Users Online: 440

Home Print this page Email this page Small font sizeDefault font sizeIncrease font size

Home | About us | Editorial board | Search | Ahead of print | Current issue | Archives | Submit article | Instructions | Subscribe | Contacts | Login 
     

   Table of Contents      
ORIGINAL ARTICLE
Year : 2022  |  Volume : 12  |  Issue : 4  |  Page : 291-299

Mental and Physical Performance of Adult during the COVID-19 Pandemic and Use of Dietary Supplements


1 Faculty of Pharmacy, DIT University, Dehradun, Uttarakhand, India
2 Institute of Clinical Research, New Delhi, India

Date of Submission09-Jul-2022
Date of Decision02-Aug-2022
Date of Acceptance30-Sep-2022
Date of Web Publication30-Nov-2022

Correspondence Address:
Havagiray R Chitme
Department of Pharmacology, Faculty of Pharmacy, DIT University, Dehradun, Uttarakhand - 248009
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijnpnd.ijnpnd_49_22

Rights and Permissions
   Abstract 


Background: Life during the COVID-19 pandemic was miserable, most of the people were in a panic situation either because of being affected by COVID-19 or losing their near and dear ones. Majority of Indian population was in the trauma condition impacting physical and mental health directly or indirectly either due to the infection or repeated lockdowns. Aim: The present study was carried out to gain knowledge of people’s physical and mental health such as anxiety, depression, and stress during the period of the pandemic in the year 2021. Material and methods: The standard questionnaires were used to conduct the online survey using google form. The questionnaire contains five sections and collects the information on anxiety, stress, depression, and physical activities. The survey started on May 23, 2021, and ended on June 2, 2021 by circulating the link through emails, WhatsApp, and messages. Result: A total of 291 people participated in this survey process and all responses were analyzed, out of which 165 were men and 126 were women. It was calculated that 59.4% of men and 40.6% of women were affected by COVID-19. Total 49.5% of people affected by COVID-19 were in favor of improvement in physical and mental performance while taking dietary supplements. Whereas 19.8% denied the statement and 28.7% of people saw slight changes in their health status. Conclusions: During the pandemic people were mostly affected by anxiety, depression, stress, and physical health and to cope with these situations dietary supplements surely be the utilitarian for the society. Through this study, it was found that if a person includes both exercise and nutraceutical products in their lifestyle, there will be a chance of living a sustainable and healthy life.

Keywords: COVID-19, dietary supplement, mental health, physical health


How to cite this article:
Tomer A, Sarkar AK, Chitme HR. Mental and Physical Performance of Adult during the COVID-19 Pandemic and Use of Dietary Supplements. Int J Nutr Pharmacol Neurol Dis 2022;12:291-9

How to cite this URL:
Tomer A, Sarkar AK, Chitme HR. Mental and Physical Performance of Adult during the COVID-19 Pandemic and Use of Dietary Supplements. Int J Nutr Pharmacol Neurol Dis [serial online] 2022 [cited 2023 Jan 26];12:291-9. Available from: https://www.ijnpnd.com/text.asp?2022/12/4/291/362416




   Introduction Top


COVID-19 pandemic had brought drastic change in lifestyle and method of livelihood.[1] The rarely used quarantine and social distancing medical methodologies were commonly practiced during the pandemic.[2] It not only affected the economy of countries but widely disturbed the emotions and physical build-up of most of the population.[3] Hardly any individual is left untouched by the adverse effect of COVID-19. People who were not affected physically were hurt by their surrounding situation. The mental and physical condition got worsed due to longer and repeated lockdowns.[4]

Lockdown could be the best strategy of social distancing but it had its own adverse affect on both mental and physical state of a person.[5] Physical activity was negligible during the lockdown, the worst part was mental condition of people that had gone to critical.[6] It was state in a study that people were arguing over the small matter during the lockdown within a family. It is all because the boredome that they faced during the lockdown and effect of closed environment.[7] For a healthy body and mind, people generally go park and gym, but during the lockdown, these were completed shutdown. This could be the possible reason why people faced mental depression, anxiety, and stress during the worldwide lockdown.[8] Different generation had different impact of lockdown, older generartion were unable to go to park to meet their friends while children had lost their studies, even the online classes had negative impact on the physical and mental state of children.[9]

