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Medicina
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The Burden of COVID-19 Pandemic on Mental Health, 2nd Edition
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The Burden of COVID-19 Pandemic on Mental Health, 2nd Edition

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Epidemiology & Public Health".

Deadline for manuscript submissions: 20 June 2026 | Viewed by 4411

Special Issue Editors

Prof. Dr. Sorin Hostiuc

E-Mail Website
Guest Editor
Department of Legal Medicine and Bioethics, Faculty of Dental Medicine, “Carol Davila University” of Medicine and Pharmacy, RO-020021 Bucharest, Romania
Interests: pathology; bioethics; sudden cardiac death; forensic; research ethics; telocytes; stem cells; organoids
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Beatrice Gabriela Ioan

E-Mail Website
Guest Editor
Legal-Medicine Department, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy of Iasi, 700115 Iasi, Romania
Interests: bioethics; medical law; forensic medicine; medical malpractice; medical communication; violence against medical professionals; burnout in medical professionals
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues, 

The COVID-19 pandemic has caused significant burdens on global mental health, manifesting across various demographics and exacerbating pre-existing psychological conditions. This Special Issue is the second one on this topic published in Medicina, entitled “The Burden of COVID-19 Pandemic on Mental Health”.

The pandemic led to a significant rise in anxiety, depression, and stress-related disorders due to contributing factors such as fear of infection, social isolation due to lockdowns, economic uncertainties, and disruptions to daily routines. Frontline healthcare professionals encountered unprecedented challenges during this period, resulting in elevated levels of burnout, anxiety, and post-traumatic stress disorder (PTSD), their psychological stress compounded by extended working hours, high patient mortality, and inadequate personal protective equipment.

In children and adolescents, the closure of educational institutions and the transition to remote learning substantially affected mental well-being, with reports of increased feelings of loneliness, anxiety, and depression and some studies indicating that over 40% of students experienced persistent feelings of sadness or hopelessness during the pandemic.

Patients with pre-existing psychiatric disorders were also significantly affected, showing increased vulnerability and exacerbation of their mental conditions. Disruptions to therapy and support services, combined with heightened stressors, resulted in increased symptomatology, burden, and even mortality within this population.

This Special Issue aims to gather significant scientific contributions in this area in the form of either original articles or reviews. We are especially interested in studies on the effect of long COVID on mental health.

Prof. Dr. Sorin Hostiuc
Prof. Dr. Beatrice Gabriela Ioan
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • COVID-19 pandemic
  • mental health
  • therapy
  • psychological stress
  • psychiatric disorders

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Related Special Issue

Published Papers (4 papers)

