PSYCHOLOGICAL COMPLICATIONS AND THE POTENTIAL TRIGGER EFFECT OF COVID INFECTION AND "LONG-COVID"

Summary: The main point of this article is to search, analyze and compare the newest available data about the psychological effects of the COVID-19 pandemic. We look at the problem both like the solo question of viral infection that damages some parts of the human body and accidentally pushes negative psychological changes and like the factor, which creates a grate socio-economic disturbance. We make sure to choose the most recent reviews with high quality and design by analyzing medical and social factors in different groups. The results help us to understand two main problems of the COVID-19 pandemic - psychological damage to vulnerable groups of people, especially women and children, and also the severe impact of the virus itself, especially in a patient with hard clinical forms of SARS..

Actuality: more than two years have passed since the first "outbreak" of the Covid-19 pandemic. Using great medical and social tools, such as quarantine, vaccination, and mass information about the principles of prophylactics and selfisolation, give us the possibility to reduce the frequency of new cases. Same time, an additional positive effect of the quarantine measures was an increase in the success rate of treatment of those patients who needed hospitalization.
However, despite the reduction of direct risks of mortality, and disabling complications, the question of the long-term consequences of the infection remains open.
Through various studies, we have learned about several non-obvious and atypical consequences of other SARS, such as long-term loss of smell, shortness of breath, pain, "mind fog" and chronic fatigue, sleep problems, and some more rare manifestations of the disease. An important question that remains open is how exactly COVID-19 affects psychological well-being and whether it is possible to evaluate the impact of the disease in isolation from the socio-economic changes caused by the pandemic and quarantine.

SECTION XXIV. MEDICAL SCIENCES AND PUBLIC HEALTH
How we respond to stress is a surprisingly dynamic process. Stress initiates a cascade of behavioral, (neuro) biological and physiological changes. To do this, we need prospective data of sufficient duration and temporal resolution to observe intermittent changes in resilience. Second, biological, psychological, and environmental data must be combined and integrated to understand the impact of pandemic-related stress at multiple levels with an understanding of the individual's unique context.
Over the past year, about 339 reviews devoted to the interaction of Covid-19 and psychological health and well-being, and more than 10,000 different articles devoted to the same issue registered in the Pubmed network, which highlights the relevance of the topic and creates a basis for further analysis.
Purpose: we start our study to determine the main changes in the psychological and mental well-being of patients who have experienced acute Covid-19, including those who suffered from the phenomenon of long-Covid, and to analyze the associations with differences in the socioeconomic status of patients and the impact of the pandemic and restrictive measures Materials and methods: we analyze scientific literature, meta-analyses, and reviews that measured changes in the psychological state of patients of various severity both immediately after acute Covid-19 and during the following 12 months, both by survey and by recording the number of patients who applied for psychological or psychiatric help and the use of special questionnaires. An important selection criterion was the use of reviews covering data from different countries, which allows us to assess the impact of different types of quarantine and social isolation and separate this factor from the infection and its impact.
Data and their discussion: we found some interesting data, such as the result of comparing the data of health-related quality of life (HRQL) questionnaires in patients of different gender and age groups [8], including independently of detected comorbidities, the indicators of the group of patients who suffered from Covid-19 showed more difficult signs of a decrease in the quality of life 12 months [6] after the disease. At the same time, comorbidity increase the risk of severe and critical course of the main disease, as well as low HRQL indicators in the prognosis.
Another study focused on assessing the impact of Covid-19 on the psychological well-being [4] of pregnant women, found that despite the lack of clear data on the impact of Covid on the formation of postnatal depression (p < 0.083). At the same time, the very fact of having a child during the pandemic led to a statistically significant to an increase in indicators on the State-Trait Anxiety Inventory (STAI) scale (p < 0.001) Analysis of earlier literature demonstrated that there is some evidence that symptoms of mild COVID-19 persist [1] after 3 weeks in a third of patients. The question at that time remained to what extent there was a tendency to preserve this changes later, including 3 months or more. More recent studies, including a review in BMC Medicine, point to the long-term effects of COVID-19 as a catalyst for negative psychological changes, including one of the factors in the onset of generalized anxiety or depressive disorders [2,4].
In all reviews impact of the pandemic itself on the mental well-being of patients was revealed, regardless of the severity of the disease. At the same time, it is СЕКЦІЯ XXIV. МЕДИЧНІ НАУКИ ТА ГРОМАДСЬКЕ ЗДОРОВ'Я noticeable [4,5,8] that the greatest impact of the pandemic and restrictions associated with it affected less economically protected population groups [3]. There is a tendency for fewer psychological changes in patients [7] from economically prosperous countries with developed social institutions and assistance mechanisms during a pandemic Conclusions: 1. The COVID-19 pandemic may have worsened gender-related mental health issues, including exacerbating gender inequality and significantly affecting pregnant women and single mothers, both through potential direct negative impacts and indirectly through economic stagnation. There is an increased risk of developing post-covid psychological complications in women, which at the same time may be associated with a worse level of self-diagnosis and referral to a doctor among the male population due to toxic traditional masculine behavior patterns.
2. Children and young people are one of the vulnerable population groups, in terms of the impact of restrictive measures and potential economic risks, while COVID-19 alone has no proven negative impact on their mental well-being.
3. COVID-19 has an impact on psychological well-being, with a more severe course of the disease leading to worse results on psychological state questionnaires and a higher number of complications, including the onset of major depressive and anxiety disorders.
4. There is an urgent need to identify individuals and populations at higher risk of psychological distress during pandemics to offer targeted psychiatric care and improve social support, physical activity, and recovery strategies for these people These approaches are necessary to strengthen one's resilience factors that protect a person from psychological stress.