Somatic symptoms associated with mental distress during the COVID-19 pandemic: a systematic review
Open accessAbstract
Objective: The primary objective of this article was to systematically review the prevalence of somatic symptoms in patients, healthcare workers and general population during the COVID-19 pandemic. The secondary objectives were to record the association between somatic symptoms and indices of mental distress and to record the qualitative characteristics of such somatic complaints. Methods: Following the PRISMA methodology we systematically searched PubMed, Scopus and Google Scholar for primary research reporting on somatic symptoms in association with mental distress. We specifically sought papers reporting on bodily distress disorder, somatic symptoms disorder or medically unexplained symptoms. Results: 1569 papers were retrieved, which yielded 36 relevant studies after screening. 15 studies referred to healthcare workers, 13 to general population, 5 to COVID-19 patients, 2 compared medical with non-medical professionals and 1 was studying COVID-19 patients some of which were also healthcare workers. The reported prevalence of somatic symptoms ranged from 7.4% to 67.8%. Commonly seen symptoms were shortness of breath, dyspnea, palpitations and pain in arms, legs and joints. Conclusions: Our systematic review suggests that somatic symptoms are very frequent during the pandemic and are often linked to mental distress. All three population groups are affected.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In recent years, the prevalence of psychological disorders such as anxiety, depression, and somatic symptoms has increased among health professionals.
“In recent years, the prevalence of psychological disorders such as anxiety, depression, and somatic symptoms has increased among this population”
From Effectiveness of a Web-Based Self-Guided Intervention (MINDxYOU) for Reducing Stress and Promoting Mental Health Among Health Professionals: Results From a Stepped-Wedge Cluster Randomized Trial (2025) · cites this paper as [6]
The review’s results table (labelled Conclusion; page unavailable) reports depression, anxiety, and somatic symptoms among healthcare workers during the COVID-19 pandemic. The 'Prevalence of somatic symptoms during the pandemic' section also describes high rates and elevated risk for healthcare professionals. These passages do not establish that the prevalence of all three increased over recent years. (LLM, conf=0.87)
Experimental — accuracy not yet measuredThe increase in psychological disorders among health professionals has been linked to the extra efforts exerted by health workers and the extremely difficult situations to which they were exposed during the COVID-19 pandemic.
“which has been linked to the extra efforts exerted by health workers and the extremely difficult situations to which they were exposed during the COVID-19 pandemic [3-6].”
From Effectiveness of a Web-Based Self-Guided Intervention (MINDxYOU) for Reducing Stress and Promoting Mental Health Among Health Professionals: Results From a Stepped-Wedge Cluster Randomized Trial (2025) · cites this paper as [6]
The Discussion (page unavailable) says healthcare workers were particularly at risk and that greater pandemic exposure was associated with greater vulnerability. Table 1, displayed under Conclusion (page unavailable), reports higher depression and anxiety symptoms among hospital employees with high job stress. These passages support a link between work-related stress or exposure and mental distress, but do not establish an increase in psychological disorders caused by workers’ extra efforts or difficult situations. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The PRISMA 2020 statement: An updated guideline for reporting systematic reviews
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., et al. (2021) · BMJ · doi:10.1136/bmj.n71 · Cited by 108,283 · see citing works
McGuinness, L. A., & Higgins, J. P. T. (2021) · Research Synthesis Methods · doi:10.1002/jrsm.1411 · Cited by 5,579 · see citing works
