Table 1.
Characteristics of included trials.
| First author Dates Country Registration |
Verified | Setting | Participants | Intervention | Comparator | N Intervention/Comparator Analyzed | Outcome Domain(s) | Mean (SD) Age | % Female |
|---|---|---|---|---|---|---|---|---|---|
|
Psychological Interventions | |||||||||
| Ding [25] NR China NR |
No | Hospital isolation ward | COVID-19 patients with pneumonia | Multifaceted, including COVID-19 related education; relaxation techniques, and encouragement to use electronic devices to connect with family | Routine nursing | 31/31 | Anxiety, Depression | Range: 22–72 | 16 |
| Gharaati [26] 05–06/2020 Iran NR |
No | General hospital | COVID-19 patients | Crisis intervention package including 4 60-min psychotherapy sessions over 4 weeks focusing on empathy, adjustment, responsibility, and spirituality | Standard individual psychotherapy | 14/16 | Anxiety, Depression, Mental Health Function, Stress | Range: 18–65 | 53 |
| Gu [27] 01–02/2020 China NR |
No | Hospital isolation ward | COVID-19 patients able to use a video chat platform | Mindfulness-based stress reduction therapy 2 20–30-min sessions per week for 4 weeks | WeChat group where doctors answer patients' questions, assess their mental health, and provide therapy and health education | 33/30 | Anxiety, Depression | 41 (14) | 46 |
| Guo [28] 02–03/2020 China NR |
No | COVID-19 hospital isolation ward | Patients with mild COVID-19 symptoms | Psychological nursing, including evaluation of psychological status, prevention of negative emotions, and encouragement of family support | Standard nursing | 30/30 | Anxiety, Depression | Intervention median 54 (3) Comparator median 53 (3) | 45 |
| Hui [29] 01–02/2020 China NR |
No | COVID-19 hospital isolation ward | Patients with mild COVID-19 symptoms | 2× per day, 14-day psychological crisis intervention | 2× per day,14-day standard psychological care | 36/36 | Anxiety, Depression | 58 (8) | 46 |
| Jiang [30] 02–03/2020 China NR |
No | COVID-19 hospital isolation ward | Patients with mild COVID-19 symptoms and anxiety or depression | Psychological care, including mindfulness therapy, health education, communication with patients, positive movies and soft songs | Standard nursing | 43/43 | Anxiety, Depression | NR | NR |
| Li J. [31] 02–03/2020 China ISRCTN68675756 |
Yes | COVID-19 treatment hospital isolation ward | Patients with mild COVID-19 symptoms with no previously diagnosed depression, current psychiatric medication, prior cognitive dysfunction or major stressful event | 30-min CBT in the morning daily for 4 weeks | Routine nursing | 47/46 | Anxiety, Depression, Stress | 48 (12) | 65 |
| Liu Ying [32] 03/2020-NR China NR |
No | General hospital | Patients hospitalized with mild COVID-19 infection | Group psychological intervention delivered via WeChat group and pulmonary rehabilitation exercises including five-tone breathing and Baduanjin exercises 30 min a day for 4 weeks | Standard COVID-19 treatment | 70/70 | Anxiety | <25 | 59 |
| Liu Yiwei [33] NR China NR |
No | Hospital isolation ward | Patients aged 18–60 with mild COVID-19 infection; no cognitive dysfunction, mental or psychiatric disorder; no severe underlying diseases | 90–120 min daily art therapy for 10 days | Standard nursing | 25/25 | Anxiety, Depression, Mental Health Function | 44 (9) | 42 |
| Liu Z [34]. NR China ChiCTR2000030084 |
No | General hospital isolation ward | Patients with mild or common type COVID-19, mild to moderate depressive or anxiety symptoms (HAMD17 or HAMA ≥7, HAMD <24, HAMA <21), no psychiatric diagnosis in last 6 months, no psychotic symptoms, no high risk of suicide, no organic mental disorders, no substance abuse or dependence, no current treatment for mental health problems | Self-directed computerized cognitive behavioral therapy (cCBT) 10 min per day for 1 week | Treatment as usual including periodic psychological assessment, general psychological support, and discussion of overall well-being and disease activity. | 126/126 | Anxiety, Depression | 43 (13) | 40 |
| Pan H. [35] 01–03/2020 China NR |
No | COVID-19 hospital isolation ward | Patients with severe COVID-19 symptoms | Routine care plus non-specific psychological interventions tailored to patient presentation: (1) for panic, assign more experienced nursing staff; (2) for dysphoria, emphasize being patient and sympathetic; (3) for depression: analyze origin of pessimistic mood and target communication | Routine care | 30/30 | Anxiety, Depression, Mental Health Function | NR | 45 |
| Pan R. [36] 01–04/2020 China NR |
