key: cord-0885121-azmi9e45 authors: Sharma, Priyanka; Sharma, Ramesh title: IMPACT OF COVID-19 ON MENTAL HEALTH AND AGING date: 2021-08-04 journal: Saudi J Biol Sci DOI: 10.1016/j.sjbs.2021.07.087 sha: 47de0680b6fc49bd955935cf931f10dbdef500e2 doc_id: 885121 cord_uid: azmi9e45 The potential ramifications of the COVID-19 pandemic on the population's mental health are a rising global concern. Both at the individual and community level, the erratic and uncertain COVID-19 outbreak has the prospective to exhibit a detrimental effect on psychological health and aging. At present, various measures are dedicated to the parameters like awareness of epidemiology, clinical aspects, mode of transmission, counteracting the spread of the infection, and public health problems, although this initiative has neglected critical mental health concerns. This study is to investigate the outbreak to study the level of harmful effects on mental health and its crosstalk with aging. Global execution of preventive, control measures and resilience establishment are challenging factors whereas reformed lifestyle such as lockdown, coping with self-isolation, quarantine, social distancing, and post-traumatic stress disorders are alarming. Hallmarks of aging which interact with each other, have been suggested to affect the healthspan in aged adults, possibly due to attenuated immunity. Among various hallmarks, we concentrated on those that show direct or indirect interaction with viral infections, comprising inflammation, genomic instability, impaired mitochondrial function, epigenetic modification, telomere attrition, and damaged autophagy. These hallmarks possibly contribute to the elicited pathophysiological responses to SARS-CoV-2 and may add an additive risk of accelerated aging post-recovery among aged adults. Here, the role of antiaging drug candidates that require main consideration in COVID-19 research is discussed briefly. In the later future, it can emerge as a potential therapeutic approach in the treatment of patients with severe infection. The anomalous impact of COVID-19 does not only affects physical health and well-being of the population but mental health too, which harms the health system. Whereas compared to physical health, the concern on mental health issues always takes a backseat. Mental well-being is a condition in which individuals can cope up well with multiple pressures of life, appreciate their potential, work productively and contribute to their communities (Pfefferbaum et al., 2020) . For the overall response and recovery from COVID-19, good mental health is as crucial as the attention on physical health. The most important mental health disorders identified that have been correlated with the outbreak of COVID-19 are stress, symptoms of depression, anxiety, insomnia, outrage, and fright throughout the globe (Torales et al., 2020) . A recent report in psychiatry advocates that COVID-19 can lead to an augmented risk of suicide (Liu et al., 2020) . Another recent study conducted in China recorded 16.5% of average to severe symptoms of depression, 28.8% of average to severe symptoms of anxiety, 8.1% of moderate to severe levels of stress because of COVID-19 (Wang et al., 2020) , and a high prevalence of mental health issues correlated with regular exposure to social media in the course of pandemic (Gao et al., 2020) . Organizations and people may build cognitive, sentimental, and interpersonal capabilities that facilitate responses to adaptive managing and contribute to both an organizational and a self-resilience plan (Albott et al., 2020) . Based on this, the distress responses to the COVID-19 contagion and strategies for improving organizational and personal resilience have been compiled in (Table 1) . Health professionals who are actively involved in the diagnosis, treatment, and care of COVID-19 patients are at risk of psychological distress and other signs of mental health. The elicited number of confirmed and suspected cases, excessive workload, lack of personal protection facilities, lack of specific medicines, and feelings of insufficient support can cause mental problems to health workers (Lai et al., 2020). There is a common concern that social restrictions to control the spread of COVID-19 would disproportionately affect older people, especially those who live alone (Armitage and Nellums, 2020) . The only study showed the effect of social isolation and self-confinement among older people during health crises focused on jobs after the MERS outbreak in South Korea (Yoon et al., 2016) . Social distance has become a major factor for increased incidences of depression, anxiety disorders, and suicide, especially in old-age homes, because of greater biological, physical, psychological, and physiological vulnerability, social isolation of the elderly age group is a significant public health concern. The study has proposed 15 smartphone applications that are thought to be beneficial during isolation for the elderly with cognitive, visual, and hearing impairments (Banskota et al., 2020) . The case fatality rate (CFR) of COVID-19, that is the death to confirmed infections ratio, was