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Original Research

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COVID-19 Pandemic and Anxiety Related Factors in Patients Treated in the Emergency Department

  • Vahide Aslihan Durak1
  • Seyda Gunay2
  • Deniz Sigirli3
  • Bedrettin Akova4
  • Erol Armagan1

1Emergency Medicine Department, Uludag University Medical Faculty, Bursa, Turkey

2Cardiology Department, Uludag University Medical Faculty, Bursa, Turkey

3Biostatistics Department, Uludag University Medical Faculty, Bursa, Turkey

4Sports Medicine Department, Uludag University Medical Faculty, Bursa, Turkey

DOI: 10.22514/sv.2020.16.0051 Vol.16,Issue 2,October 2020 pp.167-174

Published: 28 October 2020

*Corresponding Author(s): Vahide Aslihan Durak E-mail:


Aims: A novel coronavirus, now known as SARS-CoV-2019, suddenly emerged in Wuhan, China and within threemonths of the initial outbreak, the virus had spread rapidly to neighboring countries causing a pandemic. After the first case was announced, emergency departments were immediately reorganized as pandemic clinics. Special areas with maximum precautions were designed to evaluate patients. The majority of studies on this pandemic have focused on the treatment of respiratory symptoms and comorbidities in intensive care units. In this study, we sought to determine those factors that contributed to the anxiety level during the COVID-19 pandemic using the ‘State’ subscale of State-Trait Anxiety Inventory (STAI-S). Methods: A survey was performed in the emergency department by using an online questionnaire which consisted of demographic variables, questions about the opinions and behaviors of patients during the pandemic, diagnostic test results for COVID-19, and treatment methods. Results: There was a statistically significant difference between employment status (p ˂ 0.001), monthly income (p ˂ 0.001), the food consumption changes during the pandemic period (p = 0.001) and the estimated end-date for the COVID-19 pandemic (p < 0.001) and total STAI-S points. Conclusions: Our study has identified factors which significantly increase anxiety during the COVID-19 pandemic and identified those individuals who may benefit from psychiatric and social support.


Anxiety, COVID-19, Emergency department

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Vahide Aslihan Durak,Seyda Gunay,Deniz Sigirli,Bedrettin Akova,Erol Armagan. COVID-19 Pandemic and Anxiety Related Factors in Patients Treated in the Emergency Department. Signa Vitae. 2020. 16(2);167-174.


[1] Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497-506.

[2] Ahorsu D K, Lin C Y, Imani V, et al. The Fear of COVID-19 Scale: development and initial validation. Int J Ment Health Addict. 2020;27;1-9.

[3] Wang C, Pan R, Wan X, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic amongthe general population in China. Int J Environ Res Public Health. 2020;17:1729.

[4] Özdin S, Bayrak Özdin Ş. Levels and predictors of anxiety, depression and health anxiety during COVID-19 pandemic in Turkish society: The importance of gender. Int J Soc Psychiatry. 2020;66:504-511.

[5] Reifels L, Mills K, Dückers MLA, et al. Psychiatric epidemiology and disaster exposure in Australia. Epidemiol Psychiatr Sci. 2019;28:310-320.

[6] Murakami M, Takebayashi Y, Takeda Y, et al. Effect of Radiological Countermeasures on Subjective Well-Being and Radiation Anxiety after the 2011 Disaster: The Fukushima Health Management Survey. Int J Environ Res Public Health. 2018;15:124.

[7] Liang Y. Depression and anxiety among elderly earthquake survivors in China. J Health Psychol. 2017;22:1869-1879.

[8] Moise IK, Ruiz MO. Hospitalizations for Substance Abuse Disorders Before and After Hurricane Katrina: Spatial Clustering and Area-Level Predictors, New Orleans, 2004 and 2008. Prev Chronic Dis. 2016;13:E145.

[9] Spielberger, CD. State-trait anxiety inventory: a comprehensive bibliog-raphy, Palo Alto, CA: Mind Garden, 1989.

[10] Bandelow B, Michaelis S. Epidemiology of anxiety disorders in the 21st century. Dialogues Clin Neurosci. 2015;17:327-335.