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Research

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27 pages, 1626 KB  
Article
Clinical and Psychological Impact of COVID-19 on Maintenance Hemodialysis Patients: Hospitalization Burden, De Novo Anxiolytic Use, and Long-Term Survival
by Ioana Adela Ratiu, Danut Dejeu, Ozana Hocopan, Corina Moisa, Gabriel Cristian Bako, Nicu Olariu, Mihaela Pal, Edy Hagi-Islai, Anamaria Ratiu, Mirela Indries, Elena Emilia Babeș and Cristian Adrian Ratiu
Medicina 2026, 62(4), 744; https://doi.org/10.3390/medicina62040744 - 13 Apr 2026
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Abstract
Background and Objectives: Hemodialysis (HD) patients represented a highly vulnerable population during the COVID-19 pandemic, both clinically and psychologically. Data regarding acute anxiety requiring pharmacologic treatment in this setting are limited. The aim of the study was to assess factors influencing clinical [...] Read more.
Background and Objectives: Hemodialysis (HD) patients represented a highly vulnerable population during the COVID-19 pandemic, both clinically and psychologically. Data regarding acute anxiety requiring pharmacologic treatment in this setting are limited. The aim of the study was to assess factors influencing clinical evolution, psycho-emotional disturbances reflected by “de novo” anxiolytic use, and vital prognosis of hospitalized COVID-19 patients on HD. Materials and Methods: The study included 211 patients followed between 2020 and 2023 (149 were COVID-19 positive and 80 required hospitalization) and comprised two sequential phases: an in-hospital phase during COVID-19, in which disease severity factors, in-hospital mortality, and the requirement for de novo anxiolytic therapy were assessed, and a follow-up phase, which evaluated overall mortality and the impact of vaccination on long-term outcomes. Results. Hospitalized patients were older, had lower dialysis adequacy, and a lower rate of COVID-19 vaccination. Severe COVID-19, associated with elevated inflammatory markers, prolonged hospitalization, and an increased need for anxiolytic therapy to control acute psychopathological disturbances, was significantly more frequent in patients with underlying oncological comorbidities. Patients who died from COVID-19 during hospitalization were older (69.364 ± 1.973 vs. 66.426 ± 1.546, p = 0.239), predominantly male (66.69% vs. 48.93%, p = 0.064), had similar BMI (26.836 ± 1.120 vs. 26.909 ± 0.943, p = 0.961), and had shorter duration on HD (5.182 ± 4.733 vs. 7.383 ± 6.060, p = 0.085). Patients who received anxiolytic therapy during hospitalization for COVID-19 were younger, predominantly male, and had a longer dialysis vintage as well as a higher body mass index. Although the de novo need for anxiolytics during COVID hospitalization was associated with multiple parameters in the linear regression analysis, the multivariable regression model showed a significant and strong association only with corticosteroid therapy (OR = 16.403, 95% CI = 4.433–62.111, p < 0.001). COVID-19 vaccination was associated with a significant reduction in mortality risk, with vaccinated patients exhibiting a 58% lower hazard of death compared with unvaccinated individuals (HR = 0.42; 95% CI: 0.28–0.62; p < 0.001). Conclusions: COVID-19 in HD patients is a multidimensional pathology, in which clinical severity and preventive strategies, such as vaccination, significantly influence survival. Acute anxiety requiring pharmacologic intervention was highly prevalent in hospitalized HD patients with COVID-19, but was not associated with worse survival (p = 0.903). Psychological burden should be recognized as an important component of care in this population. Full article
(This article belongs to the Special Issue The Burden of COVID-19 Pandemic on Mental Health, 2nd Edition)
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19 pages, 689 KB  
Article
Mental Health in Educational Communities in Chile After a Public Health Emergency: An Assessment of Schoolchildren and Their Caregivers
by Mariela Andrades, Felipe E. García, Ryan Kilmer, Pablo Concha-Ponce and Cibelle Lucero
Medicina 2026, 62(2), 279; https://doi.org/10.3390/medicina62020279 - 29 Jan 2026
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Abstract
Background and Objectives: Public health emergencies, such as the COVID-19 pandemic, significantly impact individuals and families, particularly in educational settings. School closures and changes in daily routines reduced students’ opportunities for learning and social interaction, affecting their mental health. Caregivers also faced [...] Read more.
Background and Objectives: Public health emergencies, such as the COVID-19 pandemic, significantly impact individuals and families, particularly in educational settings. School closures and changes in daily routines reduced students’ opportunities for learning and social interaction, affecting their mental health. Caregivers also faced increased responsibilities and stressors. This study aimed to evaluate a predictive model of mental health outcomes—specifically posttraumatic stress symptoms (PTSSs) and posttraumatic growth (PTG)—in Chilean schoolchildren and their caregivers. Materials and Methods: A total of 489 students (48% female sex; aged 10–17) from educational communities in various Chilean cities participated in the study, along with their caregivers (aged 21–69; 86.5% female), including mothers, fathers, and guardians. Mental health variables were assessed through self-report instruments. Hierarchical linear regression and path analyses were used to evaluate predictive models for PTSSs and PTG in students. Results: The model predicting PTSSs in students was significant. Key predictors included female sex, aggressive behavior, coping strategies such as keeping problems to oneself, cognitive avoidance, and intrusive rumination, and caregiver PTSSs. The model for PTG was also significant, with predictors including active problem-solving, communication, a positive attitude, and deliberate rumination. These results indicate distinct psychological processes underlying negative and positive outcomes following trauma. Conclusions: The findings underscore the complexity of mental health outcomes among school-aged children and the influence of caregiver well-being. The study highlights the importance of supporting both students and caregivers through targeted interventions. Multi-level strategies addressing emotional regulation, communication, and coping mechanisms may foster resilience and psychological growth in educational communities facing the aftermath of public health emergencies. Full article
(This article belongs to the Special Issue The Burden of COVID-19 Pandemic on Mental Health, 2nd Edition)
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20 pages, 845 KB  
Article
Mental Health and Age-Related Differences in Community During the COVID-19 Pandemic: A Cross-Sectional Study from Southeastern Türkiye
by Pakize Gamze Erten Bucaktepe, Vasfiye Demir Pervane, Ömer Göcen, Sercan Bulut Çelik, Fatima Çelik, Öznur Uysal Batmaz, Ahmet Yılmaz, Tahsin Çelepkolu and Kürşat Altınbaş
Medicina 2025, 61(10), 1840; https://doi.org/10.3390/medicina61101840 - 14 Oct 2025
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Abstract
Background and Objectives: The COVID-19 pandemic has caused profound disruptions in socioeconomic, and health domains, with significant implications for mental well-being. The aim of this study was to evaluate the impact of the pandemic on stress, anxiety, and depression, alongside perceived social support, [...] Read more.
Background and Objectives: The COVID-19 pandemic has caused profound disruptions in socioeconomic, and health domains, with significant implications for mental well-being. The aim of this study was to evaluate the impact of the pandemic on stress, anxiety, and depression, alongside perceived social support, coping flexibility and related factors, and to examine how these issues vary across different age groups. Materials and Methods: A cross-sectional analytical study was conducted in Türkiye between August and December 2020. Data were collected through an online questionnaire including sociodemographic characteristics, pandemic-related concerns, and validated scales: Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS), Coping Flexibility Scale (CFS), and Multidimensional Scale of Perceived Social Support (MSPSS). Statistical analyses included descriptive and comparative tests, correlation analysis, multiple linear regression models, and correspondence analysis. Results: Among 1699 participants, 58.0% were female; 24.5% and 42.1% reported anxiety and depressive symptoms above thresholds, respectively. Younger age correlated negatively with stress, anxiety, and depression scores (p < 0.001). Feelings of loneliness, loss of control, ostracism, and sleep or concentration problems were positively associated with anxiety, depression, and stress, but negatively associated with coping flexibility and social support (p < 0.001). The 15–20 age group had the highest anxiety and depression levels and the lowest social support; the 15–30 group showed the highest stress, while the 61–75 group exhibited the lowest coping flexibility. Regression models explained 62.7% of anxiety and 56.6% of depressive symptom variances. Major predictors of anxiety included depressive symptoms, stress, and fear of dying from COVID-19, while depressive symptoms were predicted by age, stress, coping flexibility, social support, and anxiety. Conclusions: The findings highlight the considerable psychological burden and distinct vulnerabilities among age groups. Mental health interventions should be tailored according to age, emphasising the enhancement of social support and coping flexibility to strengthen resilience in future pandemics. Full article
(This article belongs to the Special Issue The Burden of COVID-19 Pandemic on Mental Health, 2nd Edition)
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Review