shown to be lower in patients under 60 years of age (1.4 percent) relative to those 60 years of age or older (4.5 percent) (Verity et al., 2020). The most productive class of any country are the young individuals who have been severely impacted by the outbreak. People may use different unhealthy ways to cope with stressors, including alcohol consumption, opioids, cigarettes, or wasting maximum time on possibly addictive chores including virtual gaming. Statistical study in Canada shows that during the pandemic, 20 percent of the population which are between 15-49 years old have surged their alcohol consumption (Dozois and David, 2020) . According to the studies by Italian and Spanish parents, many children's emotional status and actions have been impacted during quarantine. The most vulnerable are differently challenged children, those who stay and labor on the streets. To combat the issue, the book 'My Hero is You' has been written by a committee of UN and non-UN organizations to assist children with an age of 6-11 years to come up with their difficulties of pandemic (Ghebreyesus and Tedros, Psychological resilience is a progressive mechanism confining what is interpreted and understood while confronted with realities (Basim et al., 2011) . Psychological resilience improves the capacity to combat and withstand challenges that can make it easier for health care staff to recover from the pandemic. People with a sound mental state are less affected by the consequences of the pressures they encounter and could be more involved in crisis management. By fighting, resisting, and demonstrating the right attitudes, individuals with psychological resilience can easily overcome stressful circumstances (Bahar et al., 2020). Quarantine may be a required preventive measure during major infectious disease outbreaks. This study, however, indicates that adverse psychological effect is frequently correlated with quarantine. Quarantine refers to the isolation and prohibition of the movement of individuals who have been manifested to infectious disease and have a probability to be ailing, thus diminishing the chance of spreading infecting. Whereas isolation is the separation of those people who have been diagnosed with a contagious disease from healthy people but are sometimes termed interchangeably. The psychological effect of quarantine is wide-ranging and can be long-lasting. The psychological effects of not using quarantine and allowing disease to spread might be worse than the suggestions for non-implementation of quarantine. Depriving people of their rights for the broader public benefit, however, is always controversial and needs to be treated carefully. If quarantine is essential, then our findings indicate that officials should take every step to ensure that this experience is as tolerable for individuals as possible. This can be done by: reminding people what is going on and why, explaining how long it will last, providing them with meaningful things to do while in quarantine, providing consistent communication, ensuring that essential resources are available, and strengthening the sense of altruism that people can feel rightfully (Brooks et al., 2020 ). In case of emergency, accessibility of mental well-being and psychosocial help becomes a prime concern. These include supporting the actions of community that sustain social solidity and decrease loneliness. Implementation of quality-ensured tele-counselling to the frontiers, health care employees and people suffering with depression and anxiety at home (Nations, 2020) . Strategies for strengthening and COVID-19 severe manifestations increase with age, with older patients having the highest fatality rate, implying that aging-related molecular pathways contribute to COVID-19 severity. The continual shortening of telomeres, which are protective structures at the ends of chromosomes, is one cause of aging. Tissues with critically short telomeres have a lower regeneration ability, which leads to a loss of tissue homeostasis and illness. Tissues with critically short telomeres have a lower regeneration ability, which leads to a loss of tissue homeostasis and illness. We Spermidine, a natural polyamine with anti-aging characteristics, has been discovered. Supplementing with this medicine extends life and reduces the occurrence of age-related diseases. Spermidine levels decline with age in the human population, and a possible link between decreased endogenous spermidine levels and age-related declination has been investigated. Spermidine supplements in the diet help to lengthen telomeres. The proposed hypothesis also identifies genes involved in telomere preservation and aging that are altered differently after spermidine therapy. Understanding the role of spermidine in telomere maintenance will aid in deciphering the molecular mechanism behind spermidine's anti-aging effects (Sharma and Jaiswal., 2021). The analysis shows a close correlation between the fatality rate of COVID-19 and aging with the fatal respiratory diseases should be taken into consideration along with latest emerging aging diseases. Aged individuals are more prone to