Life during the pandemic was one of the harsh and extreme conditions that people faced in this century. According to World Health Organization (WHO), about 5400 millioin cases are confirmed worldwide and more than 6 million death have been reported whereas 520 million people were recovered.[10] The conditions were worsed in April 2021 in Delhi where positivity rate reaches to 3.34%.[11] Government plays crucial role in controlling the conditions, even most of the countries trying to help each other in one or other way like providing medical facilities and food to needy countries.

People were advised to do exercise, meditation, and yoga to relax the mind and body.[12] Even some nutraceutical products were also added to the diet to boost the immunity system.[13] Herbal ingredients, for instance, curcumin, tulsi, cinnamon, and many more were in great demand, even some doctors recommended vitamins tablet to enhance immunity.[14] It was seen that people were taking more and more interest in these nutraceutical products. Over the past decade, supplements are a booming industry, and there is a vast rise in the production of supplements, it all help in increasing the economy worldwide.[15] According to different surveys in the field, the positive results were seen in post-pandemic with respect to focus on physical and mental health.[16]

People were affected in one or the other way, to gain knowledge in various aspects we conducted an online survey on the mental and physical performance of adults. Through this survey we were able to gain the knowledge of intensity of COVID-19 pandemic in the life of people and role of nutritional supplements in improving the physical and mental performance in people. COVID-19 not only impact the physical condition of people but also mental state of people, there are studies also in which post COVID-19 effect are seen in the people infected with COVID-19 such as anxiety, stress, and depression. These effects not only affect the physical state of people but also mental state of the people too.


   Materials and methods Top


Tools

An online survey of the multiple-choice-based questionnaire was conducted from May 23, 2021 to June 2, 2021. Sample size for this Cross-Sectional, Cohort, and Randomized study was calculated to be 83 by adopting Kelsy method in consideration of two-sided significance level (1-alpha) 95, and Power (1-beta, % chance of detecting) 80, and odds ratio 0.23.[17] In this study, we involved more that calculated number of people, i.e., 291 of the different fields like some were students, professionals, business persons, etc.[18] The purpose of the survey was explained so that they can fill the questionnaire accordingly. The standard questionnaires in English on anxiety, stress, depression, and physical activities were used after modification for the present study.

Assessment of physical performance

The whole questionnaire is divided into five sections. The first section contains general demographic information such as age, location, whether they or their family member suffered from COVID-19, site of care, duration of suffering, etc. The second section includes questions on physical assessment developed based on International physical activity questionnaire[19] and having five questions regarding the exercise level, duration and measuriability on mental peace, meditation and yoga, time spent by sitting, conflict at home, etc.

Assessment of stress

The third section contains questions related to perceived stress assessment, it has 12 questions regarding the stress during the pandemic and its effect on people’s life and it was measured in scale of 0 to 5. The Perceived Stress Scale (PSS)[20] is one of the oldest and most reliable scale helps in understanding circumstances affecting feeling and measure stress. The total score ranges from 0 to 40. The severity of stress computed to be low if the score is between 0 and 13; moderate for the score 14 to 26, and high if the score is from 27 to 40.

Assessment of anxiety

The fourth section includes questions related to anxiety and option includes the days of its effect. The standard questionnaire on anxiety developed by using google forms that was used to assess the severity.[21] The total score was used to compute the severity of anxiety in population affected by COVID-19 and population not affected by COVID-19. It was considered to be minimal, mild, moderate, and severe if the score was 0 to 4, 5 to 9, 10 to 14, and 15 to 21 respectively.[22]

Assessment of depression

The fifth section includes standard questions related to depression as recommended by patient health questionnaire (PHQ-9).[23] This questionnaire contains question related to depression module. The five sections of questionnaire covered both eudainoic and hedonic aspects of mental state. The severity of depression was calculated to be mild, moderate, moderately severe, and severe based on the total score of 5 to 9, 10 to 14, 15 to 19, and 20 to 27 respectively.

