Objective: This study aimed to investigate the underlying causes of anxiety in patients with COVID-19 according to the "anxiety management guideline in inpatients with COVID-19" issued by the Ministry of Health and Medical Education of Iran.
Methods: Psychiatric counseling was requested for 109 adult COVID-19 patients with anxiety admitted to a hospital in Tehran City, Iran.
Results: About 59.6% of patients were female, and their mean age was 55.9 years. In 55 patients, anxiety was due to the symptoms and complications of COVID-19. The relative frequency of the causes of anxiety were as follows: delirium (11.9%), new respiratory distress (2.8%), oxygen saturation between 85 to 90 (3.7%), severe and moderate pain (5.5%), fever and chills (13.7%), cough (0.9%), and nausea and vomiting (11.9%). Anxiety in four patients (3.7%) was caused by smoking and opium withdrawal syndrome.
In 50 other patients, no medical cause was found, and oxygen-saturated biofeedback training was used to manage patients (n=22) in mild to moderate anxiety cases. In cases of severe anxiety, a short-acting benzodiazepine was used in patients without a history of psychiatry (n=18), and a combination of selective serotonin reuptake inhibitors and a benzodiazepine in patients (n=10) with a history of psychiatric disorders.
The most common comorbidities were diabetes and major depressive disorder (18.3% and 4.58%, respectively).
Conclusion: Though in the majority of cases, anxiety was caused by the direct effects or complications of COVID-19, appropriate intervention to manage the underlying factors can reduce the need for psychiatric medications.