Systematic Review and Meta-Analysis of Fear of COVID-19

Overview

Journal Front Psychol

Date 2021 Jun 28

PMID 34177712

Citations 85

Authors

Faxiang Luo

Reza Ghanei Gheshlagh

Sahar Dalvand

Sholeh Saedmoucheshi

Qingyun Li

Affiliations

Soon will be listed here.

Abstract

Due to lack of preparedness of health systems, fast spread of the new virus, high mortality rates, and lack of a definite treatment, the outbreak of Coronavirus disease (COVID-19) led to high levels of fear and anxiety in different populations. In addition, isolation, mental disorders, and limitations in social interactions as a result of lockdown and travel ban increased the fear of the new coronavirus. International databases, including Scopus, PubMed, Web of Science, and Google scholar, were searched without any time limitation, and all observational studies published in English reporting the mean of fear of COVID-19 based on the Fear of COVID-19 scale (FCV-19S) were included in the analysis. Methodological quality was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Random effects model, subgroup analysis, and meta-regression analysis were used to analyze the data. Heterogeneity across studies was examined using Cochran's test and statistic. All the statistical analyses were conducted using R software v4.0.3. A total of 44 articles with a sample size of 52,462 were reviewed. A pooled mean of 18.57 was found for fear of COVID-19. The mean of fear of COVID-19 was higher in women than in men (20.67 vs. 18.21). The highest and lowest means of fear of COVID-19 had been found in Asia (18.36) and Australia (17.43) based on continent, and in hospital staff (19.51) and college students (17.95) based on target population, respectively. In addition, the highest and lowest means of fear of COVID-19 were related to items #1 and #3 of the scale, respectively. According to the results of meta-regression analysis, there was no significant association between the mean of fear of COVID-19 and sample size and participants' age. In addition, publication error was not significant ( = 0.721). The mean of fear of COVID-19 was high around the world; therefore, it seems necessary to pay more attention to the negative effects of the COVID-19 pandemic on mental health.

Citing Articles

Prevalence of health-related behaviours and associated factors in university students in Ireland: a 4-year repeated cross-sectional study.

Noonan A, Tierney A, Norton C, Ng K, Woods C BMJ Public Health. 2025; 2(2):e001514.

PMID: 40018568 PMC: 11816961. DOI: 10.1136/bmjph-2024-001514.

Validation of the Canadian English and French Versions of the Fear of COVID-19 Scale in Quebec Nursing Staff.

Gelinas C, Maheu-Cadotte M, Di Nardo E, Lavoie-Tremblay M, Gallani M, Gosselin E Int J Environ Res Public Health. 2025; 22(2).

PMID: 40003522 PMC: 11855782. DOI: 10.3390/ijerph22020297.

Effects of the COVID-19 pandemic on the health of medical students transitioning from traditional education to distance learning: a prospective cohort.

Sankova M, Nikolenko V, Litvinova T, Volel B, Oganesyan M, Rizaeva N BMC Med Educ. 2025; 25(1):284.

PMID: 39979861 PMC: 11844135. DOI: 10.1186/s12909-024-06407-w.

Fear of COVID-19, traumatic growth, and traumatic stress symptoms: the mediating role of basic psychological needs.

Gargurevich R, Campodonico V, Matos L Front Psychol. 2025; 15:1440001.

PMID: 39916790 PMC: 11798999. DOI: 10.3389/fpsyg.2024.1440001.

Exploring the relationship between personal and cohabiting family members' COVID-19 infection experiences and fear of COVID-19: a longitudinal study based on the Japan COVID-19 and Society Internet Survey (JACSIS).

Ishikawa A, Tachikawa H, Midorikawa H, Tabuchi T BMJ Open. 2025; 14(12):e087595.

PMID: 39806713 PMC: 11667445. DOI: 10.1136/bmjopen-2024-087595.