infection, therefore approaches to address the aging process, along with antiviral approaches and those that increase the human immune system of the aged individuals can be effectively taken for treatment strategy. The points which are to be highlighted for the study encircle the mechanisms which facilitates the COVID-19 virus to target individuals especially with higher chronological age. To understand this two host receptors such as CD26 (Raha et al., 2020) and the other protein is ACE-2 (angiotensin converting enzyme 2) (Ni et al., 2020) have been known. ACE-2 is also known to inhibit cell proliferation and upregulates both chronological and replicative senescence (Gheblawi et al., 2020) . The cell undergone to senescence shows production of high levels of inflammatory cytokines because of senescence-linked secretory phenotype (SASP) and IL-6 leading to the hypothesis that the COVID-19 virus is related to increased mortality . We propose a more quick understanding of COVID-19's interactions with host aging hallmarks in order to find biomarkers that can be utilized to identify people at higher risk. Understanding the processes of COVID-19 will most likely come from comparing the illness risks and treatment responses in young men and women with COVID-19 vs older patients-to do so, older adults must be included in clinical studies. To understand the mental health deeply, the neurological aspect could not be It is crucial to monitor and assess any measures generated by the pandemic to alleviate or address mental health problems. Again, it is demand of situation to understand the level of the effects of COVID-19 on mental wellbeing and the socioeconomic effects of the outbreak, and to consult on a personal level with the affected mass. Such research will strengthen the ongoing efforts for mental health. Procurement of Expeditious knowledge required to the institution of research priorities (Holmes et al., 2020) . Collaborative research, open-data sharing and funding are some of the ways to strengthen the machinary. Therapeutic targeting of ageing processes has the ability to improve resistance to ageing and consequently to age-related diseases including agents of infectious diseases, thereby enhancing and expanding healthy living with chronological age. Understanding the overwhelming picture that COVID-19 already has, a variety of potential approaches to SARS-CoV-2 have been established and thus autophagy is one of the potential cellular process to be explored. The consequence of autophagic processes in CoV infection has gained considerable attention in the last one and a half decades. Autophagy invokes to an evolutionary preserved mechanism in which intracellular constituents such as protein aggregates and weakened organelles are submerged in a double-membrane structure called autophagosomes, which gradually merges with lysosomes to form autolysosomes for degradation (Mizushima, 2018 where the role of anti-aging drugs can be a potential candidate for pharmacological interventions and therapeutic strategies. Mental wellbeing and psychosocial support are essential for health, safety and social security, nutrition, labor, education, justice. The government should ensure that mental wellbeing is thoroughly considered in the health, socio-economic reactions, and recovery plans of governments. In addition, humanitarian coordinators should ensure that preparation and planning can provide mental health and psychosocial support. Mental well-being will persist as a primary problem even as countries emerge from the pandemic and focus on economic and social recovery. Existing evidence makes it possible to speculate that activation of autophagy may offset CoV infection at various levels, although much detailed information is certainly needed. Many biogenic or synthetic compounds having the potential to induce autophagy can resolve the concern. The prevailing outbreak is a startling indication that evolving infectious pathogens are major challenge regardless of whether modulation of autophagy will ultimately be part of COVID-19 strategies. In view of limitations of our medical systems and socio-economic well-being, this pandemic highlights the importance of further developing and safeguarding global healthcare, as well as supporting and extending comprehensive infectious disease research. On the basis of the various studies of the therapeutic interventions a hypothetical model has been proposed in Figure 4 . Along with delivering medical treatment, extensive health care experts have a major role to play in following psychosocial essentials and providing their patients, health care workers and the population particularly aged individuals with psychosocial support and activities should be incorporated into common pandemic health care. The entry into the host system of CoVs is primarily mediated by the endocytic pathway, and autophagy has also been associated with the replication of viral cells, a process linked to the formation of DMV in the host cells. The entry into the host system of CoVs is primarily mediated by the endocytic pathway, and autophagy has also been associated with the replication of viral cells, a process associated to the formation of DMV in the host cells (adopted from Yang and Shen, 2020). Addressing mental health needs: an integral part of COVID-19 response Battle Buddies: Rapid Deployment of a Psychological Resilience Intervention for Health Care Workers During the COVID-19 Pandemic Azithromycin induces epidermal differentiation and multivesicular bodies in airway epithelia COVID-19 and the consequences of isolating the elderly Can Psychological Resilience Protect the Mental Health of Healthcare Professionals during the COVID-19 Pandemic Period? 