Association between Stress, Fear of COVID-19, and Salivary Immunoglobulin A Level Among Staff Nurses at Sultan Ahmad Shah Medical Centre (SASMEC): A Cross-Sectional Study.

The COVID-19 pandemic has had a significant impact globally. Healthcare workers (HCWs) were forced to work with uncertainties about the virus, extended working hours, and increasing cases. It is known that stress causes immunosuppression, and salivary IgA (sIgA) is the immune marker most strongly related to work stress. However, the relationship between stress level, COVID-19 fear, and immunosuppression was unknown. The study investigated the relationship between COVID-19-related fear and stress of the sIgA level. A cross-sectional study was conducted among 109 staff nurses in SASMEC, Kuantan, Pahang. Stratified randomised sampling was done for selection of participants. The PSS-10 and FCV -19S-M Questionnaires were administered to objectively assess stress and fear, followed by non-invasive saliva sample collection. Quantitative measurement of IgA level was done using an Enzyme- linked Immunosorbent Assay Kit (ELISA) for sIgA. Pearson correlation test and coefficient of determination (R2) were applied. 86% of participants were female, 83% were aged between 26-45 years old, 75% were married, 95% had worked for more than 1 year, and 68% worked in high-risk stations. The majority of the participants scored moderate severity in terms of perceived stress (84%) and fear level (61%), and the mean sIgA level was 3.96ng/mL. Further analysis showed no linear correlation between stress and fear with salivary IgA levels. Conclusion: HCWs are inevitably exposed to high stress, especially during the pandemic, not just work-related stress and COVID exposure but also other demographic and situational factors. Though the current study revealed moderate stress and fear levels among the staff nurses with no significant association between salivary IgA and stress and fear, further study should examine other factors such as coping skills, working environment, and protective factors that may modify perceived stress and, subsequently, immunological response. [ABSTRACT FROM AUTHOR]