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Prevalence of Anxiety in Medical Students during the COVID-19 Pandemic: A Rapid Systematic Review with Meta-Analysis

Department of Microbiology, Pediatrics, Radiology and Public Health, Faculty of Medicine, University of Zaragoza, Building A, 50009 Zaragoza, Spain
Psychiatry Service, Hospital Universitario Miguel Servet, Paseo Isabel la Católica, 1-3, 50009 Zaragoza, Spain
Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales Medicine, Randwick 2052, Australia
Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Avenue Monforte de Lemos, 3-5, Pavilion 11, Floor 0, 28029 Madrid, Spain
Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain, Avenue San Juan Bosco, 13, 50009 Zaragoza, Spain
Department of Psychology and Sociology, Universidad de Zaragoza, Pedro Cerbuna, 12, 50009 Zaragoza, Spain
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(18), 6603;
Received: 8 August 2020 / Revised: 6 September 2020 / Accepted: 7 September 2020 / Published: 10 September 2020
(This article belongs to the Special Issue Mental Health in the Time of COVID-19)
The novel coronavirus disease (COVID-19) pandemic has brought a great deal of pressure for medical students, who typically show elevated anxiety rates. Our aim is to investigate the prevalence of anxiety in medical students during this pandemic. This systematic review and mini meta-analysis has been conducted following the PRISMA guidelines. Two researchers independently searched PubMed on 26 August 2020 for cross-sectional studies on medical students during the COVID-19 outbreak, with no language restrictions applied. We then performed a manual search to detect other potentially eligible investigations. To the 1361 records retrieved in the initial search, 4 more were added by manual search on medRxiv. Finally, eight studies were finally included for qualitative and quantitative analysis, which yielded an estimated prevalence of anxiety of 28% (95% CI: 22–34%), with significant heterogeneity between studies. The prevalence of anxiety in medical students is similar to that prior to the pandemic but correlates with several specific COVID-related stressors. While some preventive and risk factors have been previously identified in a non-pandemic context, knowledge and cognitions on COVID-19 transmission, treatment, prognosis and prevention negatively correlate with anxiety, emerging as a key preventive factor that may provide a rationale for why the levels of anxiety have remained stable in medical students during the pandemic while increasing in their non-medical peers and the general population. Other reasons for the invariability of anxiety rates in this population are discussed. A major limitation of our review is that Chinese students comprised 89% the total sample, which could compromise the external validity of our work View Full-Text
Keywords: anxiety; COVID-19; prevalence; medical students; meta-analysis anxiety; COVID-19; prevalence; medical students; meta-analysis
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Lasheras, I.; Gracia-García, P.; Lipnicki, D.M.; Bueno-Notivol, J.; López-Antón, R.; de la Cámara, C.; Lobo, A.; Santabárbara, J. Prevalence of Anxiety in Medical Students during the COVID-19 Pandemic: A Rapid Systematic Review with Meta-Analysis. Int. J. Environ. Res. Public Health 2020, 17, 6603.

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