[11] Spielberger C D, Gorsuch, R L, Lushene R, et al. Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press. 1983.

[12] Spielberger C D. Anxiety: Current trends in theory and research: I. Academic Press. 1972.

[13] Emons WH, Habibović M, Pedersen SS. Prevalence of anxiety in patients with an implantable cardioverter defibrillator: measurement equivalence of the HADS-A and the STAI-S. Qual Life Res. 2019;28:3107-3116.

[14] Öner N, Le Compte, A. Durumluk-sürekli kaygı envanteri el kitabı (Manual for the state-trait anxiety inventory-Turkish form) İstanbul: Bogazici University. 1985.

[15] Zhong B L, Luo W, Li H M, et al. Knowledge, attitudes, and practices towards COVID-19 among Chinese residents during the rapid rise period of the COVID-19 outbreak: A quick online cross-sectional survey. Int J Biol Sci. 2020;16:1745–1752.

[16] Wang Y, Di Y, Ye J et al. Study on the public psychological states and its related factors during the outbreak of coronavirus disease 2019 (COVID-19) in some regions of China. Psychol Health Med. 2020. doi: 10.1080/13548506.2020.1746817.

[17] Huang Y, Zhao N. Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey. Psychiatry Res. 2020;288:112954.

[18] Su T P, Lien T C, Yang C Y, et al. Prevalence of psychiatric morbidity and psychological adaptation of the nurses in a structured SARS caring unit during outbreak: a prospective and periodic assessment study in Taiwan. J Psychiatr Res. 2007;41:119–130.

[19] Bohlken J, Schömig F, Lemke MR, et al. COVID-19-Pandemie: Belastungen des medizinischen Personals [COVID-19 Pandemic: Stress Experience of Healthcare Workers - A Short Current Review]. Psychiatr Prax. 2020;47:190-197.

[20] Greenberg N, Docherty M, Gnanapragasam S, et al. Managing mental health challenges faced by healthcare workers during COVID-19 pandemic. BMJ. 2020;368:m1211.

[21] Lee A M , Wong J G, McAlonan G M,et al. Stress and psychological distress among SARS survivors 1 year after the outbreak. Can J Psychiatry. 2007;52:233–240.

[22] Lu Y C, Shu B C, Chang Y Y, et al. The mental health of hospital workers dealing with severe acute respiratory syndrome. Psychother Psychosom. 2006;75:370–375.

[23] Hao F, Tan W, Jiang L, et al. Do psychiatric patients experience more psychiatric symptoms during COVID-19 pandemic and lockdown? A case-control study with service and research implications for immunopsy-chiatry. Brain Behav Immun. 2020;87;100-106.

[24] Fluharty M, Taylor AE, Grabski M, et al. The Association of Cigarette Smoking With Depression and Anxiety: A Systematic Review. Nicotine Tob Res. 2017;19:3-13.

[25] O’Toole BI, Kirk R, Bittoun R et al. Combat, Posttraumatic Stress Disorder, and Smoking Trajectory in a Cohort of Male Australian Army Vietnam Veterans. Nicotine Tob Res. 2018;20:1198-1205.

[26] Leung G M. The impact of community psychological responses on outbreak control for severe acute respiratory syndrome in Hong Kong.

J. Epidemiol. Community Health. 2003;57:857–863.

[27] Mikolajczyk RT, El Ansari W, Maxwell AE. Food consumption frequency and perceived stress and depressive symptoms among students in three European countries. Nutr J. 2009;8:31.

[28] Cox RC, Olatunji BO. A systematic review of sleep disturbance in anxiety and related disorders. J Anxiety Disord. 2016;37:104-129.

[29] Razzoli M, Pearson C, Crow S, et al. Stress, overeating, and obesity:Insights from human studies and preclinical models. Neurosci Biobehav Rev. 2017;76:154-162.

[30] Lee E, Lee H. Disaster awareness and coping: Impact on stress, anxiety, and depression. Perspect Psychiatr Care. 2019;55:311-318.

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