Artículo de revisión

A non-systematic, descriptive literature review of observational research on anxiety during the first COVID-19 pandemic phase

Back to article
Description of the included studies.
StudyCountry and designAnxiety instrumentFunctional impairmentMain results
Wakode et al. [10]India; cross-sectional (n = 257); online, self-report; no comparison groupGeneralized Anxiety Disorder ScaleNo88% had moderate to severe levels of anxiety
Reddy et al. [11]India; cross-sectional (n = 247); online, self-report; compared to healthcare professionalsDepression, Anxiety, and Stress ScaleNoAnxiety scores were low (92.7%)
Velikonja et al. [22]Slovenia; cross-sectional (n = 7731); online, self-report; no comparison groupGeneralized Anxiety Disorder ScaleNoThe sample presented a mild level of anxiety
Meesala et al. [33]India; cross-sectional (n = 1346); online, self-report; no comparison groupCOVID-19 Anxiety ScaleNoThe mean Covid Anxiety Scale score was 18.9 ± 6.4 (The item with highest mean scores was: “How worried are you about people coughing or sneezing for fear that you might get COVID-19?”)
Matsungo et al. [44]Zimbabwe; cross-sectional (n = 507); online, self-report; no comparison groupGeneralized Anxiety Disorder ScaleNoThe prevalence of generalized anxiety disorder was 40.4%
Bérard et al. [55]France; cross-sectional (n = 536); telephone interview; no comparison groupGeneralized Anxiety Disorder ScaleCardiovascular risk, physical activity32% of participants reported symptoms of anxiety
Muhammad Alfareed Zafar et al. [66]Pakistan; cross-sectional (n = 1014); online, self-report; compared to healthcare professionals and medical studentsSelf-Rating Anxiety ScaleNoThe prevalence rate of anxiety symptoms was 4.6%; The general public had more anxiety than healthcare professionals
Ansari Ramandi et al. [77]Iran; cross-sectional (n = 788); online, self-report; no comparison groupHospital Anxiety and Depression ScaleNoAnxiety mean score was 7.01 ± 3.68 (119 participants had abnormal anxiety scores)
Kantor et al. [78]US; cross-sectional (n = 1005); online, self-report; no comparison groupGeneralized Anxiety Disorder ScaleNo264 subjects (26.8%) met criteria for anxiety disorder based on a GAD-7 cut-off of 10; a cut-off of 7 resulted in 416 subjects (41.4%), who met the clinical criteria for anxiety.
Demartini et al. [[79]Italy; cross-sectional (n = 432); online, self-report; compared to healthcare workersDepression, Anxiety, and Stress ScaleNo25.5% presented pathological levels of anxiety
He et al. [12]China; cross-sectional (n = 2689); online, self-report; compared to healthcare workersGeneralized Anxiety Disorder ScaleNoThe proportion of individuals with mild or serious anxiety was higher in the general population when compared to quarantined population and healthcare workers
Hoffart et al. [13]Norway; cross-sectional (n = 10 061); online, self-report; no comparison groupGeneralized Anxiety Disorder ScaleNo25.6% met the cut-off for generalized anxiety disorder
Rossi et al. [14]Italy; cross-sectional (n = 24 050); online, self-report; compared to healthcare workersGeneralized Anxiety Disorder ScaleInsomniaAnxiety symptoms had a prevalence of 21.25% for the general population group, 18.05% for second-line healthcare workers, and 20.55% for first-line healthcare workers
Vu et al. [15]Vietnam; cross-sectional (n = 406); online, self-report; no comparison groupNoQuality of lifeMost people reported having anxiety/depression problems, which were 40.1%, 38.6% and 30.0% among people in the groups that did not need isolation, self-isolation and government quarantine facilities, respectively.
Zhang et al. [16]China; cross-sectional (n = 179); online, self-report; compared to previous research (pre-COVID) in urban and rural areasSelf-Rating Anxiety ScaleNoMean anxiety scores was 40.93 ± 9.36 (below the significant cutoff value)
Xiao et al. [17]China; cross-sectional (n = 1038); online, self-report; no comparison groupGeneralized Anxiety Disorder ScaleNo63% of the sample had at least mild anxiety, with 118 (11.4%) having moderate anxiety and 75 (7.2%) severe anxiety
Alamri et al. [18]Saudi Arabia; cross-sectional (n = 1597); online, self-report; no comparison groupDepression, Anxiety, and Stress ScaleNo10% reported moderate to severe anxiety symptoms
Zhong et al. [19]China; cross-sectional (n = 2185); online, self-report; no comparison groupDepression, Anxiety, and Stress ScaleNoTen percent of the participants reported having experienced moderate to severe anxiety, and 9.8% reported mild symptoms of anxiety.
