**Abstract**

Since the upsurge of Coronavirus in 2019, the WHO and the US CDC have been detecting and characterizing new variants and providing updates to healthcare workers, the public, and global partners on its spread and effects on patients with noncommunicable diseases and co-morbid ailments. Epidemiology and virologic evidence suggest that COVID-19 and its subsequent deadly variants have been associated with mental and neurological manifestations, including delirium or encephalopathy, agitation, acute cerebrovascular disease, meningoencephalitis, impaired sense of smell or taste, anxiety, depression, and sleep problems. While data on these complications may be available in the global north and south, there is a paucity of literature in most African States. Recent developments in COVID-19-related theories and concepts include ethical principles for clinical, counseling, psycho-therapeutic, and rehabilitation options for special and vulnerable populations, such as pediatric patients, pregnant women, mothers, older people, PLWDs, and other marginalized groups. However, there is no known coordinated and multidisciplinary continuum of clinical, counseling, and psychotherapy COVID-19 care pathways for symptomatic and asymptomatic patients and their families in the African States. Hence, the need for this scoping analysis of existing literature on the psycho-social and health implications of COVID-19 Comorbidity-Related Complications for vulnerable persons in developing societies.

**Keywords:** COVID-19, COVID-19-related comorbidity, clinical care, counseling, psychotherapy, continuum of care and African states

## **1. Introduction**

#### **1.1 Background**

There is no health without mental health. Mental health is important at every stage of life, from childhood and adolescence through adulthood to senescence. However, the upsurge of Coronavirus (COVID-19) as a global burden in 2019 in Wuhan, China, its high mortality rate and attendant stressors, such as lock-downs, self-isolation and quarantines, infection fears, inadequate information, job and financial losses, stigma, and discrimination, among others have contributed significantly to the increase of negative psycho-social and mental health disorders globally. Since the WHO's declaration of the outbreak of coronavirus disease as a Public Health Emergency of International Concern (PHEIC) and a pandemic between 30th January and 11th March 2020, there had held six different International Health Regulations (IHR) Emergency Committee meetings (third to ninth) for COVID-19 in Geneva. The meetings were specifically held on 30 April 2020, 31 July 2020, 29 October 2020, 14 January 2021, 15 April 2021, 14 July 2021, and 22 October 2021. During each of these committee meetings, it was concluded that the pandemic constitutes a major PHEIC.

The physical burden associated with COVID-19 included symptoms such as mild to moderate respiratory illnesses characterized by fever, dry cough, tiredness, difficulty breathing or shortness of breath, and loss of the ability to smell and taste. Between 31st December 2019 and the week 492,021, five out of 316,017 COVID-19-related deaths and 270,327,277 cases have been recorded in line with the applied case definitions and testing strategies of affected countries. The total number of cases recorded in the global community and the EU/EEA are probably an underestimate of the true number of cases and deaths, due to various degrees of under-ascertainment and underreporting. Between 9th and 16th December 2021, there had been no changes made to the following ECDC variant classification—*the variants of concern (VOCs), variants of interest (VOIs), variants under monitoring, and de-escalated variant*s.

The COVID-19 pandemic has not only disrupted and altered lives in Africa but a surge in depressive cases, public anxieties, worries [1], and increased risk of mental health symptoms and disorders among vulnerable populations, such as unemployed adults, youth, the elderly, and frontline healthcare workers [2]. Its impact in the Democratic Republic of the Congo (DRC) was complicated by the recent Ebola virus disease (EVD) outbreak reported on 8 October 2021, in Butsili Health Area in the Beni Health Zone, North Kivu Province, even though it has been officially declared over on 16 December 2021. In total, eight confirmed and three probable EVD cases, including nine deaths (six among the confirmed cases), were reported since the start of the outbreak (8 October 2021).

Although the WHO and the US CDC have been detecting and characterizing new variants and providing updates to healthcare workers, the public and global partners on the spread and effects of COVID-19 on patients with noncommunicable diseases and co-morbid ailments, Corser [3] posit that the impact of COVID-19 on the mental health of individuals is an unfolding urgent crisis. Additionally, epidemiology and virologic evidence suggest that COVID-19 and its subsequent deadly variants have been associated with mental and neurological manifestations, including delirium or encephalopathy, agitation, acute cerebrovascular disease (including ischaemic and hemorrhagic stroke), meningoencephalitis, impaired sense of smell or taste, anxiety, depression, and sleep problems. WHO [4] found that out of 775 adults, studied in the United States, 55% believed that COVID-19 had dangerous effects on their mental

*A Scoping Analysis of the Psychosocial and Health Implications of COVID-19… DOI: http://dx.doi.org/10.5772/intechopen.104546*

health, while 71% felt agitated about the negative impacts of isolation on their mental health. Pappa, Ntella, Giannakas, Giannakoulis, Papoutsi, and Katsaounou [5] also associated personality changes consistent with depression with COVID-19-induced encephalopathy. Zhang and Ma [6] reported that symptoms of depression, anxiety, fear, stress, and insomnia, increased during the pandemic.

### **1.2 Variants of COVID-19**

Toward the end of 2020, the emergence of specific variants of the COVID-19 pandemic that constitute a greater significant risk to global public health led to the listing of specific Variants of Interest (VOIs) and Variants of Concern (VOCs). This classification aided the prioritization of global health monitoring, research, and ongoing response to the pandemic. According to the SIG Variant classification scheme, the following are the four main classes of SARS-CoV-2 variants (see **Table 1**).
