The impact of COVID-19 pandemic on physical and mental health of Asians: A study of seven middle-income countries in Asia
Open accessAbstract
The coronavirus disease (COVID-19) pandemic has impacted the economy, livelihood, and physical and mental well-being of people worldwide. This study aimed to compare the mental health status during the pandemic in the general population of seven middle income countries (MICs) in Asia (China, Iran, Malaysia, Pakistan, Philippines, Thailand, and Vietnam). All the countries used the Impact of Event Scale–Revised (IES-R) and Depression, Anxiety and Stress Scale (DASS-21) to measure mental health. There were 4479 Asians completed the questionnaire with demographic characteristics, physical symptoms and health service utilization, contact history, knowledge and concern, precautionary measure, and rated their mental health with the IES-R and DASS-21. Descriptive statistics, One-Way analysis of variance (ANOVA), and linear regression were used to identify protective and risk factors associated with mental health parameters. There were significant differences in IES-R and DASS-21 scores between 7 MICs (p<0.05). Thailand had all the highest scores of IES-R, DASS-21 stress, anxiety, and depression scores whereas Vietnam had all the lowest scores. The risk factors for adverse mental health during the COVID-19 pandemic include age <30 years, high education background, single and separated status, discrimination by other countries and contact with people with COVID-19 (p<0.05). The protective factors for mental health include male gender, staying with children or more than 6 people in the same household, employment, confidence in doctors, high perceived likelihood of survival, and spending less time on health information (p<0.05). This comparative study among 7 MICs enhanced the understanding of metal health in the general population during the COVID-19 pandemic.
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The baseline levels of stress and anxiety among our participants were significantly higher than those found in the same population of university students by previous research and in the general population.
“The baseline levels of stress and anxiety among our participants were significantly higher than those found in the same population of university students by previous research [42-44], as well as in the general population [45].”
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- Authors
- Wang, C., Tee, M., Roy, A. E., Fardin, M. A., Srichokchatchawan, W., Habib, H. A., Tran, B. X., Hussain, S., Hoang, M. T., Le, X. T., Ma, W., Pham, H. Q., Shirazi, M., Taneepanichskul, N., Tan, Y., Tee, C., Xu, L., Xu, Z., Vu, G. T., Zhou, D., Koh, B. J., McIntyre, R. S., Ho, C., Ho, R. C., & Kuruchittham, V.
- Affiliations
- Huaibei Normal University (CN)
- University of the Philippines Manila (PH)
- Universiti Malaysia Sarawak (MY)
- Islamic Azad University, Zahedan Branch (IR)
- Chulalongkorn University (TH)
- University of Karachi (PK)
- Johns Hopkins University (US)
- Duy Tan University (VN)
- Hanoi Medical University (VN)
- University of Sistan and Baluchestan (IR)
- Trường ĐH Nguyễn Tất Thành (VN)
- National University of Singapore (SG)
- University Health Network (CA)
- National University Health System (SG)
- Southeast Asia One Health University Network (TH)
- Corresponding author
- Ho, Roger C.
- ORCID
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2021-02-11
- Volume
- 16
- Issue
- 2
- Pages
- e0246824
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC7877638
- OpenAlex
- W3126849703
- Cited by
- 460
- References
- 44
- Citations by year
- 2026: 13 · 2025: 25 · 2024: 53 · 2023: 111 · 2022: 171 · 2021: 86
- FWCI
- 71.79
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- Unimas Institutional Repository (Universiti Malaysia Sarawak) (acceptedVersion)
- National University of Singapore (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Rare & Special e-Zone (The Hong Kong University of Science and Technology) (submittedVersion)
- Greater South Information System
- Funders
- Huaibei Normal University, China.
- National University of Singapore iHealthtech Other Operating Expenses (R-722-000-004-731)
- Vingroup Innovation Foundation (VINIF) COVID in Vietnam (VINIF.2020.Covid19.DA07)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- COVID-19 pandemic, mental health, physical health, anxiety, depression, stress, middle-income countries, Asia, risk factors, protective factors, cross-national comparison, health care utilization, somatic symptoms
- MeSH terms
- COVID-19, SARS-CoV-2, Adolescent, Adult, Anxiety, Asia, Child, Cross-Sectional Studies, Depression, Female, Humans, Male, Mental Health, Middle Aged, Sex Factors, Socioeconomic Factors, Stress, Psychological, Young Adult, Protective Factors
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