Ran et al. [20]China; cross-sectional (n = 1775); online, self-report; comparied to previous research (pre-COVID)Self-Rating Anxiety ScaleNoCompared to Ya'an (8.0%), participants in Jingzhou in 2020 had a significantly higher rate of anxiety (Self-rating Anxiety Scale scores ≥ 50, 24.1%)
Peters et al. [80]Germany; cohort (n = 113 928); online, self-report; compared changes in mental health scores between the NAKO baseline examination and the time of the COVID-NAKO questionnaireGeneralized Anxiety Disorder ScaleSelf-reported health statusThe increase in mean severity of both depressive symptoms and anxiety symptoms raised the proportion of those who were above the cut-off points on these two scales (≥10 points): from 4.3% to 5.7% (anxiety)
Ngoc Cong Duong et al [21]Vietnam; cross-sectional (n = 1385); online, self-report; no comparison groupDepression, Anxiety, and Stress ScaleNo14.1% presented significant levels of anxiety
Mirhosseini et al. [23]Iran; cross-sectional (n = 3565); online, self-report; no comparison groupGeneralized Anxiety Disorder ScaleNoThe average anxiety scores of the participants were 6.06
Jiang et al. [24]China; cross-sectional (n = 60 199); online, self-report; no comparison groupState-Trait Anxiety InventoryNo33.21% were mildly anxious, 41.27% were moderately anxious, and 22.99% were severely anxious
Rias et al. [25]Indonesia; cross-sectional (n = 1082); online, self-report; no comparison groupDepression, Anxiety, and Stress ScaleNoIndividuals who had low levels of spirituality had increased anxiety compared to those with higher levels of spirituality
Lenzo et al. [26]Italy; cross-sectional (n = 6314); online, self-report;with no comparison groupDepression, Anxiety, and Stress ScaleNoThe prevalence of moderate to extremely severe symptoms among participants was 24.4% for anxiety
Thomas et al. [27]United Arab Emirates; cross-sectional (n = 1039); online, self-report, no comparison groupGeneralized Anxiety Disorder ScaleNo55.7% had scores above the cut-off of GAD-7
Ferrucci et al. [28]Italy; cross-sectional (n = 10 025); online, self-report; no comparison groupNoDaily life activities (sexuality, nutrition, sleep, sense of freedom)Data from north Italy exhibited higher prevalence of high psychological impact (anxiety 28%, fear 18%, anger 21%,sadness 27%, concern 42%) compared to center-south regions (anxiety21%, fear 14%, anger 22%, sadness 23%, concern 34%)
Jacques-Aviñó et al. [29]Spain; cross-sectional (n = 7053); online, self-report; no comparison groupGeneralized Anxiety Disorder ScaleNoA total of 31.2% of women and 17.7% of men reported anxiety
Elezi et al. [30]Albania; cross-sectional (n = 1678); online, self-report; no comparison groupGeneralized Anxiety Disorder ScaleNoAnxiety symptoms were more likely to occur in those who spent a longer time focusing on the outbreak of COVID-19
Torales et al. [31]Paraguay; cross-sectional (n = 2206); online, self-report; no comparison groupNoNo41.97% of the sample reported anxiety
Lu et al. [32]China; cross-sectional (n = 1417); online, self-report; compared to healthcare workersGeneralized Anxiety Disorder ScaleNoThe median score of GAD-7 was 4 (“normal level”)
Schnell et al. [34]Germany-Austria; cross-sectional (n = 1538); online, self-report; no comparison groupNoNo41% of the sample had moderate symptoms of depression/anxiety
Hou et al. [35]China; cross-sectional (n = 3088); online, self-report; compared to healthcare workersGeneralized Anxiety Disorder ScaleNoThe prevalence of anxiety was 13.25%
Agberotimi et al. [36]Nigeria; cross-sectional (n = 884); online, self-report; compared to healthcare workersGeneralized Anxiety Disorder ScaleInsomniaThe prevalence of anxiety symptoms was significantly higher among healthcare personnel than the general population (58.4% vs. 49.6%)
Ren et al. [37]China; cross-sectional (n = 6130); online, self-report; no comparison groupGeneralized Anxiety Disorder ScaleNoThe prevalence of anxiety was 7.1%
Fisher et al. [38]Australia; cross-sectional (n = 13 829); online, self-report; no comparison groupGeneralized Anxiety Disorder ScaleNoThe estimated prevalence of clinically significant symptoms of anxiety was 21.0%
Massad et al. [39]Jordan; cross-sectional (n = 5274); online, self-report; no comparison groupThe Beck Anxiety InventoryNoThe prevalence of mild, moderate, and severe anxiety was 21.5%, 10.9%, and 6%, respectively
Pandey et al. [40]India; cross-sectional (n = 1395); online, self-report; no comparison groupDepression, Anxiety, Stress ScaleNoAnxiety was reported by 22.4%
