Association between Gender and Anxiety among Covid-19 Patients: A Meta-Analysis
Abstract
Background: The COVID-19 outbreak rapidly spread worldwide, with a significant number of cases and deaths causing anxiety, especially among the sufferers. Biologically, males and females show different psychological responses to the events at hand. This study aimed to examine the association between gender and anxiety among COVID-19 patients.
Subjects and Method: This study was a meta-analysis. The articles were obtained from databases PubMed and Scopus using keywords "Anxiety" OR "anxiety disorder" AND "COVID-19 Patients" OR "Patients with COVID-19" OR "Hospitalized" AND "Risk factors" OR "determinants" OR "Gender" OR "Factors associated". The articles included in this study were full-text with a cross-sectional design, discuss-ed the association between gender and anxiety among COVID-19 patients, published in English, studies located in Asia. The final results were presented in Adjust Odds Ratio (aOR) or Standardized Mean Difference (SMD). Data analysis was performed using Revman 5.3 software, with generic inverse variance data type for categorical outcome group (CtOG) articles and continuous data type for continue outcome group (CnOG).
Results: 9 articles were analyzed, including 4 articles CtOG and 5 articles CnOG. The forest plot of both categorical and continue outcomes showed consistent result that among COVID-19 patients who hospitalized with mild to severe symptoms. Female patients significantly had higher anxiety event (aOR= 2.19; 95% CI= 1.60 to 2.99; p<0.001; I2= 0% and SMD= 0.35; 95% CI= 0.21 to 0.49; p<0.001; I2= 12%).
Conclusion: Among COVID-19 patients, the female gender has a significantly higher risk of suffering from anxiety than the male gender.
Keywords: anxiety, COVID-19
Correspondence: Zuraida Zulkarnain. Research and Development Center of Traditional Medicinal and Medicinal Plants, Karanganyar, Central Java. Mobile: 081393933862. e-mail: zuraida.zu@gmail.com.
Journal of Health Policy and Management (2021), 06(02): 94-106
https://doi.org/10.26911/thejhpm.2021.06.02.02
References
Al Banna MH, Sayeed A, Kundu S, Christopher E, Hasan MT, Begum MR, Kormoker T, et al. (2020). The impact of the COVID19 pandemic on the mental health of the adult population in Bangladesh: a nationwide crosssectional study. Int J Environ Health Res. 1–12.
https://doi.org/10.1080/09603123.2020.1802409.
<br>Bandelow B, Michaelis S (2015). Epidemiology of anxiety disorders in the 21st century. Dialogues Clin Neurosci. 17: 327–335. https://doi.org/10.1016/j.siny.2015.10.004.
<br>Center for Evidence Based Management (2014). Critical Appraisal Checklist for CrossSectional Study. Available at: https://cebma.org/wpcontent/uploads/CriticalAppraisalQuestionsforaCrossSectionalStudyJuly20141.pdf.
<br>Chew NWS, Lee GKH, TanBYQ, Jing M, Goh Y, Ngiam NJH, Yeo LLL et al. (2020). A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID19 outbreak. Brain Behav
Immun. 1. https://doi.org/10.1016/j.bbi.2020.04.049.
<br>Das R, Hasan MR, Daria S, Islam MR (2021). Impact of COVID19 pandemic on mental health among general Bangladeshi population: a crosssectional study. BMJ Open. 11: e045727. doi: 10.1136/bmjopen2020045727
<br>Fu W, Wang C, Zou L, Guo Y, Lu Z, Yan S, Mao J (2020). Psychological health, sleep quality, and coping styles to stress facing the COVID19 in Wuhan, China. Transl. Psychiatry. 10, 225. https://doi.org/10.1038/s41398020009133.
<br>Gu Y, Zhu Y, Xu F, Xi J, Xu G (2021). Factors associated with mental health outcomes among patients with COVID19 treated in the Fangcang shelter hospital in China. AsiaPacific psychiatry: official journal of the Pacific Rim College of Psychiatrists.
