Affiliations 

  • 1 Wangaya Hospital, Department of Internal Medicine, Denpasar, Bali, Indonesia. ketutsuryana@gmail.com
  • 2 Udayana Univesity / Sanglah Hospital, Faculty of Medicine, Department of Internal Medicine, Denpasar, Bali, Indonesia
  • 3 Udayana University, Veterinary Faculty, Department of Biochemistry, Denpasar, Bali, Indonesia
  • 4 Ministry of Research and Technology / National Agency of Research and Innovation, Indonesia
  • 5 Wangaya Hospital, Department of Pulmonology, Denpasar, Bali, Indonesia
Med J Malaysia, 2021 07;76(4):461-465.
PMID: 34305105

Abstract

INTRODUCTION: COVID-19 pandemic has a substantial impact on human life including the tourism sector (TS). Bali as a tourism destinations and the TS as major incomes of its population is greatly impacted, causing many to be jobless among those involved in TS. This situation may give psychological impact causing anxiety disorder (AD).

OBJECTIVE: To investigate the association between severe anxiety disorder and other factors with COVID-19 disease severity.

METHODS: This was cross-sectional study during March - November 2020. The diagnosis of SARS-CoV-2 was done by using RT-PCR from throat swabs, based on WHO's interim guidelines. AD was measured using self-reporting Generalized Anxiety Disorder-7 (GAD-7). All participants underwent, history taking, physical examinations, blood routine examination and chest radiography. Association between severe AD and other factors with COVID-19 disease severity were analyzed. Chi-square test (bivariate) and Logistic regression (multivariate) with the precision value of 95% was done and p-value less than 5% was considered significant.

RESULTS: Positive rate of Covid-19 patients was 43% (292 / 678). Among those 292 with Covid-19, 74 (25.3%) participants had severe disease. Multivariate analysis showed severe anxiety (OR 696.11; 95%CI: 78.54 to 6169.98; p<0.001), hypertension (OR 37.02; 95%CI: 4.49 to 305.39; p=0.001) and neutrophyl lymphocyte ratio (NLR) less than 2.89 (OR 0.15; 95%CI: 0.04 to 0.62; p=0.009).

CONCLUSION: Severe anxiety, hypertension and NLR less than 2.89 are potential independent risk factors for severe infection of SARS-CoV-2 (COVID-19).

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.