Neuropsychological effects of COVID‐19: A review

Abstract Objective The purpose of this review is to examine review literature on the psychological effects of the COVID‐19 pandemic. Methods Studies were identified by an online search of the PubMed database. We selected studies published from January to May 2020 (during the COVID‐19 emergency). Results We found that psychological effects of COVID‐19 remain serious among the most of the population, in particular for people with mental disorders, adolescents, healthcare workers, and the general population that experienced high levels of stress, anxiety, and depression symptoms, with possible long‐term psychological implications. Conclusion Findings revealed that living in urban areas, having economic stability, and living with parents were protective factors against anxiety for youth groups, whereas a risk factor was represented by the presence of COVID‐19 infection that involved family members.

. In this difficult situation of global emergency, important difficulties in management were represented by hospital and healthcare workers. Röhr et al. (2020) show that the psychological stress of health workers is often due to a divergence of roles; on the one hand, there is a sense of professional responsibility, and on the other, anxiety, worries, guilt, and fear of infecting family members. A study assessed the psychological stress and trauma caused by the COVID-19 pandemic on 214 patients and 526 nurses, showing that more attention is needed to the psychological problems of healthcare professionals as well as prevention and treatment strategies for health care and for patients . The purpose of this brief review is to investigate literature researches about the psychological effects of the COVID-19 pandemic.

Search strategy
Studies were identified by an online search of the PubMed database.
We selected studies published from January to May 2020 (during the COVID-19 emergency

RESULTS
In total, 1335 articles were searched. Sixty-two articles were removed after screening due to duplication. Forty-one articles were excluded based on the screening of titles and abstracts. Three hundred and fortyfive articles were removed because they were published after May 2020. Twenty-five articles were excluded because they were not in English language. Eight hundred and seventeen articles were excluded after screening full text. Forty-five research articles met the inclusion criteria ( Figure 1). Articles described in this review investigated the psychological aspects in various groups of people and we also considered populations of different nationalities especially including China, Pakistan, Germany, Spain, Italy, the United States, and Turkey. In our review, we considered the papers in the acute period of COVID-19 pandemic. In particular, we selected articles about the psychological consequences of healthcare workers caused by the massive hospitalizations Cole et al., 2020;Hou et al., 2020;Kisely et al., 2020;Wu et al., 2020;Xiao et al., 2020;Yin et al., 2020). Symptoms of post traumatic stress disorder (PTSD) were evaluated in two articles (Dutheil et al., 2021;Yin et al., 2020), and psychological impact in adolescents was also evaluated in two other articles (Buzzi et al., 2020;. The psychological distress in adult patients was evaluated in five studies. In adults (Guo et al., 2020;Heitzman, 2020;Yang & Ma, 2020) showing that more attention is needed to the psychological problems of healthcare professionals as well as prevention and treatment strategies for health care and for patients .

DISCUSSIONS
Our review explored the effects of COVID-19 pandemic on the psychological status in the general population and specific range of  (Lai et al., 2020;Sjodin et al., 2020).
An increase in confirmed and suspected cases, workload, exhaustion of personal protection equipment, outbreaks, lack of specific drug therapy, and adequate support can all contribute to increasing the stress of workers.
In fact, Lai et al. (2020) show that 1257 Wuhan health workers, engaged in the front line in the management of the first patients with COVID-19, suffered psychological overload with symptoms of depression, anxiety, insomnia, and distress. Furthermore, Röhr et al. (2020) show that the psychological stress of health workers is often due to a divergence of roles; on the one hand, there is a sense of professional responsibility, and on the other, anxiety, worries, guilt, and fear of infecting family members.
The continuous spread of the epidemic, strict isolation measures and delays in starting schools, colleges, and universities internationally influenced the mental health of students. Institutions have therefore equipped themselves with online learning platforms. Many faculty members trained themselves to use online learning platforms either as the only delivery mode or as an add-on to face-to-face teaching (Zhai & Du, 2020). The psychological impact of the epidemic on the general public, patients, medical staff, children, and older adults was significant (80%) . However, few studies about the mental health status of students facing the epidemic have been conducted to date.
Methods of supporting students to effectively and appropriately regulate their emotions during public health emergencies and avoid losses caused by crisis events have become an urgent problem for educational institutions. In a survey conducted on 7143 medical students, many students reported anxiety, fear, and worry, among others (Cao et al., 2020).
Technology resources became more useful to provide psychological intervention during COVID-19 pandemic. For this reason, telehealth may be effective and became part of our routine healthcare system.
The spread of telehealth also requires a significant change in the management effort and the redesign of existing care models. Substantial efforts have been made to scale down the routine use of telemedicine, often with little success (Alwashmi, 2020). In Australia, despite the introduction of generous financial incentives for specialized video consultations, telehealth accounted for less than 1% of all specialist consultations provided (Hersh et al., 2001).

CONCLUSION
This review demonstrated that psychological effects of COVID-19 remain serious especially in a weak population, such as people with mental disorders, youth groups, and healthcare workers. In particular, we identified protective factors such as living in urban areas, economic stability, and living with other relatives. During the COVID-19 epidemic period, the clinicians should focus on the psychological impact of the epidemic on healthcare workers, weak populations, and young people. Future research should explore the other factors affecting mental health in public emergencies such as the COVID-19, focus on providing strategies for stress tolerance, and promote resilience and psychological wellness.

CONFLICT OF INTEREST
The authors declare no conflict of interest.

DATA AVAILABILITY STATEMENT
Data sharing is not applicable to this article as no new data were created or analyzed in this study.