Inclusion criteria

Present study involves only those who were above the age of 18 years and having moderate working and ambulatory history.

Ethics

The study was approved by University Research Ethics Committee of DIT University, Dehradun, Uttarakhand, India. (DITU/UREC/2022/dtd…………….).

Statistical analysis

At the end of the survey, data were compiled in the Microsoft excel program and expressed as counts and percentages and bar graphs are used to demonstrate the percentage of the individual affected by level of stress, anxiety, and depression. The data are segregated by the COVID positive and COVID negative population. The total score was determined by adding all the score of each sections and calculation in percentage. The data were analyzed by Pearson correlation and Chi-square analysis. P < 0.05 was considered significant by comparing COVID positive with COVID negative groups.


   Results Top


During the survey total 291 people participated [Table 1], out of which 56.7% were males and 43.3% were females. In case of males, 60% were COVID negative and 34.5% were found COVID positive. In case of females, 65.1% were COVID negative and 30.1% were COVID positive. The duration of suffering of COVID positive people for more than 14 days were 34.4% and less than 14 days were 64.6%. This show that majority of people recovered from COVID within 14 days. In this only 17.7% people went for hospital treatment otherwise 71.9% people choose home isolation and 8.3% people needed ICU treatment [Figure 1] and [Figure 2].
Table 1 Demography and medical/home care history

Click here to view
Figure 1 History of undergoing any of the treatments.

Click here to view
Figure 2 Level of stress during COVID-19.

Click here to view


Assessment of physical performance

According to survey [Table 2], 68 (70.8%) COVID positive people do physical activities from 0 to 2 hours daily and it was seen that there are individuals 2 (2.1%) who was suffered from COVID-19 and do physical activities for more than 10 hours daily. It has shown in survey that respondents 47 (26.1%) who did not suffered from COVID-19 and 32 (33.3%) respondents who suffered from COVID-19, do exercise 3 to 5 days per week and 53 (29.5%) COVID negative respondents and 24 (25%) respondents did more than 5 hours vigorous physical activities. Majority of COVID-19 infected people 69 (71.8%) agree that exercise and yoga had beneficial effect on overcoming the stress, anxiety, and depression, even the people not infected with COVID-19 agree with the concept. People generally avoid sitting at a place, it was seen that both COVID positive (15.6%) and COVID negative people 7 (3.9%) state that the sitting habit at a place is less than 1 hour. In case of 4 to 8 hours, COVID positive 23 (24%) and COVID negative 15 (8.3%) agree with the term. Eight (4.2%) COVID negative and 1 (1.0%) people had always conflicts at home.
Table 2 Impact of COVID-19 on physical activities

Click here to view


Assessment of stress

According to the data collected 10 COVID negative and 5 COVID positive people out of 291 respondents were having highly perceived stress. This number is quite different from moderate stress where 71 COVID negative and 129 COVID positive people had moderate stress. In case of low stress 15 COVID negative and 46 COVID positive people had low stress during the pandemic.

Assessment of anxiety

The data shown in [Figure 3] indicate that only 2 (2.1%) corona positive people suffered from severe anxiety where as 9 (5%) corona negative people faced the same. In this, majority of corona positive people 105 (58.3%) had minimal anxiety, where as data for moderate anxiety are 17 (9.4%) and 16 (16.7%) for COVID positive and COVID negative. This indicates that while suffering from COVID positive maximum number of people suffered from anxiety.
Figure 3 Level of anxiety among people affected by COVID-19.

Click here to view


Assessment of depression

It was surprised to see that 22 (22.92%) corona infected people score 0 to 4 in case of depression where as 84 (46.7%) COVID negative respondents show no symptoms of depression. The 9 (5%) COVID positive people show severity of depression and 5 (2.8%) COVID negative people fall under the same category. It states that people suffered from depression shows increment in depression [Figure 4] and [Figure 5].
Figure 4 Level of depression among people affected by COVID-19.

