Abstract
BackgroundDifferences in physical and mental health impact across continents during the COVID-19 pandemic are unknown.ObjectiveThis study compared the levels of impact of COVID-19 on mental health among people from Spain and China and correlated mental health parameters with variables relating to symptoms similar to COVID-19, COVID-19 knowledge, and precautionary measures.MethodsWe collected information on demographic data, physical symptoms, contact history with persons with a confirmed COVID-19 diagnosis, COVID-19 knowledge, and precautionary measures. Participants completed the Impact of Event Scale-Revised (IES-R) and the Depression, Anxiety and Stress Scale–21 Items (DASS-21). To analyze the differences in the mental health parameters, the mean scores between Chinese and Spanish respondents were compared using the independent samples t test. The differences in categorical variables between the two samples were analyzed by the chi-square test. Linear regression was used to calculate the univariate associations between the independent variables and mental health parameters for both groups separately, with adjustments made for age, gender, and education.ResultsA total of 1528 participants (Spain: n=687; China: n=841) were recruited. The mean age of the Chinese respondents was 24.73 years (SD 7.60; range 18-65 years), and the mean age of the Spanish respondents was 43.06 years (SD 11.95; range 18-76 years). Spanish participants reported significantly more symptoms similar to COVID-19 infection (eg, fever, sore throat, and breathing difficulties), contact history with COVID-19, higher perceived risk of contracting COVID-19, frequent use of medical services, and less confidence in medical services compared with their Chinese counterparts (P<.001). Spanish participants reported significantly higher DASS-21 stress and depression scores, while Chinese participants reported significantly higher IES-R scores (P<.001). Chinese participants encountered more discrimination from other countries (P<.001). Significantly more Chinese participants reported using face masks than Spanish ones (P<.001). More exposure to health information was associated with adverse mental health in Spain (depression: P=.02; anxiety: P=.02; stress: P=.001).ConclusionsOur study found that Spanish respondents reported higher levels of stress and depression as well as more symptoms and use of medical services. In preparation for the next pandemic, Spain needs to establish a prompt policy to implement rapid response and enhance medical services to safeguard physical and mental health.
Highlights
BackgroundThe city of Wuhan was ground zero of the COVID-19 outbreak, which spread to all 23 provinces of China
Our study found that Spanish respondents reported higher levels of stress and depression as well as more symptoms and use of medical services
Respondents from China came from 159 cities, and respondents from Spanish and Chinese respondents (Spain) came from all 19 autonomous regions
Summary
The city of Wuhan was ground zero of the COVID-19 outbreak, which spread to all 23 provinces of China. China became the first epicenter in Asia during the COVID-19 pandemic [1]. The Chinese government imposed lockdown measures to restrict travel to prevent transmission. Since the onset of the COVID-19 outbreak, the Chinese government’s response efforts have been swift, and 3 weeks into the epidemic, in an unprecedented move to slow the spread of the virus, a lockdown was imposed in Wuhan on January 23, 2020 [3]. Due to many new cases in February 2020, the Central Government of China deployed thousands of medical personnel to a rapidly completed hospital specially designed to treat patients with COVID-19 [4]. Differences in physical and mental health impact across continents during the COVID-19 pandemic are unknown
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