GlobalMediXChange-COVID19英文版

42 Handbook of COVID-19 Prevention and Treatment
2 Establishing a dynamic mechanism for evaluation and warning of
psychological crisis
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Patients’ mental states (individual psychological stress, mood, sleep quality, and
pressure) should be monitored every week after admission and before discharge. The
self-rating tools include: Self-Reporting Questionnaire 20 (SRQ-20), Patient Health
Questionnaire 9 (PHQ-9) and Generalized Anxiety Disorder 7 (GAD-7). The peer-rating
tools include: Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale
(HAMA), Positive and Negative Syndrome Scale (PANSS). In such a special environment
as the isolated wards, we suggest that patients should be guided to complete the
questionnaires through their cell phones. The doctors can interview and perform scale
assessing through face-to-face or online discussion.
Intervention and treatment based on the assessment
3.1 Principles of intervention and treatment
For mild patients, psychological intervention is suggested. Psychological
self-adjustment includes breathing relaxation training and mindfulness training. For
moderate to severe patients, intervention and treatment by combining medication and
psychotherapy are suggested. New antidepressants, anxiolytics, and benzodiazepines
can be prescribed to improve the patients’ mood and sleep quality. The second
generation antipsychotics such as olanzapine and quetiapine can be used to improve
psychotic symptoms such as illusion and delusion.
3.2 The recommendation of psychotropic medications in elderly patients
Middle-aged or elderly COVID-19 patients’ medical situations are often complicated by
physical diseases such as hypertension and diabetes. Therefore, when selecting
psychotropic medications, the drug interactions and their effects on respiration must be
fully considered. We recommend using citalopram, escitalopram, etc. to improve
depression and anxiety symptoms; benzodiazepines such as estazolam, alprazolam,
etc. to improve anxiety and sleep quality; olanzapine, quetiapine, etc. to improve
psychotic symptoms.
XV. Rehabilitation Therapy for COVID-19 Patients
Severe and critically ill patients suffer from different degrees of dysfunction, especially
respiratory insufficiency, dyskinesia and cognitive impairment, during both acute and
recovery stages.
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Rehabilitation therapy for severe and critically ill patients
The goal of early rehabilitation intervention is to reduce breathing difficulties, relieve
symptoms, ease anxiety and depression and lower the incidence of complications. The
process of early rehabilitation intervention is: rehabilitation assessment - therapy -
reassessment.