(2). e12443. https://doi.org/10.1111/appy.12443.
<br>Handayani R, Kuntari S, Darmayanti A, Widiyanto A, Atmojo J (2020). Faktor penyebab stres pada tenaga kesehatan dan masyarakat saat pandemi Covid19. Jurnal Keperawatan Jiwa. 8 (3): 353360. eISSN 26558106. https://jurnal.unimus.ac.id/index.php/JKJ/article/view/5990.
<br>Hawryluck L, Gold WL, Robinson S, Pogorski S, GaleaS, Styra R (2004). SARS control and psychological effects of quarantine, Toronto, Canada. Emerg Infect Dis. 10: 1206–1212. https://doi.org/10.3201/eid1007.030703.
<br>Horesh D, Kapel LevAriR, HassonOhayon I (2020). Risk factors for psychological distress during the COVID19 pandemic in Israel: loneliness, age, gender, and health status play an important role. Br J Health Psychol. 1–9. https://doi.org/10.1111/
bjhp.12455.
<br>Huremovi ́CD (2019). Mental health of quarantine and isolation. In: Psychiatry of Pandemics. Springer Nature Switzerland.
<br>Islam MS, Ferdous MZ, Potenza MN (2020). Panic and generalized anxiety during the COVID19 pandemic among Bangladeshi people: an online pilot survey early in the outbreak. J Affect Disord. 276: 30–37. https://doi.org/10.1016/j.
<br>Jacobson NC, Newman MG (2017). Anxiety and depression as bidirectional risk factors for one another: a metaanalysis of longitudinal studies. Psychol. Bull. 143: 1155–1200. https://doi.org/10.1037/bul0000111.
<br>Jiang Z, Zhu P, Wang L, Hu Y, Pang M, Ma S, Tang X (2021). Psychological distress and sleep quality of COVID19 patients in Wuhan, a lockdown city as the epicenter of COVID19. Journal of psychiatric research, 136: 595–602. https://doi.org/10.1016/j.jpsychires.2020.10.034.
<br>Kang E, Lee SY, Kim MS, Jung H, Kim KH, Kim KN, Park HY, et al. (2021). The psychological burden of COVID19 stigma: Evaluation of the mental health of isolated mild condition COVID19 Patients. J Korean Med Sci. 36(3). e33. https://doi.org/10.3346/jkms.2021.36.e33.
<br>Kong X, KongF, ZhengK, Tang M, ChenY, Zhou J, Li Y, et al. (2020). Effect of psychologicalbehavioral intervention on the depression and anxiety of COVID19 Patients. Frontiers in psychiatry, 11, 586355. https://doi.org/10.3389/fpsyt.2020.586355.
<br>Li X, Tian J, Xu Q (2020). The associated factors of anxiety and depressive symptoms in COVID19 patients hospitalized in Wuhan, China. Psy chiatric Quarterly. Psychiatric Quar terly. doi: 10.1007/s11126020098659.
<br>LosadaBaltar A, JiménezGonzalo L, GallegoAlberto L, PedrosoChaparro MDS, FernandesPires J, MárquezGonzález M (2021). Association of selfpercep tions of aging, personal and family resources, and loneliness with psychological distress during
the lockdown
period of COVID19. J Gerontol B Psychol Sci Soc Sci. 76(2):e10e16. doi: 10.1093/geronb/gbaa048.
<br>Lu H, Stratton CW, Tang YW (2020). Outbreak of pneumonia of unknown etiology in Wuhan, China: The mystery and the miracle. J Med Virol. 92(4): 401402. doi: 10.1002/jmv.25678.