BARSKY, A. J., Orav, E. J., & Bates, D. W. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.8.903 · Cited by 912 · see citing works
Barello, S., Palamenghi, L., & Graffigna, G. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.113129 · Cited by 713 · see citing works
Somatoform Disorders and Medically Unexplained Symptoms in Primary Care
Haller, H., Cramer, H., Lauche, R., & Dobos, G. (2015) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.2015.0279 · Cited by 284 · see citing works
COVID-19 and mental health in Brazil: Psychiatric symptoms in the general population
Goularte, J. F., Serafim, S. D., Colombo, R., Hogg, B., Caldieraro, M. A., & Rosa, A. R. (2020) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2020.09.021 · Cited by 257 · see citing works
COVID‐19‐related anxiety predicts somatic symptoms in the UK population
Shevlin, M., Nolan, E., Owczarek, M., McBride, O., Murphy, J., Gibson Miller, J., Hartman, T. K., Levita, L., Mason, L., Martinez, A. P., et al. (2020) · British Journal of Health Psychology · doi:10.1111/bjhp.12430 · Cited by 208 · see citing works
Liu, S., Liu, Y., & Liu, Y. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.113070 · Cited by 207 · see citing works
Hong, S., Ai, M., Xu, X., Wang, W., Chen, J., Zhang, Q., Wang, L., & Kuang, L. (2020) · Nursing Outlook · doi:10.1016/j.outlook.2020.07.007 · Cited by 185 · see citing works
Hilderink, P. H., Collard, R. M., Rosmalen, J. G. M., & Voshaar, R. C. O. (2012) · Ageing Research Reviews · doi:10.1016/j.arr.2012.04.004 · Cited by 169 · see citing works
Medically unexplained symptoms in the times of COVID-19 pandemic: A case-report
Colizzi, M., Bortoletto, R., Silvestri, M., Mondini, F., Puttini, E., Cainelli, C., Gaudino, R., Ruggeri, M., & Zoccante, L. (2020) · Brain Behavior & Immunity - Health · doi:10.1016/j.bbih.2020.100073 · Cited by 149 · see citing works
Caregivers’ Mental Health and Somatic Symptoms During COVID-19
Park, S. S. (2020) · The Journals of Gerontology Series B · doi:10.1093/geronb/gbaa121 · Cited by 147 · see citing works
Xu, X., Ai, M., Hong, S., Wang, W., Chen, J., Zhang, Q., Hu, H., Xuemei, L., Lixia, W., Cao, J., et al. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.07.092 · Cited by 140 · see citing works
Maciaszek, J., Ciułkowicz, M., Misiak, B., Szcześniak, D. M., Łuc, D., Wieczorek, T., Fila-Witecka, K., Gawłowski, P., & Rymaszewska, J. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9082527 · Cited by 114 · see citing works
Anxiety in Older Adolescents at the Time of COVID-19
Smirni, P., Lavanco, G., & Smirni, D. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9103064 · Cited by 106 · see citing works
Symptom Cluster of ICU Nurses Treating COVID-19 Pneumonia Patients in Wuhan, China
Yifan, T., Ying, L., Chunhong, G., Jing, S., Wang, R., Zhen-yu, L., Zejuan, G., & Pei-Hung, L. I. A. O. (2020) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2020.03.039 · Cited by 95 · see citing works
Kang, E., Lee, S. Y., Kim, M. S., Jung, H., Kim, K. H., Kim, K., Park, H. Y., Lee, Y. J., Cho, B., & Sohn, J. H. (2021) · Journal of Korean Medical Science · doi:10.3346/jkms.2021.36.e33 · Cited by 95 · see citing works
Zhang, H., Shi, Y., Jing, P., Zhan, P., Fang, Y., & Wang, F. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.113541 · Cited by 83 · see citing works
Pan, X., Xiao, Y., Ren, D., Xu, Z., Zhang, Q., Yang, L., Liu, F., Hao, Y., Zhao, F., & Bai, Y. (2020) · Asia-Pacific Psychiatry · doi:10.1111/appy.12427 · Cited by 79 · see citing works
Huang, Y., Wang, Y., Zeng, L., Yang, J., Song, X., Rao, W., Li, H., Ning, Y., He, H., Li, T., et al. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.568329 · Cited by 78 · see citing works
Wielgus, B., Urban, W., Patriak, A., & Cichocki, Ł. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17238764 · Cited by 51 · cited 2× · see citing works
“6% experienced somatic symptoms while Wielgus et al.(22) reported at least one somatic symptom in 53.”
