Caring for anxiety among adults in the face of COVID-19: A cross-sectional online survey

Highlights • Symptoms of anxiety were more prevalent among farmer, people staying out of Beijing during the epidemic, poor sleep, and those who did not exercise. • The status of anxiety symptoms were significantly higher than usually, but it were lower than that during Ebola, influenza A and SARS outbreak. • Knowledge and perceptions of COVID-19, physical activity, and sleeping time are the main factors affecting anxiety.
Background The outbreak of COVID-19 poses a challenge to psychological resilience. The aim of this study was to evaluate the prevalence of anxiety and identify risk and protective factors associated with the presence of anxiety symptoms in the face of COVID-19 among adults. Methods A cross-sectional online survey was conducted in adults from March 2nd to March 16th 2020. The self-rating anxiety scale (SAS) was used to measure the status of anxiety. Unconditional multivariate logistic regression was performed to identify the factors associated with anxiety. Results Among the 7144 respondents, 9.3% met the criteria for anxiety risk based on the SAS. Symptoms of anxiety were more prevalent among farmer (OR=1.43, 95%CI: 1.03-1.99), respondents lived in urban out of Beijing during the COVID-19 outbreak (OR=1.73, 95%CI: 1.14-2.63), and slept less than six hours per day (OR=2.64, 95%CI: 1.96-3.57). Compared to participants who didn’t exercise, a lower risk of anxiety was observed in those exercised 30-60 minutes/day (OR=0.62, 95%CI: 0.41-0.94) and more than 60 minutes/day (OR=0.57, 95%CI: 0.37-0.88). And compared with participants whose knowledge and perceptions of COVID-9 scores in lower quartile, the OR (95%CI) for the second, third and upper quartile were 0.58 (0.46, 0.73), 0.48 (0.37, 0.61) and 0.42(0.33, 0.52), respectively. Limitations No diagnostic interview for mental disorders was administered in the original studies limiting analysis of sensitivity and specificity of the Swahili PHQ-9. Conclusion There was a high level of anxiety in the face of COVID-19 among adults. The results point to characteristics of adults in particular need for attention to anxiety and suggest possible targets for intervention such as strengthening of physical activity and knowledge and perceptions of COVID-19.