Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Feb 23, 2025
Date Accepted: Dec 29, 2025
Prevalence and factors associated with acute stress disorder among adults ever infected with COVID-19 during the ending phase of the pandemic in China: a cross-sectional study in seven Chinese cities
ABSTRACT
Background:
Acute stress disorder (ASD) among people ever infected with COVID-19 (PEIC) is prevalent and may lead to post-trauma stress disorder. Soon after China relaxed her COVID-19 control measures in November/December 2022, the infection rate surged rapidly, creating huge uncertainty and stressful situations.
Objective:
Little is known about situations regarding ASD at the ending phase of the pandemic. Potential personal cognitive/emotional factors and environmental factors of ASD were investigated in this study.
Methods:
A cross-sectional study was conducted among 5,545 PEIC aged 18-60 years from December 27, 2022 to January 9, 2023 living in seven cities of China. The 5-item Chinese version of the Primary Care PTSD Screen was used to assess ASD. Multiple logistic regression analyses were performed to identify factors of ASD.
Results:
The prevalence of ASD was 21.2%. Adjusted for the background variables, significant personal cognitive risk factors (COVID-19 infection severity, perceived high reinfection risk and perceived weak natural immunity acquired), emotional risk factors (worry about the long-term physical harms, and panic about infection of elderly or young family members), and significant environmental risk factors (difficulties in getting information and medical supplies, having unvaccinated old/young family members, and having significant others suffering from severe COVID-19 symptoms) were identified.
Conclusions:
The prevalence of ASD among PEIC was noticeable. It is warranted to identify those at high risk of developing ASD and provide them with care and early interventions to prevent deterioration. Such programs may consider modifying the risk factors found in this study.
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