Click here to view
Figure 5 Comparative analysis of mental disturbance in patients with COVID + and COVID −.

Click here to view


Need of dietary supplements

According to the respondents, majority of COVID positive people 48 (50%) agree with dietary supplements helps in improvement of the stress, anxiety, and depression, 73 (40.5%) COVID negative respondents agree with the statement. Nineteen (19.7%) COVID positive respondents go with no and 27 (28.1%) respondents with slightly. This clearly states that majority of people are more focus on taking dietary supplements [Figure 6].
Figure 6 Benefit of dietary supplements to improve anxiety, depression, stress, and physical activities.

Click here to view


According to data [Figure 7], majority of respondents agree with the term that exercise and yoga help in overcome stress, anxiety, dizziness, and mental stability. Out of 291 people, 214 answered yes whereas 27 people donot know about the effect of exercise over the mental conditions. Although the condition was against the doing due to lockdown still somehow people manage to do exercise at home or either at their terrace. This cause beneficial effect on overcoming the mental instability that was caused by pandemic and lockdown.
Figure 7 Help of exercise/yoga to overcome stress, anxiety, dizziness, and mental ability.

Click here to view


In survey, it was seen that 49 (48.5%) COVID positive people never used nutritional supplement where as 17 (16.8%) COVID positive people used nutritional supplements. Fifty (49.5%) agree with the improvement in anxiety, depression, and stress where as 20 (19.8%) people disagree with this statement. This states that people feels that nutritional supplement can help in improving the effect of COVID-19. According to findings, it has been seen that 53.1% people agree of using nutritional supplement either regularly or sometimes, and 82.02% respondents agree with the notion that nutritional supplements helps in overcoming the mental disturbance totally, slightly, and efficiently. [Table 3].
Table 3 Nutritional supplement used

Click here to view



   Discussion Top


During the pandemic there was no way to escape from the situation. One can only handle by keeping their immunity strong due to which majority of people started having diet rich of nutrients and minerals. In this pandemic situation one can only be prevent infection either stay away from infected people or immunity of the person should be strong. People use many ways to keep their immunity strong, like using herbal supplements, immunity booster, and many more. This pandemic has impacted life of people adversely. People’s physical and mental conditions were challenged in many, losing of near and dear ones had impacted mind stability. Even the lockdown affect the mental state of people in different ways. People’s life got stucked, there was no movement, sometimes they felt depressed that they attempted suicide also. In one of the study in UK college one out of total respondents tried to attempt suicide because of the pandemic.[24] The economy of the countries went down during that time due to non-circulation of money. It was in the history of world economy that went down due to pandemic. The chain of supply and demand totally went down because of less working hours which causes increase in unemployment.[25]

There are so many studies based on the mental conditions of people during the pandemic that said life impacted most in the pandemic. Most of the people felt anxiety, depression, and stressed due to lockdown and COVID-19.[26] It is all because, either they or their family members under attacked by COVID-19. According to one of the research, there was a significant rise in both anxiety and depression from March to April 2020.[27]

The discovery of the present study showed that the most of the participants were affected by the conditions like pandemics and lockdown. It not only affected the single country but also worldwide, people were come under control of this severe situation. On March 11, 2020 World health Organization has declared the global pandemic. This created the panic situation worldwide, it pretentious not only the economy of the countries but also the mental condition of the people.[28]

It was hard to escape from these conditions, and the only way to survive is to increase the immunity of the body, which can only be achieved by doing proper exercise, and increasing the quality of intake on daily basis. Most people use herbal ingredients like ginseng, ginger, Valerian, and many more to increase the immunity of the body. Most of the people take dietary supplements to boost the immunity. It is observed that intake of dietary supplements are rising from the past decade, this is only because nowadays, people are aware of benefits of the nutraceutical products. The sale of dietary supplements were on the peak during the pandemic period, it is all because that people were fond of increasing immunity toward deadly virus which can only be achieved by living healthy life and having proper nutritional requirement of the body.[29]

