• Yasemin Cag, Hakan Erdem, Aynur Gormez, Handan Ankarali, Sally Hargreaves, João Ferreira-Coimbra, Francesca Rubulotta, Mirko Belliato, Joana Berger-Estilita, Paolo Pelosi, Stijn Blot, Jean Yves Lefrant, Masoud Mardani, Ilad Alavi Darazam, Yakup Cag, and Jordi Rello.
• Department of Infectious Diseases and Clinical Microbiology, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Turkey. Electronic address: yasemncag@yahoo.com.
• Gen Hosp Psychiatry. 2021 Jan 1; 68: 90-96.

ObjectiveWe aimed to explore anxiety status across a broad range of HCWs supporting patients with COVID-19 in different global regions.MethodThis was an international online survey in which participation was on voluntary basis and data were submitted via Google Drive, across a two-week period starting from March 18, 2020. The Beck Anxiety Inventory was used to quantify the level of anxiety.Results1416 HCWs (70.8% medical doctors, 26.2% nurses) responded to the survey from 75 countries. The distribution of anxiety levels was: normal/minimal (n = 503, 35.5%), low (n = 390, 27.5%); moderate (n = 287, 20.3%), and severe (n = 236, 16.7%). According to multiple generalized linear model, female gender (p = 0.001), occupation (ie, being a nurse dealing directly with patients with COVID-19 [p = 0.017]), being younger (p = 0.001), reporting inadequate knowledge on COVID-19 (p = 0.005), having insufficient personal protective equipment (p = 0.001) and poor access to hand sanitizers or liquid soaps (p = 0.008), coexisting chronic disorders (p = 0.001) and existing mental health problems (p = 0.001), and higher income of countries where HCWs lived (p = 0.048) were significantly associated with increased anxiety.ConclusionsFront-line HCWs, regardless of the levels of COVID-19 transmission in their country, are anxious when they do not feel protected. Our findings suggest that anxiety could be mitigated ensuring sufficient levels of protective personal equipment alongside greater education and information.Copyright © 2020 Elsevier Inc. All rights reserved.

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