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Introduction Selective serotonin reuptake inhibitors are considered the drugs, whose effectiveness in viral pandemics has been studied. The aim of this study was to evaluate of adding fluoxetine to the treatment regimen of patients with COVID‐19 pneumonia. Methods This study was a double‐blind randomized placebo controlled clinical trial .36 patients in the fluoxetine and 36 patients in the placebo group were enrolled. Patients in the intervention group were first treated with fluoxetine 10 mg for 4 days and then the dose of 20 mg was continued for 4 weeks. Data analysis was conducted using SPSS V. 22.0. Results There was no statistically significant difference between the two groups in terms of clinical symptoms at the beginning of the study and also the score of anxiety and depression, oxygen saturation at the time of hospitalization, mid‐hospitalization and discharge periods. The need for mechanical ventilator support (p = 1.00), the need for admission in the intensive care unit (ICU) (p = 1.00), rate for mortality (p = 1.00), and discharge with relative recovery (p = 1.00) were not significantly different between the two groups. The distribution of CRP within the study groups showed a significant decrease during different time periods (p = 0.001), and although there was no statistically significant difference between the two groups on the first day (p = 1.00) and at discharge (p = 0.585), mid‐hospital CRP showed a significant decrease in the fluoxetine group (p = 0.032). Conclusion Fluoxetine resulted in a faster reduction of patients' inflammation without association with depression and anxiety. The aim of this study was to evaluate the efficacy and safety of adding fluoxetine to the treatment regimen of hospitalized patients with COVID‐19 pneumonia. According to the Friedman test, the distribution of CRP within the study groups showed a significant decrease during different time periods (p = 0.001). It can be concluded that administration of fluoxetine resulted in a faster reduction of patients' inflammation. Further research and large randomized clinical trials are needed.

Background and aim Delirium has been presented as the leading cause of sudden change in the mental state of patients with coronavirus disease 2019 (COVID‐19). Given that the delayed diagnosis of such a dysfunction is often associated with excess mortality, it seems essential to devote vastly more attention to this significant clinical characteristic. Materials and methods This cross‐sectional study was performed on 309 patients [viz. 259 cases hospitalized in general wards and 50 individuals admitted to the intensive care unit (ICU)]. For this purpose, a Demographic‐Clinical Information Questionnaire, the Confusion Assessment Method (CAM), the Confusion Assessment Method for the ICU (CAM‐ICU), the Richmond Agitation‐Sedation Scale (RASS) and face‐to‐face interviews were completed by a trained senior psychiatry resident. The data analysis was further done with the SPSS Statistics V22.0 software package. Results Out of 259 patients admitted to the general wards and 50 cases in the ICU due to COVID‐19, 41 (15.8%) and 11 (22%) individuals were diagnosed with delirium, respectively. As well, a significant relationship was observed between the incidence rate of delirium and age (p < 0.001), level of education (p < 0.001), hypertension (HTN) (p = 0.029), a history of stroke (p = 0.025), a history of ischemic heart disease (IHD) (p = 0.007), a history of psychiatric disorders, a history of cognitive impairment (p < 0.001), use of hypnotic and antipsychotic medications (p < 0.001) and a history of substance abuse (p = 0.023). Among 52 patients with delirium, only 20 cases had received psychiatric consultation by consultation‐liaison psychiatry service for the possibility of delirium. Conclusion In view of the high frequency of delirium among COVID‐19 inpatients, their screening for this important mental state should be a priority in clinical settings. From 309 hospitalized patients with COVID‐19, 37.8% had delirium. Regarding the high frequency of important complication, further attention should be paid to the mental state of patients with COVID‐19.

Background and aimAlexithymia is defined as emotional response inhibition. As well, empathy refers to the ability to put oneself in someone’s position and resilience is the capacity to recover from a series of negative emotional experiences. Considering the psychological distress induced by the coronavirus disease 2019 (COVID-19) pandemic together with academic stress and the role of empathy in physician–patient relationships, the present study was to investigate alexithymia, empathy, and resilience in Iranian medical interns and residents.Materials and methodsThis cross-sectional study was fulfilled in northern Iran in 2021–2022. In total, 394 medical interns and residents were initially recruited for this purpose. Then, an online sociodemographic survey form (SDSF), the Jefferson Scale of Empathy (JSE), the Toronto Alexithymia Scale (TAS-20), and the Connor–Davidson Resilience Scale (CD-RISC) were completed. The data analysis was performed using the IBM SPSS Statistics (ver.26) software in regard to the p < 0.05 significance level.ResultsThe mean age of the study participants was 28.8 ± 5.00. As well, 38.1% of these individuals were male, 62.2% of the cases were single, and 54.6% of them were medical interns. The mean value of empathy, resilience and alexithymia was 89.90 ± 14.00, 49.75 ± 10.56, and 46.40 ± 16.40, respectively. No significant relationship was found between empathy and educational level (p = 0.532). As well, medical interns empathy and resilience than residents (p = 0.000 & p = 0.000, respectively). Besides, male participants had more empathy and resilience (p = 0.000 & p = 0.007).ConclusionLow empathy and resilience in medical interns and residents, especially in women who make up the majority of them, can be a warning for health care in Iran.