key: cord-298846-qb0frju1
authors: Waszkiewicz, Napoleon
title: Possible special needs for mental online support in female and male health care workers during the COVID‐19
date: 2020-07-14
journal: J Med Virol
DOI: 10.1002/jmv.26273
sha: 
doc_id: 298846
cord_uid: qb0frju1

In their article Wu and colleagues, similarly to other authors, present the effects of stress on medical staff during the COVID-19 pandemic as an unprecedented challenge for all communities. Their observation is within current literature trends, which identify 7 population subgroups affected by the psychosocial consequences of the COVID-19: general population affected by restrictive measures, people subjected to quarantine, positive for the virus (isolated/hospitalized), health care personnel, relatives of persons who died, and mentally ill patients. This article is protected by copyright. All rights reserved.

Possible special needs for mental online support in female and male health care workers during the COVID-19

To the Editor, In their article Wu and colleagues, 1 similarly to other authors, 2 Knowledge about the COVID-19 increases over time. However, the proportion of COVID-19 cases in health care workers is still very high (up to 20%). 4 Medical staff is still mobilizing to work with patients infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). At the same time they often feel verbal social support but also feel social stigma and a huge stress due to developing the COVID-19 and spreading it. [2] [3] [4] In some countries they still learn to wear protective clothing from the internet pages, are supplied with equipment that does not fully meet the requirements or is rarely tested for coronavirus. 4, 5 Generally, perceived stress and insufficient coping behavior contribute significantly to higher mortality rates in a doseresponse pattern. 6 Although robust evidence suggests that chronic stress plays a significant role in the onset of severe psychiatric conditions such as major depressive disorder, bipolar disorder, and posttraumatic stress disorder, 7 perceived stress is more strongly associated with death than mental health conditions per se. 6 On the other hand, mental health conditions are associated with multimorbidity, influence the quality of life worldwide, and are linked to a wide range of adverse health outcomes such as higher risk of cardiovascular events, metabolic syndrome, and death. 6 A possible explanation of stress-related harm includes deregulation of stress-related activation of neuroendocrine hypothalamicpituitary-adrenal (HPA) axis, subsequent rise in cortisol levels and deregulation of immune/inflammatory system. 6 As corticosteroids can activate latent viruses, 8 they can potentially increase the spread of viruses. Hyperactivated HPA axis increases also levels of catecholamines (noradrenaline and adrenaline) that can block the activity of macrophages-critical for virus clearance. 8 Other explanations may include stress-related undesirable health behaviors such as a sedentary lifestyle or substance abuse/dependence, which might affect the prognosis of mental and somatic diseases. 6 Neurologic manifestations of SARS-CoV-2 infection such as anosmia, ageusia, ataxia and seizures, and the presence of viral-like particles in brain and capillary endothelium suggest that the virus may be neurotropic 9 and these brain changes can potentially affect further stress tolerance.

The truism is that medical health workers who are well, best serve their patients. 2 Another truism is that there is "no health without mental health." 10 Coronavirus appears to pose a particular threat to men. 5 The death rate among men seems to be 50% higher than among women, 11 which might be the result of the fact that men smoke more cigarettes than women. Smokers made up

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