People with Suspected COVID-19 Symptoms Were More Likely Depressed and Had Lower Health-Related Quality of Life: The Potential Benefit of Health Literacy.

Journal of clinical medicine. 2020;9(4)

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Plain language summary

COVID-19 has been spreading to a growing number of countries and is recognized as a global health concern that has set global public health institutions on high alert. Improving health literacy is a strategic approach to preventing and controlling diseases. The aim of this study was to investigate the association of suspected COVID-19 symptoms (S-COVID-19-S) with depression and health related quality of life (HRQoL), and the effect modification of health literacy on the associations among people who visited outpatient departments. This is a cross-sectional study which recruited participants (aged between 18 and 85 years) from outpatient departments of six hospitals and three health centers across Vietnam. Results indicate that participants with S-COVID-19-S had a higher likelihood of depression and lower HRQoL. Whereas, those participants having S-COVID-19-S and with higher health literacy had a low occurrence of depression and better HRQoL compared to those people with lower health literacy. Authors conclude that health literacy can help to protect the mental health and HRQoL of people with S-COVID-19-S during the pandemic.


undefined: The coronavirus disease 2019 (COVID-19) epidemic affects people's health and health-related quality of life (HRQoL), especially in those who have suspected COVID-19 symptoms (S-COVID-19-S). We examined the effect of modifications of health literacy (HL) on depression and HRQoL. A cross-sectional study was conducted from 14 February to 2 March 2020. 3947 participants were recruited from outpatient departments of nine hospitals and health centers across Vietnam. The interviews were conducted using printed questionnaires including participants' characteristics, clinical parameters, health behaviors, HL, depression, and HRQoL. People with S-COVID-19-S had a higher depression likelihood (OR, 2.88; < 0.001), lower HRQoL-score (B, -7.92; < 0.001). In comparison to people without S-COVID-19-S and low HL, those with S-COVID-19-S and low HL had 9.70 times higher depression likelihood ( < 0.001), 20.62 lower HRQoL-score ( < 0.001), for the people without S-COVID-19-S, 1 score increment of HL resulted in 5% lower depression likelihood ( < 0.001) and 0.45 higher HRQoL-score ( < 0.001), while for those people with S-COVID-19-S, 1 score increment of HL resulted in a 4% lower depression likelihood ( = 0.004) and 0.43 higher HRQoL-score ( < 0.001). People with S-COVID-19-S had a higher depression likelihood and lower HRQoL than those without. HL shows a protective effect on depression and HRQoL during the epidemic.

Lifestyle medicine

Fundamental Clinical Imbalances : Neurological
Patient Centred Factors : Triggers/Covid-19/nutrition
Environmental Inputs : Diet ; Mind and spirit
Personal Lifestyle Factors : Psychological
Functional Laboratory Testing : Not applicable

Methodological quality

Allocation concealment : Not applicable
Publication Type : Journal Article


Nutrition Evidence keywords : Body mass index ; BMI ; Physical activity