No | COVID-19 hospital isolation ward | Patients with mild COVID-19 symptoms | Psychological nursing, including building comfortable environment, stabilizing mood, educating patients about COVID-19 knowledge, and alleviating negative affect | Standard nursing | 16/16 | Anxiety, Depression | 53 (6) | 44 |
| Parizad [37] NR Iran IRCT20131112015390N5 |
Yes | General Hospital | COVID-19 patients with an oxygen saturation > 90%, no severe visual or auditory disorders, no mental disorders | 25 min guided imagery sessions 2× per day for 5 consecutive days | Routine care | 55/55 | Anxiety | 40 (12) | 44 |
| Shaygan [38] NR Iran IRCT20201001048893N1 |
Yes | General hospital | Mild to severely infected COVID-19 patients with no previous experience of quarantine and no history of psychiatric disorders or taking psychiatric medications. | Online multifaceted multimedia psycho-educational intervention, 1 60-min module per day for 14 days | Offer to receive telephone-based counselling if needed | 26/22 | Mental Health Function, Stress | 37 (12) | 44 |
| Shi Q. [39] 01–03/2020 China NR |
No | COVID-19 hospital isolation ward | People hospitalized with mild COVID-19 symptoms | Daily psychoeducation focused on emotional regulation; psychological assessment of patients on the 1st, 7th and 14th day after admission; daily traditional Chinese medicine emotional therapy and corresponding diet therapy | Standard nursing care | 30/30 | Anxiety, Depression | 34 (3) | 48 |
| Shi Y. [40] 01–04/2020 China NR |
No | General hospital intensive care unit | Hospitalized in intensive care with COVID-19 infection; have no pre-existing mental disorders, insomnia, or severe comorbidity | Psychological care, including COVID-19 information and relaxation support | Standard care | 30/30 | Anxiety | 52 (10) | 45 |
| Wang M. [41] NR China NR |
No | University hospital | Patients hospitalized with severe COVID-19, no recent major life events, no malignant tumor, no prior psychiatric disorder or anti-depressant use | Standard nursing plus daily 20–30 min psychological intervention including empathic listening, transposition thinking, information organizing, and feedback exchanging | Standard nursing | 20/20 | Anxiety, Depression | 46 (7) | 45 |
| Wang Y. [42] 02–03/2020 China NR |
No | COVID-19 treatment hospital | Hospitalized COVID-19 patients | Routine nursing plus multifaceted psychological intervention, including providing patients and their families with COVID-19 information, teaching patients relaxation and psychological regulation techniques for 14 days | Routine nursing | 39/39 | Anxiety, Depression | 57 (4) | 47 |
| Wei [43] 02/2020 China NR |
No | University hospital | COVID-19 patients with PHQ-9 or GAD-7 of ≥5 and < 15, at least a junior middle school level of education, no suicidal ideation, and no antipsychotic use. | Self-help multifaceted internet-based intervention including mindfulness techniques, relaxation training, “refuge” skills, and butterfly hug method with instructions to do 50 min daily for 2 weeks | Daily supportive care | 26/22 | Anxiety, Depression | 45 (12) | 38 |
| Zhang A. [44] NR China NR |
No | General hospital | Patients with mild and ordinary COVID-19, no cognitive disorders. | Routine treatment plus traditional Chinese medicine prescription for pneumonia and shared decision-making psychological counselling | Routine treatment | 106/100 | Anxiety | 36 (5) | 42 |
| Zhu L [45] NR China NR |
No | COVID-19 hospital isolation ward | Patients with mild COVID-19 symptoms and no psychiatric disorder | Standard nursing plus 5–6 15–30 min individualized daily acceptance and commitment therapy (ACT) sessions | Standard nursing | 46/46 | Anxiety, Depression | Intervention 65 (NR) Comparator 67 (NR) | 45 |
|
Physical/Breathing Exercise Interventions | |||||||||
| Chen X. [46] 02–03/2020 China NR |
No | COVID-19 hospital isolation ward | Patients with mild COVID-19 symptoms | 3-week Baduanjin exercise, 10 times per week, 2 times per day | Standard care | 14/15 | Anxiety, Depression | 69 (11) | 55 |
| Liu K. [47] 01–02/2020 China NR |
No | Hospital Isolation ward | Patients with confirmed COVID-19 | Progressive muscle relaxation and deep breathing 20–30 min per day for 5 consecutive days | Standard care | 25/26 | Anxiety | 50 (13) | 45 |
| Özlü [48] 05–08/2020 Turkey NR |
No | General hospital COVID-19 clinic |
Adult COVID-19 patients receiving treatment | 20–30 min progressive muscle relaxation exercises delivered on TV via CD twice a day for 5 days | Routine care | 33/34 | Anxiety | 35 (12) | 45 |
