Psychological Resilience, Coping, and Distress in Admitted Patients With COVID-19 Infection

To assess psychological resilience, coping, and related psychological distress in admitted COVID-19 patients. Predictors of subsequent development of posttraumatic stress symptoms (PTSS) and disability were also studied.

: Stable inpatients with COVID-19 (aged > 18 years with mild symptoms) admitted to a tertiary care hospital from April 2020 to December 2020 were recruited for the study. During admission, the patients were assessed for resilience, coping, and psychological distress using the 10-item Connor-Davidson Resilience Scale (CD-RISC-10), Brief COPE (Coping Orientation to Problems Experienced), and 4-item Patient Health Questionnaire (PHQ-4). Similarly, they were assessed at 4 weeks after discharge using the PTSD Checklist for DSM-5 and World Health Organization Disability Assessment Schedule.

A total of 176 patients were recruited for the study and assessed during their admission, and 102 were reassessed during follow-up. Of the patients, 17.6% during admission and 58.8% at follow-up had significant psychological distress (PHQ-4 score > 2). The mean ± SD CD-RISC-10 score was 27.94 ± 5.82. The most used coping strategies were emotional support, religion, and acceptance. Increased resilience was associated with better education (rs[100] = 0.265, P = .007), less psychological distress (r[100] = -0.596, P = .001), and healthy coping strategies. PHQ-4, PCL-5, and disability scores at follow-up were positively correlated (Pearson correlation). The multiple regression model statistically significantly predicted PTSS (F_{7, 94} = 2.660, P < .015, adjusted R² = 0.103).

COVID-19 patients with better resilience are associated with reduced psychological distress. Better resilient traits and reduced psychological distress may prevent ensuing PTSS and disability.