Anxiety a Target for Treatment of Patients With COVID-19

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The results show high centrality of anxiety and depression in patients with COVID-19 and anxiety had the highest bridge influence in the network.

A new analysis shows patients with COVID-19 should be treated for anxiety, which could have a positive impact on other mental illnesses.1

A team, led by Giovanna Fico, Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona (UB), investigated the network structure of mental disorders symptoms, social support, and psychological resilience, and changes in network structures according to the presence of a pre-existing mental disorder or hospitalization for COVID-19.

The COVID-19 Pandemic

It is difficult to quantify the relationship of psychological, socio-demographics, and clinical factors in patients with COVID-19.

“Patients hospitalized for COVID-19 may also be subject to worse mental health or cognitive outcomes, since they may have several physical complications after hospital discharge and being exposed to various external stressors, such as isolation, economic problems, or lack of social support or internal, biologically related factors,” the authors wrote. “Furthermore, hospitalization for COVID-19 might worsen previous psychiatric symptoms or conditions, and treatment for COVID-19 may have adverse effects on mental health and contribute to problems such as anxiety and insomnia.”

The network approach could be useful in disentangling complex interactions between different systems.

The Study

In the study, the investigators used data from a multicenter, cross-sectional, survey of patients with COVID-19 in Spain between July and November 2020.

Each participant completed a survey to evaluate sociodemographic characteristics, COVID-19 infection status, resilience, social support, and symptoms of depression, anxiety disorders, post-traumatic stress disorder (PTSD), panic attacks, and substance use disorder.

Overall, there were 2084 patients with COVID-19 included in the study. The team evaluated network and bridge centrality using network analysis and compared between COVID-19 patients with and without a history of lifetime mental disorder, and between hospitalized and non-hospitalized patients.

There were some limitations of the study, such as generalization of the findings are challenging because of differences in network connectivity could exist in different populations or samples.

The results show high centrality of anxiety and depression in patients with COVID-19 and anxiety had the highest bridge influence in the network.

There were low influence on mental disorder symptoms for resilience and social support. There were also no statistically significant changes between patients with and without pre-existing mental disorders or between hospitalized and non-hospitalized patients using global network estimations.

“Anxiety might be a key treatment target in patients with COVID-19 since its treatment might prevent other mental health adverse outcomes,” the authors wrote.


Fico, G., Oliva, V., De Prisco, M., Fortea, L., Fortea, A., Giménez-Palomo, A., Anmella, G., Hidalgo-Mazzei, D., Vazquez, M., Gomez-Ramiro, M., Carreras, B., Murru, A., Radua, J., Mortier, P., Vilagut, G., Amigo, F., Ferrer, M., García-Mieres, H., Vieta, E., & Alonso, J. (2023). Anxiety and depression played a central role in the COVID-19 mental distress: A network analysis. Journal of Affective Disorders.