The survey findings are presented in tables regarding stress, anxiety, and depression and how people overcome the curse of pandemics and lockdown. Out of 291 people, 214 people considered exercise helped overcome stress, anxiety, and depression. A total of 291 people participated in 11 days process and all responses were analyzed, out of which 165 were men and 125 were women. It was calculated that 59.4% of men and 40.6% of women were affected. 49.5% of people affected by COVID-19 are in favor of improvement in physical and mental performance while taking dietary supplements. 19.8% denied the statement and 28.7% of people saw slight changes in their state. 39.5% people who are not affected by COVID agree that dietary supplements help in improving the depression, anxiety, and stress cause in daily life. During this period exercise and dietary supplements were considered to be a constructive part of life. People somehow overcome their fear of this pandemic situations by one or other way. It was seen in this survey that 17.9% people take nutritional supplements regularly, where as in a study in UAE it was found that dietary supplements are used to prevent and treatment of COVID-19.[30] It was seen in the data that people are now focus on their health and fitness, post-COVID people generally aware of nutritional supplements as more and more people are aimed to live better life. This pandemic not only changes the people perception about their lifestyle, but also tilting towards the nutritional supplements that boost their immunity and strength.The percentage of people affected by the depression is much higher than those found in a study in China, China was known as the original point of COVID-19, in that study where 509 college students participated and the author found that 19% of respondents showed some level of depression. The present survey was in the end of May and starting of June when India was facing the second wave, that adversely effected the mental and physical condition of people. In our finding the percentage is more compare to previous study.[31] Furthermore, three people out of 291 had thought of better be dead. This state the severity of depression in those repondents, and this might cause severe illness in mental condition. In this study we can observe that the level of mental illness is changed moderately due to COVID situation. In one of the study, the severe level of anxiety similarly in UK college going students, it was found that pandemic cause increase in the level of anxiety and stress.

The Indian psychiatric society took responsibility in this direction, in the early period of lockdown, by providing mental aid at free of cost to the needy people.[32] This step causes beneficial effect on mental state of people and it cause decline in the state of mental illness.


   Conclusion Top


The conclusion of the survey suggests that more than 50% of respondents faced stress, anxiety, and depression during the pandemic. Nutrients and supplements could be the better choice of overcoming these situations.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Zhao H, Guo X, Peng N. What catalyzes the proactive recovery of peasants from the COVID-19 pandemic? A livelihood perspective in Ningqiang County, China. Int J Disaster Risk Reduct 2000;73:102920. https://doi.org/10.1016/j.ijdrr.2022.102920  Back to cited text no. 1
    
2.
Grignoli N, Petrocchi S, Bernardi S et al. Influence of empathy disposition and risk perception on the psychological impact of lockdown during the coronavirus disease pandemic outbreak. Front Public Health 2021;8:567337.  Back to cited text no. 2
    
3.
Esterwood E, Saeed SA. Past epidemics, natural disasters, COVID19, and mental health: learning from history as we deal with the present and prepare for the future. Psychiatr Q 2020; 91(4):1121-33. https://doi.org/10.1007/s11126-020- 09808-4  Back to cited text no. 3
    
4.
Singh S, Roy D, Sinha K, Parveen S, Sharma G, Joshi G. Impact of COVID-19 and lockdown on mental health of children and adolescents: a narrative review with recommendations. Psychiatr Res 2020;293:113429. https://doi.org/10.1016/j.psychres.2020.113429  Back to cited text no. 4
    
5.
Williams SN, Armitage CJ, Tampe T, Dienes K. Public perceptions and experiences of social distancing and social isolation during the COVID-19 pandemic: a UK-based focus group study. BMJ Open 2020;10:e039334. https://doi.org/10.1136/bmjopen- 2020-039334  Back to cited text no. 5
    
6.
Pancani L, Marinucci M, Aureli N, Riva P. Forced social isolation and mental health: a study on 1,006 Italians under COVID-19 lockdown. Front Psychol 2021;12:663799. https://doi.org/10.3389/fpsyg.2021.663799  Back to cited text no. 6
    
