Objective: This study aimed to investigate the underlying causes of anxiety in patients with Covid-19 according to the "Anxiety Management Guideline in Inpatients with Covid-19" released by the Ministry of Health and Medical Education of Iran.
Methods: 109 adult patients with Covid-19 admitted to hospital in Tehran, for whom psychiatric counseling was requested due to anxiety were investigated.
Results: 59.6% patients were female, and the mean age was 55.9 years. In 55 patients, anxiety was due to the symptoms and complications of COVID-19. The relative frequency of these causes of anxiety includes delirium 11.9%, new respiratory distress 2.8%, oxygen saturation between eighty-five to ninety 3.7%, severe and moderate pain 5.5%, fever and chills 13.7 %, cough 0.9%, nausea and vomiting 11.9%. Anxiety in four patients (3.7%) was caused by smoking and opium withdrawal syndrome.
In 50 other patients, no medical cause was found, and oxygen-saturated biofeedback training was used to manage patients (n=22) in mild to moderate anxiety cases. In cases of severe anxiety, a short-acting benzodiazepine was used in patients without a history of psychiatry (n=18), and a combination of SSRI and a benzodiazepine in patients (n=10) with a history of psychiatric disorders.
The most common comorbidities were diabetes and major depressive disorder (MDD) (18.3% and 4.58%, respectively).
Conclusion: Though in majority of cases anxiety is caused by the direct effects or complications of Covid-19, appropriate intervention to manage the underlying factors, can reduce the need for psychiatric medications.