Psychosocial Impact of Coronavirus Disease 2019 and Related State-imposed Lockdown on Patients Presenting with Respiratory Complaints: A Study from North India

Abstract

Clinical presentation of coronavirus disease 2019 (COVID-19) mimics many respiratory ailments. The aim of this study was to explore the psychosocial impact of COVID-19 and subsequent state-imposed lockdown on patients presenting with respiratory complaints. This was a prospective study on 82 outpatients at a tertiary care institute from North India during the period of strict lockdown. Baseline assessment was conducted using socioclinical pro forma, COVID-19-related questionnaire, lockdown-related questionnaire, and General Health Questionnaire-12 (GHQ-12) Hindi version. Reassessment was done twice: immediately and 41–45 days after relaxation of strict lockdown. Quality of life (QOL) at first and second follow-up versus the prelockdown times (Score A and Score C) and first follow-up versus unlockdown (Score B) was noted. Psychological distress was experienced in 45.1% and 17.1% of patients at baseline and first follow-up (P < 0.001). Clinical symptoms, worry for COVID-19, negative thoughts, and total score (lockdown) decreased significantly at first follow-up. The mean C score was significantly better than the mean A score (P < 0.001). Baseline and follow-up psychological distress was significantly more in those with poorer values of total score (lockdown) and its domains. On logistic regression, follow-up GHQ-12 correlated positively with Domain 2 (P = 0.027; odds ratio [OR] = 0.7) and “worry for COVID” (P = 0.017; OR = 10.136). Persons presenting with respiratory complaints and experiencing “worry for COVID-19” at the start of the lockdown were more likely to also experience psychological distress, which decreased significantly but persisted for prolonged periods even after relaxation in lockdown. Policymakers, while indulging in mental health planning in pandemics, should not ignore this issue of development and perpetuation of psychological distress in such otherwise “psychologically normal” individuals.