Prevalence of Anxiety in Medical Students during the COVID-19 Pandemic: A Rapid Systematic Review with Meta-Analysis.

Isabel Lasheras,Javier Santabárbara,Concepción De La Cámara,Juan Bueno-Notivol,Raúl López-Antón,Patricia Gracia-García,Antonio Lobo,Darren M Lipnicki

doi:10.3390/ijerph17186603

Abstract

The novel coronavirus disease (COVID-19) pandemic has brought a great deal of pressure for medical students, who typically show elevated anxiety rates. Our aim is to investigate the prevalence of anxiety in medical students during this pandemic. This systematic review and mini meta-analysis has been conducted following the PRISMA guidelines. Two researchers independently searched PubMed on 26 August 2020 for cross-sectional studies on medical students during the COVID-19 outbreak, with no language restrictions applied. We then performed a manual search to detect other potentially eligible investigations. To the 1361 records retrieved in the initial search, 4 more were added by manual search on medRxiv. Finally, eight studies were finally included for qualitative and quantitative analysis, which yielded an estimated prevalence of anxiety of 28% (95% CI: 22–34%), with significant heterogeneity between studies. The prevalence of anxiety in medical students is similar to that prior to the pandemic but correlates with several specific COVID-related stressors. While some preventive and risk factors have been previously identified in a non-pandemic context, knowledge and cognitions on COVID-19 transmission, treatment, prognosis and prevention negatively correlate with anxiety, emerging as a key preventive factor that may provide a rationale for why the levels of anxiety have remained stable in medical students during the pandemic while increasing in their non-medical peers and the general population. Other reasons for the invariability of anxiety rates in this population are discussed. A major limitation of our review is that Chinese students comprised 89% the total sample, which could compromise the external validity of our work

Highlights

The outbreak of the novel coronavirus disease (COVID-19) in Wuhan, China, in December 2019 has rapidly escalated into a global health crisis and was declared a pandemic by the World HealthOrganization (WHO) on 11 March 2020 [1]
Due to the rising numbers of disease cases and deaths, and the highly contagious nature of the disease, some countries began quarantining their population for indefinite periods of time in order to prevent the spread of the disease [3]. While such restrictive measures can be effective in the containment of the virus, concern has arisen about their possible psychological impact on the well-being of the general population and individuals who might be vulnerable to mental health diseases [4], as anxiety and depression have been demonstrated to stem from similar circumstances in the past [5,6]
Our goal is to conduct a systematic review and meta-analysis of studies investigating the prevalence of anxiety in medical students during the COVID-19 pandemic

Summary

Introduction

The outbreak of the novel coronavirus disease (COVID-19) in Wuhan, China, in December 2019 has rapidly escalated into a global health crisis and was declared a pandemic by the World HealthOrganization (WHO) on 11 March 2020 [1]. Due to the rising numbers of disease cases and deaths, and the highly contagious nature of the disease, some countries began quarantining their population for indefinite periods of time in order to prevent the spread of the disease [3]. While such restrictive measures can be effective in the containment of the virus, concern has arisen about their possible psychological impact on the well-being of the general population and individuals who might be vulnerable to mental health diseases [4], as anxiety and depression have been demonstrated to stem from similar circumstances in the past [5,6]. Several sources of stressors related to pandemics and their Public Health management have been described in the past, such as the unpredictable nature of the disease [7,8], the lack of timely and transparent information disclosure by authorities [3], the loss of personal freedom, sudden changes and impossibility of future planning and social distancing, together with the worry about one’s own health and that of one’s relatives and acquaintances [8], and the large financial losses expected [9].

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