Table 1.
Characteristics and key findings of the included meta-analyses. Heterogeneity between studies included in each meta-analysis was expressed in I2
| Original meta-analysis | Number of studies included | Total sample size | Diagnostic tool | Heterogeneity % | Overall prevalence % (95% CI) | Subgroup analyses | Subgroup analyses findings | AMSTAR-2 |
|---|---|---|---|---|---|---|---|---|
| Dong et al., 2021 [19] | 27 | 6,002 | PHQ-9; SDS; HADS; SCL-90; HAMD; PHQ-2 | I2=98 | 38 (29–46) | COVID-19 severity | Combined prevalence for patients clinically stable was 31% (7–55, 95% CI) while combined prevalence for severe patients was 66% (16–117, 95% CI). Combined prevalence for discharged patients was 52% (25–79, 95% CI) | Low |
| Liu et al., 2021 [20] | 20 | 3,834 | PHQ-9; HADS-D; SDS; BDI; SCL-90; DASS-21 | I2=98 | 38 (25–51) | Sex | Combined prevalence was higher in female (46%, 95% CI 32–60) than in male patients (32%, 95% CI 17–47) | Moderate |
| Country | Compared to other Countries (e.g., China, India, South Korea, Iran, Ecuador, Jordan; Turkey), Italy showed the lowest pooled prevalence of depression 11% (6–18, 95% CI) | |||||||
| Study design | Single-arm cohort studies showed higher pooled prevalence of depression 88% (44–100, 95% CI) | |||||||
| Severity of depressive symptoms | The pooled prevalence of mild depression (29%, 95% CI 24–34) was higher than both that of moderate depression 17% (11–22, 95% CI) and severe depression 10% (2–20, 95% CI) | |||||||
| Disease stage | The pooled prevalence of depression among undergoing COVID-19 patients (42%, 95% CI 29–56) was higher than that in those who were in the recovery stage (14%, 95% CI 0–48) | |||||||
| Deng et al., 2020 [18] | 23 | 4028 | PHQ-9; SDS; HADS-D; SCL-90 | I2=96 | 45 (37–54) | Sex | Combined prevalence was higher in female (50%, 95% CI 38–62) than in male patients (39%, 95% CI 26–53) | High |
| Country | Compared to other countries (e.g., China, Ecuador, Iran), Italy registers the lowest rate of depression in COVID-19 infected people, with a pooled prevalence of 38% (29–47, 95% CI) | |||||||
| Hospitalization | The pooled prevalence of depression for inpatients was 48% (35–61, 95% CI) while the pooled prevalence of depression for outpatients was 35% (22–48, 95% CI) | |||||||
| Severity of depressive symptoms | The pooled prevalence of mild depression was 33% (26–39, 95% CI), for moderate depression was 14% (11–16, 95% CI), and for severe depression was 7% (4–10, 95% CI) | |||||||
| Study design | The pooled prevalence of depression for cohort-studies was 74% (62–83, 95% CI) was significantly higher than the pooled prevalence of cross-sectional studies 44% (36–53, 95% CI) | |||||||
| Screening Tools | Studies that used HADS-D and SCL-90 showed lower prevalence of depression (respectively 20% and 19%), on the contrary studies that used PHQ-9 and ZSDS show higher prevalence (respectively 52% and 53%) | |||||||
| Wu et al., 2021 [22] | 4 | 480 | WHO-5; BDI-II; CES-D; DASS-21 | I2=90 | 42 (26–58) | Target population | Compared to quarantined persons, general population, students, physician and nurses, non-medical staff, COVID-19 patients show the greatest pooled prevalence of depressive symptoms, that is 42% (26–58, 95% CI) | Moderate |
| Khraisat et al., 2021 [8] | 20 | 7994 | Validated Questionnaire | I2=97 | 21 (16–28) | NA | NA | Low |
AMSTAR Assessment of multiple systematic reviews, BDI Beck Depression Inventory, CES-D Center for Epidemiology Scale for Depression, CI confidence interval, COVID Coronavirus Disease 2019, DASS-21 Depression Anxiety and Stress Scale-21, HADS Hospital Anxiety and Depression Scale, HAMD Hamilton Depression Scale, NA not available, PHQ-9 Patient Health Questionnaire, SCL-90 Symptoms Checklist Revised-90, SDS Self-Rating Depression Scale, WHO-5 WHO-Five Well-Being Index