O’Connor et al. [81]UK; cohort (n = 3077); online, self-report; repeated measuresGeneralized Anxiety Disorder ScaleNoSymptoms of anxiety did not change significantly
Stylianou et al. [41]Cyprus; cross-sectional (n = 216); online, self-report; no comparison groupGeneralized Anxiety Disorder ScaleNoThe overall prevalence of generalized anxiety disorder was 8.33%
Canet-Juric et al. [82]Argentina; cohort (n = 6057); online, self-report; repeated measuresState-Trait Anxiety InventoryNoAnxiety levels showed a slight decrease in the full sample
Shevlin et al. [42]UK; cross-sectional (n = 2025); online, self-report; no comparison groupGeneralized Anxiety Disorder Scale NoThe prevalence of anxiety was 21.6%
Qian et al. [43]China; cross-sectional (n = 1011); online, self-report; compared to general population samples (Wuhan and Shanghai)Generalized Anxiety Disorder ScaleNoThe prevalence of moderate or severe anxiety was significantly higherin Wuhan (32.8%) than Shanghai (20.5%)
Huang et al. [45]China; cross-sectional (n = 1172); online, self-report; no comparison groupGeneralized Anxiety Disorder ScaleInsomnia, physical symptomsThe percentage of anxiety was 33.02%
Fiorillo et al. [46]Italy; cross-sectional (n = 20 720); online, self-report; compared general population samples from different geographical regionsDepression, Anxiety, and Stress ScaleNo17.6% reported severe or extremely severe anxiety symptoms
Parlapani et al. [47]Greece; cross-sectional (n = 3029); online, self-report; no comparison groupGeneralized Anxiety Disorder ScaleNoA significant proportion reported moderate-to-severe anxiety symptoms (77.4%)
Passos et al. [48]Portugal-Brazil; cross-sectional (n = 550); online, self-report; compared general population samples from different geographical regionsGeneralized Anxiety Disorder ScaleNoThe prevalence of anxiety was 71.3% (mild anxiety was present in 43.1%)
Zhao et al. [49]China; cross-sectional (n = 1501); online/telephone interview, self-report/interview; compared general population samples at different timesGeneralized Anxiety Disorder ScaleNoThe prevalence of anxiety was similar between 2016 and 2017 but greatly increased during the COVID-19 outbreak
Campos et al. [50]Brazil; cross-sectional (n = 12 196); online, self-report; compared general population samples from different geographical regionsDepression, Anxiety, and Stress ScaleNoThe prevalence of mild, moderate and severe, or extremely severe anxiety was 8.5%, 19.2%, and 16.5%, respectively
Hossain et al. [51]India; cross-sectional (n = 880); online, self-report; no comparison groupGeneralized Anxiety Disorder ScaleNoThe prevalence of anxiety was 49.1%
van der Velden [83]Netherlands; cohort (n = 3983); online, self-report; repeated measuresNoNoThe prevalence of anxiety and depression symptoms did not increase compared to the pre-outbreak prevalence
Azizi et al. [84]Morocco; cohort (n = 537); online, self-report; repeated measuresNoQuality of lifeNo significant differences in total anxiety and depression symptom scores
Duan et al. [52]China; cross-sectional (n = 1390); online, self-report; compared general population samples at different timesNoNoThere were no significant differences in compulsion-anxiety between the outbreak and the remission of pandemic, but fear significantly decreased
Casagrande et al. [53]Italy; cross-sectional (n = 2291); online, self-report; no comparison groupGeneralized Anxiety Disorder ScaleSleep quality32.1% reported high anxiety
Rossi et al. [54]Italy; cross-sectional (n = 18 147); online, self-report; compared general population samples from different geographical regionsGeneralized Anxiety Disorder ScaleInsomnia20.8% reported severe anxiety symptoms
Sameer et al. [56]India-Pakistan- Saudi Arabia-UK-US-Canada-United Arab Emirates-Estonia, Netherlands-Germany-Bangladesh-Chile-Korea-Japan-Malaysia-Switzerland; cross-sectional (n = 418); online, self-report; compared general population samples from different geographical regionsDepression, Anxiety, and Stress ScaleNoFor anxiety, among male participants, 11.5% had moderate, 10.7% severe, and 36.9% extremely severe anxiety; while among female participants, 4.6% had moderate, 8.0% severe, and 54% extremely severe anxiety
Pakenham et al. [57]Italy; cross-sectional (n = 1035); online, self-report; no comparison groupGeneralized Anxiety Disorder ScaleNo12.3% and 3% of the sample reported moderate and severe anxiety levels, respectively.