7.
Morrissette M. School closures and social anxiety during the COVID-19 pandemic. J Am Acad Child Adolesc Psychiatr 2021;60:6-7. https://doi.org/10.1016/j.jaac.2020.08.436  Back to cited text no. 7
    
8.
Schmidt S, Anedda B, Burchartz A et al. Physical activity and screen time of children and adolescents before and during the COVID-19 lockdown in Germany: a natural experiment. Sci Rep 2020;10:21780. https://doi.org/10.1038/s41598-020- 78438-4  Back to cited text no. 8
    
9.
Viner R, Russell S, Saulle R et al. School closures during social lockdown and mental health, health behaviors, and well-being among children and adolescents during the first COVID-19 wave: a systematic review. JAMA Pediatr 2022;176:400-9. https://doi.org/10.1001/jamapediatrics.2021.5840  Back to cited text no. 9
    
10.
Mohan S, Solanki AK, Taluja HK, Anuradha , Singh A. Predicting the impact of the third wave of COVID-19 in India using hybrid statistical machine learning models: a time series forecasting and sentiment analysis approach. Comput Biol Med 2022;144:105354. https://doi.org/10.1016/j.compbiomed.2022.105354  Back to cited text no. 10
    
11.
Sharma N, Sharma P, Basu S et al. The seroprevalence of severe acute respiratory syndrome coronavirus 2 in Delhi, India: a repeated population-based seroepidemiological study. Trans R Soc Trop Med Hyg 2022;116:242-51. https://doi.org/10.1093/trstmh/trab109  Back to cited text no. 11
    
12.
Haynes A, Gilchrist H, Oliveira JS et al. What helps older people persevere with yoga classes? A realist process evaluation of a COVID-19-affected yoga program for fall prevention. BMC Public Health 2022;22:463. https://doi.org/10.1186/s12889-022- 12818-5  Back to cited text no. 12
    
13.
Santos HO. Therapeutic supplementation with zinc in the management of COVID-19-related diarrhea and ageusia/dysgeusia: mechanisms and clues for a personalized dosage regimen. Nutr Rev 2022;80:1086-93. https://doi.org/10.1093/nutrit/nuab054  Back to cited text no. 13
    
14.
Prajapati SK, Malaiya A, Mishra G et al. An exhaustive comprehension of the role of herbal medicines in Pre- and Post-COVID manifestations. J Ethnopharmacol 2020;296:115420. Advance online publication. https://doi.org/10.1016/j.jep.2022.115420  Back to cited text no. 14
    
15.
Al-Shatnawi SF, Khasawneh RA, Alhamad H. Healthcare providers’ perspectives toward the integration of over the counter supplements during COVID-19 pandemic: a cross-sectional study from Jordan. Inquiry 2022;59:469580221095825. https://doi.org/10.1177/00469580221095825  Back to cited text no. 15
    
16.
Banerjee D, Bhattacharya P. “Pandemonium of the pandemic”: impact of COVID-19 in India, focus on mental health. Psychol Trauma 2020;12:588-92. https://doi.org/10.1037/tra0000799  Back to cited text no. 16
    
17.
Kelsey MM, Zaepfel A, Bjornstad P, Nadeau KJ. Age-related consequences of childhood obesity. Gerontology 2014;60: 222-8. https://doi.org/10.1159/000356023  Back to cited text no. 17
    
18.
Memarian A, Aghakhani K, Sani SR, Abdolkarimi L, Soltani S. Pattern of inflicted injuries to motorcyclists referred to Hazrat-E-Rasoul Akram hospital in Tehran during 2015–2016. J Fam Med Prim Care 2021;10:4212-17. https://doi.org/10.4103/jfmpc.jfmpc_321_21  Back to cited text no. 18
    
19.
Craig CL, Marshall AL, Sjöström M et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 2003;35:1381-95. https://doi.org/10.1249/01.MSS.0000078924.61453.FB  Back to cited text no. 19
    