| Zhang Y. [49] 02–03/2020 China NR |
No | COVID-19 treatment hospital isolation ward | Patients with mild COVID-19 symptoms | Multifaceted, including Fitness Qigong group training 3 days a week, twice a day in 60 min sessions; Chinese medicine and nursing from 4 pm–5 pm daily; ear acupoint bean-pressing: 10–15 times a day for 3–5 min | Routine nursing | 14/14 | Anxiety, Depression | 50 (4) | 39 |
| Zhu [50] 02–03/2020 China NR |
No | COVID-19 treatment hospital isolation ward | Patients with mild COVID-19 symptoms | One-on-one health education for 9 days including medication guidance and monitoring vital signs plus breathing exercises twice daily | Standard nursing | 40/40 | Anxiety, Depression | 36 (12) | 43 |
|
Mixed Interventions | |||||||||
| Cai [51] NR China NR |
No | COVID-19 hospital | Mildly infected or ordinary type COVID-19 patients with no severe underlying diseases | Multifaceted intervention, including COVID-19 education, psychological intervention targeted at alleviating patients' negative emotions; nutrition guidance; and exercise | Standard nursing | 30/30 | Anxiety, Depression | 43 (12) | 45 |
| Cao [52] 01–03/2020 China NR |
No | COVID-19 treatment hospital isolation ward | Severely infected COVID-19 patients not on ventilators aged 41–79 | Humanistic nursing including nutrition plan, individualized pulmonary recovery plan, and attending to patients' emotions | Standard care | 68/68 | Anxiety, Depression | 60 (12) | 29 |
| Cha [53] 01–03/2020 China NR |
No | COVID-19 treatment hospital isolation ward | Patients with mild COVID-19 symptoms | Systematic nursing, including psychological nursing to alleviate patients' negative emotions; rehabilitation training to enhance immune system; increasing ward rounds to monitor changes in patients' symptoms; and nutrition guidance | Routine nursing | 50/50 | Anxiety, Depression | 45 (6) | 48 |
| Chakeri [54] NR Iran NR |
No | Emergency department | People given a definitive diagnosis of COVID-19 and prescribed home quarantine, medication, and continued treatment at home | Information about COVID-19 symptoms and methods of preventing transmission plus tele-nursing counselling for 3 weeks every other day | Information about COVID-19 symptoms and methods of preventing transmission | 50/50 | Anxiety | 43 (9) | NR |
| Chen Y. [55] NR China NR |
No | COVID-19 treatment hospital | Patients with mild COVID-19 symptoms | Standard nursing plus humanized nursing (psychological care; health education; relaxation training therapy) | Standard nursing | 40/40 | Anxiety | NR | NR |
| Deng [56] NR China NR |
No | COVID-19 treatment hospital isolation ward | Mild to moderate COVID-19 infected patients with no other underlying diseases | Standard psychological nursing plus personalized psychological nursing and peer-support group including online psychological counselling 4× over 2 weeks | Standard psychological nursing including education about COVID-19 | 30/30 | Anxiety, Depression | NR | 45 |
| Dong [57] 02–03/2020 China NR |
No | COVID-19 treatment hospital isolation ward | Patients with mild COVID-19 symptoms | Routine nursing plus humanistic care, including sanitary improvement of the ward; educating patients on COVID-19; and using verbal encouragement to decrease patients' anxiety and loneliness; encouraging them to communicate with their families via telephone and video | Routine nursing | 46/46 | Anxiety, Mental Health Function | 42 (8) | 45 |
| Fan [58] 01–03/2020 China NR |
No | COVID-19 treatment hospital isolation ward | Patients with mild COVID-19 symptoms | Systematic nursing, including psychological nursing to alleviate patients' negative emotions; rehabilitation training to enhance immune system; increasing ward rounds to monitor changes in patients' symptoms; and nutrition guidance | Routine nursing | 50/50 | Anxiety, Depression | 45 (6) | 48 |
| Huang [59] NR China NR |
No | Traditional Chinese hospital | Patients hospitalized with COVID-19 infection | Health education and psychological nursing during and after treatment focusing on eliminating patients' negative affect | Standard nursing | 37/36 | Anxiety, Depression | 56 (NR) | 53 |
| Li Lan [60] NR China NR |
No | COVID-19 hospital | Adult patients of light or ordinary type COVID-19, with a score of HAMD ≥8 or SAS ≥50, no severe somatic diseases | Five Elements Music therapy, Six Words Formula therapy (breathing exercise) and psychological nursing twice daily for 2 weeks; practicing Six Words Formula therapy while listening to music | Routine psychological nursing focusing on encouraging patients to express their emotions, educating on COVID-19, facilitating family support, and performing abdominal breathing | 30/30 | Anxiety, Depression | 45 (14) | 48 |