Galindo-Vásquez et al. [58]Mexico; cross-sectional (n = 1508); online, self-report; no comparison groupGeneralized Anxiety Disorder ScaleNo20.8% had symptoms of severe anxiety
Han et al. [59]China; cross-sectional (n = 9764); online, self-report; compared general population samples from different geographical regionsState-Trait Anxiety InventoryNoPeople in Hubei province were the most anxious (37.2% with high anxiety), followed by those living in Beijing (30.5% with high anxiety) and Shanghai (30.2% with high anxiety)
Fernández et al. [60]Argentina; cross-sectional (n = 4408); online, self-report; no comparison groupBrief Symptom Inventory-53NoParticipants reported elevated symptoms of anxiety (31.8%) and phobic-anxiety(41.3%)
Al-Qahtani [61]Saudi Arabia; cross-sectional (n = 1508); online, self-report; compared saudi and non-saudi participantsDepression, Anxiety, and Stress ScaleNoAnxiety levels differed significantly between saudi and non-saudi samples
Nekliudov et al. [62]Russia; cross-sectional (n = 23 756); online, self-report; compared general population samples from different geographical regionsState-Trait Anxiety Inventory NoState Anxiety Scale scores were higher than Trait Anxiety Scale scores across all regions of Russia
Ran et al. [63]China; cross-sectional (n = 1840); online, self-report; compared general population samples from different geographical regionsGeneralized Anxiety Disorder ScaleNoThe prevalence of moderate and severe anxiety was 6% and 2.8%, respectively
Guo et al. [64]China; cross-sectional (n = 2331); online, self-report; no comparison groupHospital Anxiety and Depression ScaleNo32.7% experienced elevated anxiety or depression symptoms
Hyland et al. [65]Ireland; cross-sectional (n = 1041); online, self-report; no comparison groupGeneralized Anxiety DisorderScaleNo20% of the sample screened positive for generalized anxiety disorder
Islam et al. [67]India; cross-sectional (n = 1311); online, self-report; no comparison groupGeneralized Anxiety Disorder Scale No37.3% reported generalized anxiety
Alkhamees et al. [68]Saudi Arabia; cross-sectional (n = 1160); online, self-report; no comparison groupDepression, Anxiety, and Stress ScaleNo24% reported moderate to severe anxiety symptoms,
Solomou et al. [69]Cyprus; cross-sectional (n = 1642); online, self-report; no comparison groupGeneralized Anxiety DisorderScaleQuality of life, including finances, personal health, and satisfaction with life14% scored moderate anxiety and 9.1% severe anxiety
Petzold et al. [70]Germany; cross-sectional (n = 6509); online, self-report; no comparison group NoLimitations in daily lifeMore than 50% reported having anxiety and psychological distress related to the COVID-19 pandemic.
Gualano et al. [71]Italy; cross-sectional (n = 1515); online, self-report; no comparison groupGeneralized Anxiety Disorder ScaleAvoidance of physical activity, insomniaAnxiety symptoms prevalence 23.2%
Shi et al. [72]China; cross-sectional (n = 56 679); online, self-report; compared general population samples from different geographical regionsGeneralized Anxiety DisorderScaleInsomnia31.6% reported significant anxiety levels
Naser et al. [73]Jordan; cross-sectional (n = 4126); online, self-report; compared to healthcare professionalsGeneralized Anxiety Disorder ScaleNoThe prevalence of anxiety was 13.1%
Verma et al. [74]India; cross-sectional (n = 354); online, self-report; no comparison groupDepression, Anxiety, and Stress ScaleNo28% suffered from moderate to extremely severe anxiety.
Shevlin et al. [75]UK; cross-sectional (n = 2025); online, self-report; no comparison groupGeneralized Anxiety Disorder ScaleSomatic symptomsThere may be increased levels of generalized anxiety in the general population, but there may also be anxiety specifically associated to COVID-19
González-Sanguino [76]Spain; cross-sectional (n = 3480); online, self-report; no comparison groupGeneralized Anxiety Disorder ScaleNo21.6% were likely to be diagnosed with anxiety.
Wang et al. [85]China; cohort (n = 1738); online, self-report; repeated measuresDepression, Anxiety, and Stress ScalePhysical symptomsDuring the initial evaluation, moderate-to-severe anxiety was noted in 28.8% with no longitudinal changes

GAD-7, Generalized Anxiety Disorder Scale.

Prepared by the authors based on the results of the study.