Psychosocial status and COVID-19 outcome are significantly associated | Journal of Health, Population and Nutrition

Total confirmed cases per million of population (TCCM) and total deaths per million of population (TDM)

The impact was assessed in relation to the rate of diagnosis/ Covid testing, lockdown during this time, and the concomitant psychological condition (caused by constraints, self-isolation, and quarantine). We investigated the total confirmed cases (TCC) and total deaths (TD) from Covid-19 as documented in WHO Corona virus disease (Covid-19) Situation Report–161 day [13]. According to WHO the “data as received by WHO from national authorities by 10:00 CEST, 29 June 2020” (WHO Situation Report– 161, 2020). The total estimated population as on July 2020 of the respective countries/territories/areas was collected from the Department of Economic and Social Affairs Population Dynamics of United Nations (UN, World Population Prospects 2019). The TCCM and TDM of population were calculated by the following equations.

TCCM: [(TCC of Covid-19of a specific country/territory/area)/(Total estimated population of the same country/territory/area)] X 1 million.

TDM: [(TD from Covid-19 of a specific country/territory/area) /(Total estimated population of the same country/territory/area)] X 1 million.

Case fatality rate (CFR) of Covid-19

CFR describes the risk of persons dying from a certain disease within a given time period. CFR was calculated here as the number of deaths from Covid-19 during the experimental period divided by number of cases of the disease during the same time (Park, 23rd Ed. 2015).

CFR = (Number of deaths from a specific disease during a specific time period/Number of cases of the disease during the same time period) X 100.

CFR was divided into five categories on the severity of the affected countries viz. < 1.01, 1.01–3.00, 3.01–6.00, 6.01–9.00 and > 9.00.

As we mentioned in the introduction section, we explain that from the onset on Dec 2019, in 13–14 weeks (approx. 90–100 days) the Covid-19 was ubiquitously outspread throughout the globe and a large number of Asian, African, American and European countries became affected. So, this time scale was helpful to us to make comparison among different geographical and socio-economical territories. And the end date (approx. 29–30 weeks) was selected based on main two reasons. During this time period, other major mutants namely Delta or D614 or Omicron did not appear, so the results what we got that is only from the pure wild type, popularly designated as Wuhan variety. Another reason is that, during this time period no vaccination or other established therapeutic strategies were developed. Application of vaccination or testing some new drugs was uneven on time scale in different territories. Quarantine, lockdown, repurposing of old drugs were globally acclaimed strategies during this period. So, to avoid the statistical bias in comparison among some uneven situations, we selected this 14th to 29th weeks time period.

Income economies

For the current 2020 fiscal year, low-income economies, lower middle-income economies, upper middle-income economies, high-income economies were determined based on Gross National Income (GNI) per capita which was calculated using World Bank Atlas method. The criteria of GNI for the income economies of the countries were given below (The World Bank, 2020a).

Low-income economies: GNI per capita ≤ $1,025.

Lower middle-income economies: GNI per capita = $1,026 – $3,995.

Upper middle-income economies: GNI per capita = $3,996 – $12,375.

High-income economies: GNI per capita ≥ $12,376.

World happiness

Happiness score of the countries/territories/areas was collected from the World Happiness Report, which was annually published by United Nations Sustainable Development Solutions Network. This score was prepared using the six variables (viz. GDP per capita, social support, healthy life expectancy, freedom, generosity, and absence of corruption) (Helliwell et al. World Happiness Report, 2020).

Quality of life (QoL) in a country

All together thirty different factors were included for calculating overall index of QoL of a country/territory/area, which were divided into seven subject area or sub-sectors such as stability (deals with economic and political stability), civil rights (deals with legal system and civil rights), health and medical services (includes different factors including average life expectancy and the treatment facilities in relation to the number of inhabitants), security, climate (deals with the geographical environment, the optimum environment assumed as maximum daily temperature of 25 °C at 55% humidity and nearly 8 rainy days per month), costs (deals with costs and expenses that includes national cost of living and average annual income) and popularity (includes general migration rate and number of foreign tourists visited in that area). The best achievable value in each division or subject area or sub-sectors was 100. The contribution of these earlier mentioned seven subject areas for the calculation of overall index of QoL were 14%, 16%, 16%, 16%, 14%, 16% and 8%, respectively (Quality of life, 2020).

The global health security (GHS) index

The GHS Index was the first accountable parameter that is the comprehensive assessment and benchmarking of health security and related capabilities across the 195 countries. This is associated with the indexing of the International Health Regulations. The GHS Index was an important proposal of the Johns Hopkins Center for Health Security. It was developed by The Economist Intelligence Unit [11].

Anxiety disorders prevalence (ADP)

According to WHO, “Anxiety disorders refer to a group of mental disorders characterized by feelings of anxiety and fear, including generalized anxiety disorder (GAD), panic disorder, phobias, social anxiety disorder, obsessive–compulsive disorder (OCD) and post-traumatic stress disorder (PTSD)” [28]. We followed the latest report of WHO for the prevalence of anxiety disorders [28].

Depressive disorders prevalence (DDP)

According to WHO, “Depressive disorders were characterized by sadness, loss of interest or pleasure, feelings of guilt or low self worth, disturbed sleep or appetite, feelings of tiredness, and poor concentration. Depression can be long lasting or recurrent, substantially impairing an individual’s ability to function at work or school or cope with daily life. In this regard, caution should be made considering the two interdependent factors like environmental and psychic so that a vicious circle is not created. Another painful situation that may mimic depression but noted as demoralization (does not fulfill criteria according to DSM-V). This situation may sometime develop resilience in some individuals (Costanza et. Al., 2021). Depression can lead to suicide at its most severe condition [28]. We followed the latest report of WHO for the prevalence of depressive disorders [28].

Prevalence of tobacco smoking (TSP)

The age-standardized prevalence of tobacco smoking among persons aged 15 years and older in different countries/territories/areas were given in the latest report of World health statistics developed by WHO in 2019 was used in this study [29].

Suicide mortality rate (SMR)

SMR per 100,000 (SMRL) in different countries/territories/areas were given in the latest report of World health statistics developed by WHO in 2019 was used in this study [29]. The important determinants which are associated with SMR are Perceived stress (PSS), availability of social provisions (SPS), Short self-report scale of loneliness (SLON) and personality assessment (BFI-S), neuroticism scale [BFIS-N], BFI-S openness scale [BFIS-O], BFI-S agreeableness scale [BFIS-A], BFI-S conscientiousness scale [BFIS-C]). The particulars of these factors were collected from the COVIDiSTRESS Global Survey dataset on psychological and behavioral consequences of the Covid-19 outbreak [23].

Lockdown period during Covid-19

The information regarding lockdown in different countries during the Covid-19 pandemic was collected from the Wikipedia literature [https://en.wikipedia.org/wiki/COVID-19_lockdowns].

Total test (TT) and total confirm cases and Total test ratio (TCC: TT) of Covid-19 cases

Country wise the total test during the investigation tenure were collected from [ The TCC: TT was calculated by dividing the number of total confirm cases on 161 days / number of total tests on the same day.