References

Zolotov Y, Reznik A, Bender S, Isralowitz R . COVID-19 Fear, Mental Health, and Substance Use Among Israeli University Students. Int J Ment Health Addict. 2020; 20(1):230-236. PMC: 7299139. DOI: 10.1007/s11469-020-00351-8. View

Vanni G, Materazzo M, Pellicciaro M, Ingallinella S, Rho M, Santori F . Breast Cancer and COVID-19: The Effect of Fear on Patients' Decision-making Process. In Vivo. 2020; 34(3 Suppl):1651-1659. PMC: 8378027. DOI: 10.21873/invivo.11957. View

Lin C, Brostrom A, Griffiths M, Pakpour A . Investigating mediated effects of fear of COVID-19 and COVID-19 misunderstanding in the association between problematic social media use, psychological distress, and insomnia. Internet Interv. 2020; 21:100345. PMC: 7449889. DOI: 10.1016/j.invent.2020.100345. View

Garcia-Reyna B, Castillo-Garcia G, Barbosa-Camacho F, Cervantes-Cardona G, Cervantes-Perez E, Torres-Mendoza B . Fear of COVID-19 Scale for Hospital Staff in Regional Hospitals in Mexico: a Brief Report. Int J Ment Health Addict. 2020; 20(2):895-906. PMC: 7640993. DOI: 10.1007/s11469-020-00413-x. View

Gasparro R, Scandurra C, Maldonato N, Dolce P, Bochicchio V, Valletta A . Perceived Job Insecurity and Depressive Symptoms among Italian Dentists: The Moderating Role of Fear of COVID-19. Int J Environ Res Public Health. 2020; 17(15). PMC: 7432196. DOI: 10.3390/ijerph17155338. View

Soraci P, Ferrari A, Abbiati F, Del Fante E, De Pace R, Urso A . Validation and Psychometric Evaluation of the Italian Version of the Fear of COVID-19 Scale. Int J Ment Health Addict. 2020; 20(4):1913-1922. PMC: 7198091. DOI: 10.1007/s11469-020-00277-1. View

Hossain M, Jahid M, Hossain K, Walton L, Uddin Z, Haque M . Knowledge, attitudes, and fear of COVID-19 during the Rapid Rise Period in Bangladesh. PLoS One. 2020; 15(9):e0239646. PMC: 7514023. DOI: 10.1371/journal.pone.0239646. View

Zhang J, Wu W, Zhao X, Zhang W . Recommended psychological crisis intervention response to the 2019 novel coronavirus pneumonia outbreak in China: a model of West China Hospital. Precis Clin Med. 2022; 3(1):3-8. PMC: 7107095. DOI: 10.1093/pcmedi/pbaa006. View

Nguyen L, Drew D, Graham M, Joshi A, Guo C, Ma W . Risk of COVID-19 among front-line health-care workers and the general community: a prospective cohort study. Lancet Public Health. 2020; 5(9):e475-e483. PMC: 7491202. DOI: 10.1016/S2468-2667(20)30164-X. View

10.

Xiang Y, Yang Y, Li W, Zhang L, Zhang Q, Cheung T . Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. Lancet Psychiatry. 2020; 7(3):228-229. PMC: 7128153. DOI: 10.1016/S2215-0366(20)30046-8. View

11.

Ahorsu D, Imani V, Lin C, Timpka T, Brostrom A, Updegraff J . Associations Between Fear of COVID-19, Mental Health, and Preventive Behaviours Across Pregnant Women and Husbands: An Actor-Partner Interdependence Modelling. Int J Ment Health Addict. 2020; 20(1):68-82. PMC: 7289236. DOI: 10.1007/s11469-020-00340-x. View

12.

Sakib N, Bhuiyan A, Hossain S, Al Mamun F, Hosen I, Abdullah A . Psychometric Validation of the Bangla Fear of COVID-19 Scale: Confirmatory Factor Analysis and Rasch Analysis. Int J Ment Health Addict. 2020; 20(5):2623-2634. PMC: 7213549. DOI: 10.1007/s11469-020-00289-x. View

13.

Pang N, Kamu A, Hambali N, Mun H, Kassim M, Mohamed N . Malay Version of the Fear of COVID-19 Scale: Validity and Reliability. Int J Ment Health Addict. 2020; 20(1):263-272. PMC: 7333973. DOI: 10.1007/s11469-020-00355-4. View

14.

Giordani R, Silva M, Muhl C, Giolo S . Fear of COVID-19 scale: Assessing fear of the coronavirus pandemic in Brazil. J Health Psychol. 2020; 27(4):901-912. DOI: 10.1177/1359105320982035. View

15.

Saravanan C, Mahmoud I, Elshami W, Taha M . Knowledge, