Saqib K, Goel V, Dubin J A, VanderDoes J, Butt Z A
School of Public Health Sciences, University of Waterloo, Ontario, Canada.
School of Public Health Sciences, University of Waterloo, Ontario, Canada; School of Pharmacy, University of Waterloo, Ontario, Canada.
Public Health. 2024 Nov;236:70-77. doi: 10.1016/j.puhe.2024.07.008. Epub 2024 Aug 20.
There is a need to consider COVID-19 a syndemic; which calls for a comprehensive approach to tackle the associated interconnected challenges. The objective of this study is to investigate the potential syndemic nature of COVID-19, with a specific focus on understanding how viral infection, mental health (such as anxiety and depression), and pre-existing comorbidities interact and influence each other.
Retrospective population-based cohort study.
We conducted a population-based retrospective cohort study using linked health administrative data from the Institute for Clinical Evaluative Sciences, Ontario. The study included 2,863,423 Ontario residents from January 2020 to March 2021. We analysed healthcare services utilisation (physician visits, emergency visits, and hospitalisations) for chronic conditions among individuals with both COVID-19 and either anxiety or depression, to understand the syndemic impact of COVID-19 and mental health issues among Ontario population.
Multiple regression models were used to explore the study's objective. In the final adjusted regression model for the sample, it was found that the individuals who were COVID-19 positive and had either anxiety or depression were more likely to utilise health services for chronic conditions of interest during the pandemic than those who were COVID-19-negative with mental health issues (odds ratio [OR]:, 1.33; 95% confidence interval [CI]: 1.12-1.58). A higher risk of morbidity was observed among males (OR: 1.28; CI: 1.16-1.41), as well as in individuals with diverse ethnic backgrounds and low socioeconomic status.
The impact of COVID-19 on mental health, particularly among vulnerable populations with chronic diseases, can be seen as a syndemic. This complex interaction emphasises the need for integrated public health strategies.
有必要将新冠病毒病视为一种综合征；这就需要采取综合方法来应对相关的相互关联的挑战。本研究的目的是调查新冠病毒病潜在的综合征性质，特别关注了解病毒感染、心理健康（如焦虑和抑郁）以及既往合并症如何相互作用和相互影响。
基于人群的回顾性队列研究。
我们利用安大略省临床评估科学研究所的关联健康管理数据进行了一项基于人群的回顾性队列研究。该研究纳入了2020年1月至2021年3月期间的2,863,423名安大略省居民。我们分析了新冠病毒病患者以及患有焦虑或抑郁的个体中慢性病的医疗服务利用情况（看医生、急诊和住院），以了解新冠病毒病和心理健康问题对安大略省人群的综合征影响。
使用多元回归模型来探究研究目的。在样本的最终调整回归模型中，发现新冠病毒病检测呈阳性且患有焦虑或抑郁的个体在疫情期间比那些新冠病毒病检测呈阴性但有心理健康问题的个体更有可能因感兴趣的慢性病而利用医疗服务（优势比[OR]：1.33；95%置信区间[CI]：1.12 - 1.58）。在男性（OR：1.28；CI：1.16 - 1.41）以及具有不同种族背景和社会经济地位较低的个体中观察到更高的发病风险。
新冠病毒病对心理健康的影响，特别是在患有慢性病的弱势群体中，可被视为一种综合征。这种复杂的相互作用强调了综合公共卫生策略的必要性。