15 Smartphone Apps for Older Adults to Use While in Isolation During the COVID-19 Pandemic 2019-nCoV epidemic: address mental health care to empower society Metformin as a tool to target aging Yetişkinler için Psikolojik Dayaniklilik Ölçeği'nin Guvenilirlik ve Geçerlilik Çalişmasi Rapamycin for longevity: opinion article The psychological impact of quarantine and how to reduce it: rapid review of the evidence Impact of COVID-19 pandemic on pre-existing mental health problems Psychological distress and negative appraisals in survivors of severe acute respiratory syndrome (SARS) Human coronaviruses and other respiratory viruses: underestimated opportunistic pathogens of the central nervous system? Anxiety and depression in Canada during the COVID-19 pandemic: A national survey Psychological interventions for people affected by the COVID-19 epidemic Mental health problems and social media exposure during COVID-19 outbreak Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019-COVID-NET, 14 States Analysis of SARS-CoV-2-controlled autophagy reveals spermidine, MK-2206, and niclosamide as putative antiviral therapeutics SKP2 attenuates autophagy through Beclin1-ubiquitination and its inhibition reduces MERS-Coronavirus infection SARS-CoV-2 receptor and regulator of the renin-angiotensin system: celebrating the 20th anniversary of the discovery of ACE2 The impact of death and dying on the personhood of medical students: a systematic scoping review Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science Mechanisms of Beta-lactam resistance of Streptococcus uberis isolated from bovine mastitis cases Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019 Biological Functions of Autophagy Genes: A Disease Perspective Polyamines: Small Molecules with a Big Role in Promoting Virus Infection SIRT6 acts as a negative regulator in dengue virus-induced inflammatory response by targeting the DNA binding domain of NF-κB p65 Online mental health services in China during the COVID-19 outbreak Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding Spermidine in health and disease TORC1 inhibition enhances immune function and reduces infections in the elderly Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China A brief history of autophagy from cell biology to physiology and disease AMP-activated kinase restricts Rift Valley fever virus infection by inhibiting fatty acid synthesis Interferon-induced spermidine-spermine acetyltransferase and polyamine depletion restrict Zika and chikungunya viruses Policy brief: COVID-19 and the need for actions on mental health2020 Role of angiotensin-converting enzyme 2 (ACE2) in COVID-19 Inhibition of human immunodeficiency virus (HIV-1) infection in human peripheral blood leucocytes-SCID reconstituted mice by rapamycin Possibility for reverse zoonotic transmission of SARS-CoV-2 to free-ranging wildlife: A case study of bats Functions of Polyamines in Mammals Coronavirus replication complex formation utilizes components of cellular autophagy In silico studies evidenced the role of structurally diverse plant secondary metabolites in reducing SARS-CoV-2 pathogenesis Investigation of CD26, a potential SARS-CoV-2 receptor, as a biomarker of age and pathology Shorter telomere lengths in patients with severe COVID-19 disease COVID-19 is an emergent disease of aging COVID-19 is an emergent disease of aging COVID-19 and chronological aging: senolytics and other anti-aging drugs for the treatment or prevention of corona virus infection? SPERMIDINE MAINTAINS TELOMERE LENGTH AND DELAYS AGING mTOR and Aging: An Old Fashioned Dress The outbreak of COVID-19 coronavirus and its impact on global mental health Estimates of the severity of coronavirus disease 2019: a model-based analysis Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China Occupational moral injury and mental health: systematic review and meta-analysis Joint international collaboration to combat mental health challenges during the coronavirus disease 2019 pandemic Targeting the Endocytic Pathway and Autophagy Process as a Novel Therapeutic Strategy in COVID-19 System effectiveness of detection, brief intervention and refer to treatment for the people with post-traumatic emotional distress by MERS: a case report of community-based proactive intervention in South Korea This manuscript has not been submitted to, nor is under review at, another journal or other publishing venue. The authors have no affiliation with any organization with a direct or indirect financial interest in the subject matter discussed in the manuscript