BackgroundInfluentialAcute psychological impact on COVID-19 patients in Hubei: a multicenter observational study
Wang, M., Hu, C., Zhao, Q., Feng, R., Wáng, Q., Cai, H., Guo, Z., Xu, K., Luo, W., Guo, C., et al. (2021) · Translational Psychiatry · doi:10.1038/s41398-021-01259-0 · Cited by 48 · see citing works
Lixia, W., Xu, X., Shi, L., Hong, S., Wang, W., Xin, F., Chen, J., Zhang, Q., Ai, M., & Kuang, L. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.10.013 · Cited by 47 · see citing works
Coping Styles, Mental Health, and the COVID-19 Quarantine: A Nationwide Survey in Poland
Kołodziejczyk, A., Misiak, B., Szcześniak, D. M., Maciaszek, J., Ciułkowicz, M., Łuc, D., Wieczorek, T., Fila-Witecka, K., Chładzińska-Kiejna, S., & Rymaszewska, J. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.625355 · Cited by 46 · see citing works
Wang, Y. Y., Duan, Z., Peng, K., Li, D., Ou, J., Wilson, A. D., Wang, N., Si, L., & Chen, R. (2020) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000851 · Cited by 30 · see citing works
Sudden and persistent dysphonia within the framework of COVID-19: The case report of a nurse
Buselli, R., Corsi, M., Necciari, G., Pistolesi, P., Baldanzi, S., Chiumiento, M., Lupo, E. D., Guerra, P. D., & Cristaudo, A. (2020) · Brain Behavior & Immunity - Health · doi:10.1016/j.bbih.2020.100160 · Cited by 29 · see citing works
Jowett, S., Shevlin, M. E., Hyland, P., & Karatzias, T. (2020) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000890 · Cited by 29 · see citing works
Singh, J., Sood, M., Chadda, R. K., Singh, V., & Kattula, D. (2021) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2021.102685 · Cited by 29 · see citing works
Shangguan, F., Quan, X., Qian, W., Zhou, C., Zhang, C., Zhang, X., & Liu, Z. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.08.035 · Cited by 27 · see citing works
Online Mental Health Assessments of COVID-19 Patients in South Korea
Lee, J. H., Lee, D., Hyun, S. Y., Hong, J. S., Kim, C., Kim, W., & Sim, M. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.685445 · Cited by 23 · see citing works
Oyama, O. N., Paltoo, C., & Greengold, J. (2007) · PubMed · Cited by 22 · see citing works
Li, H., Zhang, Y., Wang, H., Liang, J., Zhou, Y., Huang, Y., Zhai, T., Yang, Q., Yang, M., Ning, Y., et al. (2020) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s282124 · Cited by 21 · see citing works
Yi, J., Kang, L., Li, J., & Jian-fang, G. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.590101 · Cited by 21 · see citing works
COVID-19 related fear and mental health in Indian sample: The buffering effect of support system
Suhail, A., Dar, K. A., & Iqbal, N. (2021) · Current Psychology · doi:10.1007/s12144-021-01694-8 · Cited by 19 · see citing works
Huang, S., Zhuang, W., Wang, D., Zha, L., Xu, X. Z., Li, X., Shi, Q., Wang, X. S., & Qiao, G. (2021) · Medical Science Monitor · doi:10.12659/msm.930447 · Cited by 17 · see citing works
Biermann, M., Vonderlin, R., Mier, D. U., Witthöft, M., & Bailer, J. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.678860 · Cited by 17 · see citing works
Huang, Y., Zhou, Y., Wei, Y., Zeng, L., Yang, J., Li, Y., Song, X., Li, H., He, H., Li, T., et al. (2021) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s300719 · Cited by 15 · see citing works
Daniels, N. F., Ridwan, R., Barnard, E., Amanullah, T. M., & Hayhurst, C. (2021) · Clinical Medicine · doi:10.7861/clinmed.2020-1093 · Cited by 12 · see citing works
Alnaser, M. Z., Alotaibi, N. M., Nadar, M. S., Manee, F., & Alrowayeh, H. N. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.891276 · Cited by 10 · see citing works
Engelmann, P., Toussaint, A. C., Addo, M. M., Brehm, T. T., Lohse, A. W., Weigel, A., Thompson, M., & Löwe, B. (2022) · Journal of Mental Health · doi:10.1080/09638237.2022.2069709 · Cited by 7 · see citing works
Somatic symptom disorder, a new DSM-5 diagnosis of an old clinical challenge
Rosic, T., Kalra, S., & Samaan, Z. (2016) · BMJ Case Reports · doi:10.1136/bcr-2015-212553 · Cited by 6 · see citing works
Gaur, V., Jain, A., Purohit, G., & Gaur, K. (2021) · Archives of Psychiatry Research · doi:10.20471/dec.2021.57.02.04 · Cited by 4 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Qian Z, Caihong H, Renjie F, et al. Investigation of the mental health of patients with COVID-19. Chin J Neurol 2020; 53: 432-436.