20.
Simon PD. The 10-item perceived stress scale as a valid measure of stress perception. Asia Pac Psychiatry 2021;13:e12420. https://doi.org/10.1111/appy.12420  Back to cited text no. 20
    
21.
Roy D, Tripathy S, Kar SK, Sharma N, Verma SK, Kaushal V. Study of knowledge, attitude, anxiety & perceived mental healthcare need in Indian population during COVID-19 pandemic. Asian J Psychiatr 2020;51:102083. https://doi.org/10.1016/j.ajp.2020.102083  Back to cited text no. 21
    
22.
Joanne KS, Spirit P. Paws & Breathe®: Interspecies stress reduction collaboration to support clinician well-being. J Interprofess Educ Pract 2021;25:100470. https://doi.org/10.1016/j.xjep.2021.100470.  Back to cited text no. 22
    
23.
Levis B, Benedetti A, Thombs BD, DEPRESsion Screening Data (DEPRESSD) Collaboration. Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis. BMJ 2019;365:l1476. https://doi.org/10.1136/bmj.l1476  Back to cited text no. 23
    
24.
Fata Nahas A, Elkalmi RM, Al-Shami AM, Elsayed TM. Prevalence of depression among health sciences students: findings from a Public University in Malaysia. J Pharm Bioallied Sci 2019;11:170-5. https://doi.org/10.4103/jpbs.JPBS_263_18  Back to cited text no. 24
    
25.
Padhan R, Prabheesh KP. The economics of COVID-19 pandemic: a survey. Econ Anal Policy 2021;70:220-37. https://doi.org/10.1016/j.eap.2021.02.012  Back to cited text no. 25
    
26.
Wang X, Hegde S, Son C, Keller B, Smith A, Sasangohar F. Investigating mental health of US College students during the COVID-19 pandemic: cross-sectional survey study. J Med Internet Res 2020;22:e22817. https://doi.org/10.2196/22817  Back to cited text no. 26
    
27.
Aknin LB, De Neve JE, Dunn EW et al. Mental health during the first year of the COVID-19 pandemic: a review and recommendations for moving forward. Perspect Psychol Sci 2022;17:915-36. https://doi.org/10.1177/17456916211029964  Back to cited text no. 27
    
28.
Zhang C, Hao J, Liu Y, Cui J, Yu H. Associations between online learning, smartphone addiction problems, and psychological symptoms in Chinese college students after the COVID-19 pandemic. Front Public Health 2022;10:881074. https://doi.org/10.3389/fpubh.2022.881074  Back to cited text no. 28
    
29.
Lordan R. Dietary supplements and nutraceuticals market growth during the coronavirus pandemic − implications for consumers and regulatory oversight. PharmaNutrition 2021;18:100282. https://doi.org/10.1016/j.phanu.2021.100282  Back to cited text no. 29
    
30.
Radwan H, Hasan H, Jaafar Z et al. (2022). Diets and dietary supplements used during the COVID-19 pandemic in the United Arab Emirates: a cross-sectional survey. Saudi Pharm J 2022;30:421-32. https://doi.org/10.1016/j.jsps.2022.01.019  Back to cited text no. 30
    
31.
Zeng Y, Wang G, Xie C, Hu X, Reinhardt JD. Prevalence and correlates of depression, anxiety and symptoms of stress in vocational college nursing students from Sichuan, China: a cross-sectional study. Psychol Health Med 2019;24:798-811. https://doi.org/10.1080/13548506.2019.1574358  Back to cited text no. 31
    
32.
Wang X, Hegde S, Son C et al. Investigating mental health of US College students during the COVID-19 pandemic: cross-sectional survey study. J Med Internet Res 2020;22:e22817. https://doi.org/10.2196/22817  Back to cited text no. 32
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7]
 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

Top
 
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    Abstract
   Introduction
    Materials and me...
   Results
   Discussion
   Conclusion
    References
    Article Figures
    Article Tables

 Article Access Statistics
    Viewed220    
    Printed18    
    Emailed0    
    PDF Downloaded29    
    Comments [Add]    

Recommend this journal