Fear of COVID-19 among patients with prior SARS-CoV-2 infection: A cross-sectional study in Estonian family practices

Abstract

Background Fear of coronavirus disease (COVID-19) has been associated with significant health effects. Objectives To assess COVID-19 fear and investigate factors associated with higher fear among COVID-19 survivors over 6 months after infection. Methods Cross-sectional study using multistage sampling (family practices within the highest 5th percentile of numbers of SARS-CoV-2 infected patients and random sample of patients within these practices) performed from March 15 to 17 July 2021. Adult patients with a laboratory-confirmed history of COVID-19 were recruited for a self-administered 79-item questionnaire including demographics, self-rated health, physical activity, COVID-19 characteristics, severity and the fear of COVID-19 Scale (FCV-19S). Comorbidity data were extracted from Estonian Health Insurance Fund. Logistic regression models were used to evaluate factors associated with COVID-19 fear. Results Of 341 participants included, 60% were women, 24.2% were hospitalised due to COVID-19 and 22.2% had long COVID, 143 (42%) participants reported high levels of fear (cut-off FCV-19S >17.8). Higher fear was associated with being female (aOR 2.12, 95% CI 1.14–3.95), age ≥61 years (aOR 3.23, 95% CI 1.28–8.16), two-member-households (aOR 3.70, 95% CI 1.40–9.77) physical inactivity 6 months prior to COVID-19 (aOR 3.53, 95% CI 1.26–9.95), and symptom severity during acute COVID-19. Long COVID was not associated with higher COVID-19 fear (aOR 1.82 95% CI 0.91–3.63). Conclusion Almost half of participants reported COVID-19 fear more than 6 months after infection. Greater fear was associated with sociodemographic factors, physical activity prior to COVID-19 and COVID-19 symptom severity. There is a need to target this population to develop appropriate interventions.

A 'special issue on COVID-19'. Fourteen primary care publications with implications for practice, teaching, and research

“…A population-based cross-sectional study (data collection in 2020) from Israel shows that physical activity might protect against the SARS-CoV infection [ 15–17 ]. In an Estonian study (data collection in 2021), symptoms of fear patients experienced after an episode of COVID-19 were studied [ 18 ]. The results of an international study conducted in 11 countries on long-COVID and post-COVID among outpatients (data collection in 2021 and 2022) indicate that half of all patients had symptoms after eight weeks, and one-third still had symptoms after three months.…”