<br>Moayed MS, Vahedian Azimi A, Mirmomeni G, RahimiBashar F, Goharimoghadam K, Pourhoseingholi MA, AbbasiFarajzadeh M, et al. (2021). Depression, anxiety, and stress among patients with COVID19: A crosssectional study. Advances in experimental
medicine and biology. 1321: 229–236. https://doi.org/10.1007/9783030592615_19.
<br>Nie XD, Wang Q, Wang MN, Zhao S, Liu L, Zhu YL, Chen H (2020). Anxiety and depression and its correlates in patients with coronavirus disease 2019 in Wuhan. Int J Psy chiatry Clin Prac. 1–6. https://doi.org/10.1080/13651501.2020.1791345.
<br>Orellana CI, Orellana LM (2020). Predictores de síntomas emocionales duran te la cuarentena domiciliar por pandemia de COVID19 en El Salvador. Actual. En Psicol. 34, 103–120. https://doi.org/10.15517/ap.v34i128.41431.
<br>Paulino M, DumasDiniz R, Brissos S, Brites R, Alho L, Simo ̃es MR, Silva CF (2020). COVID19 in Portugal: exploring the immediate psychological impact on the general population. Psychol. Health Med. https://doi.org/10.1080/ 13548506.2020.1808236.
<br>Rodríguez Rey R, GarridoHernansaiz H, Collado S (2020). Psychological impact and associated factors during the initial stage of the coronavirus (COVID19) pandemic among the general population in Spain. Front. Psychol. 11. https://doi.org/10.3389/fpsyg.2020.01540.
<br>Şahan E, Ünal SM Kırpınar İ (2021). 'Can we predict who will be more anxious and depressed in the COVID19 ward?. J Psychosomatic Res. 140: 110302. doi: 10.1016/j.jpsychores.2020.110302.
<br>Stein DJ, Scott KM, de Jonge P, Kessler RC (2017). Epidemiology of anxiety disorders: from surveys to nosology and back. Dialogues Clin Neurosci. 19(2): 127–136. https://dx.doi.org/10.31887%2FDCNS.2017.19.2%2Fdstein.
<br>Salari N, Hosseinianfar A, Jalali R, Vaisiraygani A, Rasoulpoor S (2020). Prevalence of stress, anxiety, depression among the general population during the COVID19 pandemic: a systematic review and metaanalysis. Glob Health. 16(1): 57. https://doi.org/10.1186/s1299202000589w.
<br>Stanikova D, Luck T, Pabst A, BaeYJ, Hinz A, Glaesmer H, Stanik J (2019). Associations between anxiety, body mass index, and sex hormones in women. Frontiers in psychiatry, 10: 479. https://doi.org/10.3389/fpsyt.2019.00479.
<br>StantonR, TomQG, Khalesi S, Williams SL, Alley SJ, Thwaite TL, Fenning AS et al. (2020). Depression, anxiety and stress during COVID19: Associations with changes in physical activity, sleep, tobacco and alcohol use in Australian adults.
Int J Environ Res Public Health, 17(11): 4065. https://doi.org/10.3390/ijerph17114065,
<br>Xu Q, Mao Z, Wei D, Liu P, Fan K, Wang J, Wang X, et al. (2021). Prevalence and risk factors for anxiety symptoms during the outbreak of COVID19: A large survey among 373216 junior and senior high school students in China. J Affect Disord.
:1722. doi: 10.1016/j.jad.2021.03.080.
<br>Zhang J, Yang Z, Wang X, LiJ, Dong L, Wang F, Li Y et al. (2020). The relationship between resilience, anxiety and depression among patients with mild symptoms of COVID19 in China: A crosssectional study. J Clin Nursing, 29(2122): 4020–4029.
https://doi.org/10.1111/jocn.15425
<br>Zu ZY, Jiang MD, Xu PP, Chen W, Ni QQ, Lu GM, Zhang LJ (2020). Coronavirus disease 2019 (COVID19): A perspective from China. Radiology. 296 (2): E15–E25. https://doi.org/10.1148/radiol.2020200490.