| Li Li [61] 01–04/2020 China NR |
No | COVID-19 treatment hospital isolation ward | Patients with mild COVID-19 symptoms | High quality nursing including psychological and dietary intervention | Standard care | 58/57 | Anxiety, Depression, Mental Health Function | 54 (3) | 47 |
| Liu Q. [62] NR China NR |
No | COVID-19 treatment hospital isolation ward | COVID-19 patients with blood oxygen saturation > 93% and breathing rate less than 24/min; with no psychiatric disorder or other comorbidity | Standard nursing plus psychological nursing and humanistic nursing focusing on monitoring and stabilizing patients' affect and helping them accept their negative emotions | Standard nursing | 22/22 | Anxiety, Depression | 49 (3) | 52 |
| Liu R. [63] 02–03/2020 China NR |
No | COVID-19 treatment hospital | Patients with mild COVID-19 symptoms | Individualized psychotherapy plus group music therapy and physical exercise over 4 weeks | Standard care | 75/75 | Anxiety, Depression | 52 (7) | 59 |
| Lu [64] 01–05/2020 China NR |
No | General Hospital | Hospitalized COVID-19 patients | quality care including monitoring vital signs every 30 min; psychological care focusing on decreasing patients' negative affect and increasing treatment compliance; high-protein-high-energy liquid diets with no more than 200 ml per day; and close monitoring of signs of fever | Routine care | 60/60 | Anxiety, Depression, Mental Health Function | 55 (4) | 48 |
| Ma [65] 02–03/2020 China NR |
No | COVID-19 treatment hospital isolation ward | Patients with COVID-19 symptoms | Standard nursing plus improving ward environment and individualized humanistic intervention focusing on alleviating patients' negative affect | Standard care | 130/130 | Depression | 64 (NR) | 42 |
| Nie [66] 02–03/2020 China NR |
No | COVID-19 treatment hospital isolation ward | Severely infected COVID-19 patients | Humanistic care including paying attention to negative emotions, providing proper diet, educating on COVID-19 and protecting patients' privacy for 4 weeks | Standard intensive care | 15/15 | Anxiety | 36 (6) | 43 |
| Xu [67] 02–04/2020 China NR |
No | General Hospital | Patients with mild symptoms of COVID-19 | Routine nursing plus humanistic care focusing on improving patients' negative emotions, providing a comfortable ward environment, psychological care targeting patients' needs, and spiritual support through reminding patients of their families | Routine nursing | 40/40 | Anxiety, Depression | 60 (7) | 43 |
| Yang [68] NR China NR |
No | COVID-19 hospital | Patients with mild COVID-19 infection, no severe cardiac, hepatic, or renal functional diseases, and no severe neurological diseases | Traditional Chinese medicine syndrome differentiation nursing methods lasting for 1 month and acupoint massage, lasting 2 min per acupoint 2–3 times daily | Routine nursing | 44/44 | Anxiety, Depression | 49 (0) | 33 |
| Zhang Y. [69] 01–02/2020 China NR |
No | COVID-19 hospital isolation ward | Patients with mild COVID-19 symptoms with no serious complications | Personalized guidance including watching educational videos and discussing effective plans every other day; 30–60 min per session, 1 session every two days for 10 days | Standard nursing | 12/12 | Anxiety | 46 (3) | 46 |
| Zheng C. [70] NR China NR |
No | COVID-19 hospital | Patients with no history of psychiatric disorder or severe cognitive disorder | Traditional health education plus “Atlas Menu” health education including presenting knowledge about what patients would encounter during their hospital stay in a menu-like pattern with images for patients' study on their own | Traditional health education at different stages of hospitalization including psychological nursing and safety risk-related information delivered once every 3–5 days | 56/56 | Anxiety, Depression | 59 (6) | 54 |
| Zheng Y. [71] NR China NR |
No | COVID-19 hospital isolation ward | Patients with mild COVID-19 infection, no mental disorder history, recent trauma, or psychiatric disorder. | Humanistic care based on Traditional Chinese Medicine, including cognitive intervention aimed at helping patients build correct cognitions about COVID-19, behavioral intervention aimed at instructing patients on exercises, music intervention to calm patients, and auricular massage intervention 3–5 times per day, 30s per session | Routine care | 30/30 | Anxiety, Depression | 63 (4) | 52 |