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SARS-CoV-2 or COVID-19 pandemic outbreak has been creating havoc and has imposed a sense of severe insecurity and panic like situation (Tandon, 2020a, 2020b). The mass media/telecommunications /newspaper/blogs have been updating the information about the rapid rise in cases leading to admission to the hospital, being kept in the isolation ward, requiring oxygen support, being admitted in intensive care units (ICUs), associated mortality and the fate of the dead bodies (packaging/filled up graveyards/crematorium). All this news has led to a significant fear, anxiety, uncertainty, and restlessness in the general public. In this background, when one is diagnosed with COVID-19 infection, the diagnosis brings, in a feeling of shock and disbelief, and a feeling of being on the death bed. Many a time, the diagnosis not only leads to admission into the hospital but also leads to a diagnosis of COVID-19 infection in other family members, family members being sent to quarantine and other contacts being traced to the person (Sahoo et al., 2020a). Given the high infectivity and reported consequences of infections, including mortality, COVID-19 is known to have significant negative mental health outcomes, not only in those who are diagnosed with the infection and their family members but also in the general public (Wang et al., 2020; Zhao and Huang, 2020) and the front line health care workers (HCWs) (Kang et al., 2020; Lai et al., 2020; Rossi et al., 2020; Tan et al., 2020). Currently, there are viewpoints and perspectives of mental health professionals regarding the different emotional reactions/issues and possible psychiatric problems which may arise in people diagnosed with COVID infection (Grover et al., 2020; Yao et al., 2020). Due to the negative mental health consequences, it is suggested that a mental health professional should be part of the core team managing patients with COVID-19 infection(Grover et al., 2020). Available literature from the previous epidemics of infectious diseases suggests the occurrence of post-traumatic stress disorder, depression, and anxiety disorders in patients admitted with SARS (2002) and Middle East Respiratory Syndrome (MERS, 2012) during the post-illness/recovery stage (Rogers et al., 2020). Further, emerging evidence also suggests the occurrence of delirium (confusion, agitation, altered consciousness) in patients admitted to ICUs with severe COVID-19 infection (Chen et al., 2020; Helms et al., 2020) and neuropsychological deficits (dysexecutive syndrome) at discharge (Helms et al., 2020). However, there is very limited literature on the psychological experience of patients with COVID-19 during their hospital stay. One study (n = 144) reported significant anxiety (34 %) and depression (28 %) at admission to isolation wards (Kong et al., 2020), the other (n = 26) study reported higher anxiety and depressive scores on HAM-A and HAM-D respectively after one week of hospitalization, which decreased after comprehensive psychological interventions (Yang et al., 2020). Another study (n = 57) found prevalence of depression to be around 30 % in newly recovered COVID-19 patients (Zhang et al., 2020). Further, a study with large sample (n = 714) of hospitalised but stable patients with COVID-19 reported post-traumatic stress symptoms in 96.2 % patients (Bo et al., 2020). However, these studies had not explored in detail the emotional reactions which the patients went during the entire period of hospital stay till discharge. We reported the narrative experiences of our patients during their hospital stay, who had significant distress when diagnosed with COVID-19 infection (Sahoo et al., 2020a, 2020b). These experiences of few patients prompted us to evaluate the experience of all the patients, admitted to the COVID-19 ward. In this background, the current study aimed to evaluate the emotional reactions/experiences which the patients go through, while admitted to the COVID-19 ward, at the time of discharge.

Background To date, no study has evaluated the association of alcohol dependence with the outcome of the COVID-19 infection. Aim The current study aimed to evaluate the association of substance dependence (alcohol and tobacco) with the outcome (i.e., time to have two consecutive negative test reports) of the COVID-19 infection. Results The mean age of the study participants (n = 95) was 37.2 yrs (SD-13.2). More than half of the participants were males. About one-fourth (N = 25; 26.3 %) were consuming various substances in a dependent pattern. Alcohol dependence was present in 21 participants (22.1 %), and Tobacco dependence was present in 10.5 % of participants. Even after using gender, age, and physical illness as covariates, patients with any kind of substance dependence had a significantly lower chance of having a negative report on RT-PCR on 14th day, 18th 23rd day. Conclusion Persons with substance dependence takes a longer time to test negative on RT-PCR, once diagnosed with COVID-19 infection. Mental health professionals involved in the care of patients with COVID-19 should accordingly prepare these patients for a possible longer hospital stay to reduce the distress associated with prolongation of hospital stay.

Aim The aim of this study was to evaluate the prevalence of mild cognitive impairment (MCI) in patients with hypertension and to evaluate the association of MCI with metabolic syndrome (MetS). Methodology 186 subjects with hypertension were evaluated on Montreal Cognitive Assessment (MoCA) and Patient Health Questionnaire (PHQ-9) for cognitive decline and depression, respectively and MetS was diagnosed as per the Consensus definition. Results The prevalence of MCI was 65.6 % and that of MetS was 45.7 %. Compared to those without MetS, those with MetS had significantly poorer cognitive functioning on the all cognitive domain of the MoCA, even after controlling for age, education, severity of the depression and duration of illness. Low High-Density Lipoprotein (HDL) was found to have a positive correlation with MoCA. Higher age, lower education, higher duration of illness and use of higher numbers of medications were associated with significantly lower score on MoCA. Conclusion Presence of MetS among persons with hypertension is associated with cognitive decline. Hence, there is a need to monitor and manage other parameters of MetS among patients with hypertension, to reduce the risk of cognitive decline and future dementia.

COVID-19 pandemic has emerged as a disaster for the human beings. All the Governments across the globe have been preparing to deal with this medical emergency, which is known to be associated with mortality in about 5% of the sufferers. Gradually, it is seen that, many patients with COVID-19 infection have mild symptoms or are asymptomatic. Due to the risk of infecting others, persons with COVID-19 infection are kept in isolation wards. Because of the isolation, the fear of death, and associated stigma, many patients with COVID-19 infection go through mental distress. In this report, we discuss the experience of 3 persons diagnosed with COVId-19 infection and admitted to the COVID ward.

Objective Medically unexplained physical symptoms (MUPS) are commonly seen across health care settings. Earlier studies have focussed on prevalence, cost-utilization and burden. Data from India is scarce. Patients with persistent MUPS have more impairment and psychological distress. This study was designed to assess psychological morbidity, health anxiety (HA), somatic symptom load, disability, quality of life (QOL) in patients with persistent MUPS presenting to a general medical outpatient service and compare it with patients with medically explained physical symptoms (MEPS). Methods The study was conducted in the outpatient service of the Department of Internal Medicine in a tertiary hospital in North India. Persistent MUPS was defined as physical symptoms of at least 3 months duration leading to dysfunction and with no identifiable medical cause. 70 patients with persistent MUPS and MEPS each were recruited. Psychiatric morbidity was assessed using the Mini International Neuropsychiatric interview, somatic symptom load with Patient Health Questionniare-15 (PHQ-15), HA with Whiteley Index, disability with WHODAS 2.0 and QOL with WHOQOL-Bref. Results Both the groups were comparable on socio-demography and length of symptoms. Prevalence of psychiatric disorders and HA was significantly greater in MUPS. Patients with persistent MUPS had significantly more health care utilization, number and burden of somatic symptoms, greater disability and worse QOL. Conclusions Patients with persistent MUPS have a different profile when compared to MEPS. There is a need to screen and identify patients with MUPS and manage them keeping in mind the psychological factors and chronic nature and number of symptoms.