**4. Anxiety**

Anxiety is an emotion characterized by the feeling of tension, worried thoughts and physical changes such as increased heart rate, according to the American psychological association. Since the onset of pandemic, many studies have been conducted to ascertain the prevalence of COVID-19 related anxiety among various sectors of the population. Conventional tools utilized to assess anxiety are:


The magnitude of anxiety varies across the country of origin of study, measurement tool used and size of the studied sample.

#### **4.1 Anxiety among patient population**

Patients suspected or diagnosed with SARS-CoV2 infection experience significant anxiety related to disease and external factors associated with having the infection. Several patient related factors influence the vulnerability to anxiety such as sex, marital status, symptoms and sleep quality, among others [27–30]. There are many patient-related factors associated with anxiety such as:


The external factors include spread of misinformation by media, government regulations such as quarantine procedure, lockdown and travel restrictions, and social stigmatization. The current pandemic underlined the vital role played by media in dissemination of information. Ideally, media should ensure that crisis communication helps in dispelling fear and uncertainty, but in the recent pandemic it played a reverse role in spreading anxiety and panic behavior [31–33]. The endless newsfeeds related to COVID-19 infection and death rates considerably increased the adverse psychological outcomes in general population as well as patients. The spread of misleading narratives, provoking controversies and advertisement of unapproved therapies resulted in widespread fear, confusion and panic with serious mental health consequences such as anxiety [34, 35]. Quarantine and isolation of suspected and confirmed cases as per government regulations also led to abnormally increased anxiety. Additional measures like lockdown and travel restrictions also contribute to feeling of uncertainty, perceived lower social support, separation from loved ones, loss of freedom and boredom [2]. Notably, individuals with a previous health disorder experienced worsening of their symptoms due to anxiety.

#### **4.2 Anxiety among HCW population**

Healthcare workers are directly involved in diagnosis, treatment and care of SARS-CoV2 patients and therefore experience the highest share of mental health issues compared to the other groups in the population. The prevalence of anxiety among healthcare workers is high and has been assessed to be between 23.2% to 30.5% [36, 37]. Several factors have been attributed to cause anxiety in healthcare workers. These include increased workload, inadequate PPE, inadequate isolation precautions, risk of contracting disease, high infectivity and mortality of disease, burnout, lack of clinical experience, young age, chronic health illness and prior history of mental health disorders [31–33]. Socio-demographic variables play a key role in determining the level of anxiety in healthcare workers with higher prevalence among those above the age 40, females, unmarried individuals and presence of offspring [38]. Anxiety in this group manifests as palpitations, tremors, dryness of

*Mental Impact of COVID-19 – Fear, Stress, Anxiety, Depression and Sequels DOI: http://dx.doi.org/10.5772/intechopen.102754*

mouth, feeling scared without any reason and tendency to panic [15]. These symptoms are more prevalent in workers who were assigned duties in COVID designated areas and those who encountered SARS-CoV2 suspected or confirmed patients without adequate protection [5]. Nurses have unfavorable mental health outcomes among the healthcare staff since they usually spend more time caring for patients than any other group of HCWs [11, 36, 39]. The existence of anxiety is associated with reduced performance and fatigue in healthcare workers and impedes optimum healthcare delivery to the population.
