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.

Keywords:

• FCV-19S
• COVID-19 fear scale
• post covid
• primary care
• long covid

Acknowledgements

We would like to express our deepest gratitude to the entire team of researchers from the Institute of Technology, University of Tartu. The paper and the research behind it would not have been possible without their substantial support. Alla Piirsoo and Marko Piirsoo contributed significantly to the study design, execution, acquisition of data, and analysis. We also thank Karolin Toompere for remarks on statistical analysis. We are also deeply grateful to all family care practicioners and patients for their participation in the study and for making the study possible.

Authors contribution

AÜ, KS, RK and TM designed the study and the study questionnaire and performed data collection. AS and SV carried out the analysis. AS wrote the first draft. All authors participated in the interpretation of the results and in critically reviewing the manuscript.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

This work was supported by the European Regional Development Fund (RITA 1/02-120).