Journal of Preventive Medicine

Dear Editor

The efforts of scientists in the world are focused on the COVID-19. They are trying to expand their knowledge of how to care for patients with this disease, and develop vaccines and treatment methods. As our knowledge of the pathophysiology of COVID-19 continues to expand rapidly, it is also important to answer questions about the psychological effects of the disease [1]. In this situation, the importance of knowing the psychological consequences caused by COVID-19, at the individual and social level, is evident. The COVID-19 has affected the mental health of a wide range of vulnerable groups, including those with confirmed infection and those at risk of infection (such as healthcare workers). Studies after the epidemic of severe acute respiratory syndrome in 2003 showed that people suffering from stress were infected with the disease far more than healthy people and medical personnel [2]. Research also showed that 1/4 of the people who recovered from the COVID-19 infection had post-traumatic stress disorder, and almost 1/6 of them had depressive disorders after infection. During the COVID-19 pandemic, medical center employees experienced fear caused by fatigue and social stigma, who were more at risk of developing acute stress disorder [3]. The social consequences of COVID-19 are still not well known. 
Due to social distancing, many activities of people in various fields were limited. As a result, many people in fields such as education, business and family relations suffered from the changes caused by this rule. Little is known about the risks associated with psychological disorders due to social distancing and home quarantine. Therefore, information related to psycho-social disorders caused by COVID-19 is necessary for formulating therapeutic interventions [4]. A wide range of psychological disorders occur in an infected person. Early studies from Wuhan showed that 1/5 of people who died from the COVID-19 developed encephalopathy, possibly caused by the release of cytokines in response to the infection [1]. Admission to the intensive care unit (ICU) itself is stressful and is associated with physiological and emotional disorders. Studies show that these issues become more severe due to sensory problems and limited communication with treatment personnel and can lead to ICU syndrome and delirium in these patients [5]. This highlights the importance of considering long-term mental health outcomes for COVID-19 patients who survive the ICU.
The secondary effects of the pandemic created additional challenges. The financial consequences of job loss and work schedule changes negatively affect mental health [6]. After this pandemic, assessing mental health problems and their potential treatments may identify opportunities for better access to psychiatric interventions in the future. As healthcare systems are rapidly adopting telemedicine to deliver care and minimize the risk of exposure to COVID-19, it has an opportunity to evaluate the benefits of telemedicine for managing the ongoing needs of the psychiatric patients [7]. Access to care in rural areas is limited, but the health care system has the potential to expand access using this technology [8].
It is important that the patients with COVID-19 not only be safe in terms of physical health, but also in mental health. Effective measures should be taken to find immediate and long-term solutions to deal with the problem caused by COVID-19. Understanding the mental problems of patients infected with COVID-19 can provide the basis for effective prevention, education and treatment of these patients.

Ethical Considerations
Compliance with ethical guidelines
This study was carried out in full compliance with the principles of ethics in library research.

Funding
This study was not financially supported by any organization or institution and all financial resources were provided by the authors.

Authors' contributions
The both authors contributed equally in the design of this article, presentation of scientific materials, preparation of the manuscript and revision of the final version.

Conflicts of interest
The authors declared no conflict of interest.

Acknowledgements
The authors thank and appreciate the support of Gholam Ali Afrooz.

References

1. Velavan TP, Meyer CG. The COVID-19 epidemic. Trop Med Int Health. 2020; 25(3):278-80. [DOI:10.1111/tmi.13383] [PMID] [PMCID]
2. Maunder R, Hunter J, Vincent L, Bennett J, Peladeau N, Leszcz M, et al. The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital. CMAJ. 2003; 168(10):1245-51. [PMID] [PMCID]
3. Eken HN, Dee EC, Fuchs DC. Letter to the editor: COVID-19; an opportunity to study mental health at the individual and population levels. J Psychiatr Res. 2020; 129:15-16. [DOI:10.1016/j.jpsychires.2020.05.032] [PMID] [PMCID]
4. Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. Lancet. 2020; 395(10227):912-20. [DOI:10.1016/S0140-6736(20)30460-8] [PMID]
5. Kotfis K, Williams Roberson S, Wilson JE, Dabrowski W, Pun BT, Ely EW. COVID-19: ICU delirium management during SARS-CoV-2 pandemic. Crit Care. 2020; 24(1):176. [DOI:10.1186/s13054-020-02882-x] [PMID] [PMCID]
6. Campbell AM. An increasing risk of family violence during the COVID-19 pandemic: Strengthening community collaborations to save lives. Forensic Sci Int. 2020; 2:100089.[DOI:10.1016/j.fsir.2020.100089] [PMCID]
7. Hollander JE, Carr BG. Virtually perfect? Telemedicine for COVID-19. N Engl J Med. 2020; 382(18):1679-81. [DOI:10.1056/NEJMp2003539] [PMID]
8. Rahbar Karbasdehi E. [Impact of coronavirus 2019 on students with special needs (Persian)]. J Shahid Sadoughi Univ Med Sci. 2021; 29(5):3693-7. [DOI:10.18502/ssu.v29i5.6769]
9. Duan L, Zhu G. Psychological interventions for people affected by the COVID-19 epidemic. Lancet Psychiatry. 2020; 7(4):300-2. [DOI:10.1016/S2215-0366(20)30073-0] [PMID]
10. Mezzina R, Sashidharan SP, Rosen A, Killaspy H, Saraceno B. Mental health at the age of coronavirus: Time for change. Soc Psychiatry Psychiatr Epidemiol. 2020; 55(8):965-8. [DOI:10.1007/s00127-020-01886-w] [PMID] [PMCID]