; Mental health; Randomized controlled trials; Systematic review.

Publication types

Review
Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Breathing Exercises / methods
COVID-19*
Health Personnel
Humans
Mental Health*
Randomized Controlled Trials as Topic