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Wiadomości Lekarskie, VOLUME LXXIV, ISSUE 7, JULY 2021 © Aluna Publishing
INTRODUCTION
The pandemic crisis of SARS-CoV-2 (Severe Acute
Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2)
(COVID-19) has brought enormous societal pressure
worldwide. For example, in Germany as many as 30%
of respondents feared a pandemic [1], and in Poland the
percentage of young adults (18-35 years old) sufering
from depressed mood increased from 16.2% to 36.6% [2].
Yet, difcult situations may not only lead to various
types of disorders, fears, anxieties and feelings of loss.
Tey can also lead to positive changes, even to devel-
opment or growth afer experienced trauma, to positive
adaptation, to changes in self-perception, changes in
interpersonal relations or philosophy of life [3]. People
who have experienced sufering can change their per-
ception of reality, perceiving its diferent dimension.
Terefore, experiencing difcult situations may lead to
transforming the experienced sufering and loss into an
important, positive value for a specifc individual, but
also into searching for more efective ways of medical or
psychological interventions [4, 5].
COVID-19, a disease caused by a novel coronavirus, is a
major global human threat and was declared a pandemic
by the World Health Organization as of 11 March 2020 [6-
10]. Te disease caused by this new strand of coronoavirus
has high morbidity and mortality in the elderly and in
comorbid populations [7, 8]. According to the published
data, older patients with underlying clinical conditions
such as diabetes mellitus, hypertension, and cardiovascular
disease tend to be vulnerable to COVID-19 and display
more severity clinical course of the illness [9].
Chronic kidney disease (CKD) is an increasingly prev-
alent condition, recognized as a public health priority,
afecting 10-12% of the population [10, 11]. Chronic kidney
disease and kidney end-stage renal disease (ESRD) consti-
tute a clinical problem worlddwide. Tus, if CKD patients
were to populate a separate country, its population would
be the third largest in the world [5, 6].
CKD and uremic patients on maintenance dialysis are
exposed not only to a higher comorbidity and poor quality
of life, but also to a high overall mortality, mainly due to pre-
mature cardiovascular disease (CVD) and infections [9-12].
Patients with uremia receiving maintenance hemodial-
ysis are particularly susceptible to infections because of
multiple comorbidities (such as cardiovascular disease,
diabetes, and cerebrovascular disease, malnutrition) and
immune dysregulation compared with general population
[12]. Te uremia state is associated with impairment of
THE IMPORTANCE OF MENTAL RESILIENCE AGAINST LONELINESS
DURING THE COVID-19 PANDEMIC IN DIALYSIS PATIENTS
DOI: 10.36740/WLek202107134
Urszula Ołdakowska-Jedynak
1
, Maria Ryś
2
, Tomasz Sztajerwald
2
, Jolanta Malyszko
1
1
NEPHROLOGY, DIALYSIS AND INTERNAL MEDICINE, WARSAW MEDICAL UNIVERSITY, WARSAW, POLAND
2
INSTITUTE OF PSYCHOLOGY, CARDINAL STEFAN WYSZYŃSKI UNIVERSITY, WARSAW, POLAND
ABSTRACT
The pandemic crisis of COVID-19 has caused anxiety and depressive symptoms to increase in many people worldwide. Yet, difcult situations may not only lead to various types
of disorders, fears, anxieties and feelings of loss. They can also lead to positive changes, even to development or growth after experienced trauma, to positive adaptation, to
changes in self-perception, changes in interpersonal relations or philosophy of life.
Patients with chronic kidney disease, especially those on renal replacement therapy, often experience severe psychological problems such as anxiety disorders, depressive
disorders, or difculties related to coping with excessive stress.
The aim of our review is to disscus the appropriatness of mental health screening tools in patients with chronic kidney disease, including those on dialyses, during COVID-19
pandemic. Recently published studies indicate the limited available data evaluating the diagnostic accuracy of screening tools for mental status in patients with chronic kidney
disease. This, it seems reasonable to stress the mental health associations with situational stress in this group of patients during the SARS-CoV-2 pandemic. It is also worth
pointing out the need to research the impact of the mental disorders in this population on morbidity and mortality, taking into account other organ complications and the
quality of life of patients not only during the SARS-CoV-2 pandemic. It is worth to to make every efort to reduce the severity of the anxiety and feelings of hopelessness in
dialysis patients, to cope with the pandemic.
KEY WORDS: mental health, pandemic during COCID-19, end-stage renal disease, renal replacement therapy
Wiad Lek. 2021;74(7):1758-1762
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