Cited by
Sorted by citations
Ahmed, L. A. E. H. A., Ali, M. I. E. B., Ali, S. S., & Nashwan, A. J. (2025) · BMC Nursing · doi:10.1186/s12912-025-03228-0 · Cited by 11 · see citing works
López-del-Hoyo, Y., Fernández-Martínez, S., Perez-Aranda, A., Monreal-Bartolomé, A., Barceló-Soler, A., Camarero-Grados, L., Armas-Landaeta, C., Guzmán-Parra, J., Carbonell, V., Campos, D., et al. (2025) · Journal of Medical Internet Research · doi:10.2196/59653 · Cited by 9 · see citing works
“…the high frequency with which health professionals experience anxiety, depressive, and somatic symptoms, especially following the COVID-19 pandemic [3-6], the effectiveness of this intervention in reducing these symptoms represents a significant contribution to mental health promotion and supports…”
Robles, E., Angelone, C., Ondé, D., & Vázquez, C. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.07.087 · Cited by 9 · see citing works
Webb, E. L., Morris, D. J., Khan, M. N., & Al-Refai, N. (2024) · Issues in Mental Health Nursing · doi:10.1080/01612840.2024.2412597 · Cited by 4 · see citing works
Zhang, S., & Gu, X. (2024) · BMJ Leader · doi:10.1136/leader-2024-001041 · Cited by 4 · see citing works
Askarian, M., Taherifard, E., Jazzabi, F., Shayan, Z., Assadian, O., Groot, G., Hatam, N., Askarian, A., Faghihi, S. M., & Taherifard, E. (2024) · BMC Public Health · doi:10.1186/s12889-024-19543-1 · Cited by 2 · see citing works
Katsouda, A., Sikelianou, D., Kougioumtzis, G. Α., Dolma, C., & Koliniatii, T. (2024) · Psychology the Journal of the Hellenic Psychological Society · doi:10.12681/psy_hps.39622 · Cited by 1 · see citing works
Karhula, K., Halonen, J., Mänttäri, S. K., Punakallio, A., Puttonen, S., Sihvola, M., Säynäjäkangas, P., & Sallinen, M. (2025) · Industrial Health · doi:10.2486/indhealth.2024-0211 · Cited by 1 · see citing works
Grocott, L., King, J. D., McQuaid, A., Leeson, V. C., & Crawford, M. (2025) · medRxiv · doi:10.1101/2025.02.26.25322939
Askarian, M., Taherifard, E., Jazzabi, F., Shayan, Z., Assadian, O., Groot, G., Hatam, N., Askarian, A., Faghihi, S. M., & Taherifard, E. (2024) · Figshare · doi:10.6084/m9.figshare.26384641
Alhawatmeh, H. N., Abusaif, L., Alharrasi, M., & Abuhammad, S. (2026) · Journal of Nursing Scholarship · doi:10.1111/jnu.70067
Wörle, K., Dietz, P., Letzel, S., Rigotti, T., Mülder, L. M., & Reichel, J. L. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2026.1827225
Gueta, K., & Klar‐Chalamish, C. (2026) · Journal of Interpersonal Violence · doi:10.1177/08862605261451870
- Authors
- Theocharis, A., Antonopoulos, V., & Christodoulou, N. G.
- Affiliations
- University of Thessaly (GR)
- Faculty of Medicine, University of Thessaly, Larissa, Greece; and Department of Psychiatry, Medical School, University of Thessaly, Larissa, Greece
- Corresponding author
- Theocharis, Andreas
- Venue
- Australasian Psychiatry
- Publisher
- SAGE Publications
- Published
- 2023-02-24
- Volume
- 31
- Issue
- 2
- Pages
- 147-156
- ISSN
- 1039-8562 (ISSN-L)
- 1440-1665
- PMC
- PMC9969186
- OpenAlex
- W4321749517
- Cited by
- 13
- References
- 42
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 7
- FWCI
- 0.66
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Australasian Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Keywords
- somatic symptoms, psychological distress, COVID-19 pandemic, medically unexplained symptoms, healthcare workers, prevalence, dyspnea, palpitations
- MeSH terms
- Medically Unexplained Symptoms, COVID-19, Mental Disorders, Health Personnel, Humans, Pandemics
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