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37 pages, 574 KB  
Review
Burnout, PTSD, and Medical Error: The Medico-Legal Implications of the Mental Health Crisis Among Frontline Healthcare Professionals During COVID-19
by Sorin Hostiuc and Florentina Gherghiceanu
Medicina 2026, 62(2), 305; https://doi.org/10.3390/medicina62020305 - 2 Feb 2026
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Abstract
Background and Objectives: The COVID-19 pandemic has led to an unprecedented mental health crisis among workers in the healthcare field, with average burnout rates increasing from about 32% before the pandemic to 46–52% during peak times and post-traumatic stress disorder (PTSD) affecting [...] Read more.
Background and Objectives: The COVID-19 pandemic has led to an unprecedented mental health crisis among workers in the healthcare field, with average burnout rates increasing from about 32% before the pandemic to 46–52% during peak times and post-traumatic stress disorder (PTSD) affecting 24–34% of frontline staff. The primary objective of this article is to synthesize evidence on the prevalence of burnout and PTSD among healthcare workers before and during the COVID-19 pandemic. The secondary objectives are: (a) to examine the mechanisms and empirical evidence linking clinician mental health to medical errors and patient safety outcomes and (b) to analyze the medico-legal implications of this relationship, including malpractice liability, institutional responsibility, and opportunities for policy reform. Materials and Methods: We conducted a narrative review searching PubMed (November 2025–January 2026) using predefined keyword combinations. Inclusion criteria comprised original research, systematic reviews, and meta-analyses examining mental health outcomes or patient safety among clinical staff. Data were synthesized narratively across five thematic domains. Results: Burnout prevalence increased from approximately 32% pre-pandemic to 46–52% during peak periods, with emotional exhaustion reaching 67.5% in some settings. PTSD rates rose to 24–34% among frontline staff, exceeding pre-pandemic levels of 15–20%, with ICU staff particularly affected (27–40%). Substantial overlap exists between conditions (86–98% comorbidity). Physician burnout is associated with 2.72 times higher odds of self-reported errors (95% CI: 2.19–3.37), with each point increase in emotional exhaustion raising the error risk by 5–11%. Mechanisms include cognitive impairment (reduced executive function, g = −0.39; impaired working memory, g = −0.36) and sleep disturbance. Malpractice litigation compounds psychological harm, increasing depression and suicidal ideation. Conclusions: This review, synthesizing data from over 500,000 healthcare workers, demonstrates bidirectional relationships among burnout, PTSD, and medical errors with significant medico-legal ramifications. Addressing this crisis requires systemic interventions including workload management, psychological support, blame-free reporting cultures, and policy reforms balancing accountability with recognition of system-level contributors to error. Full article
(This article belongs to the Special Issue The Burden of COVID-19 Pandemic on Mental Health, 2nd Edition)
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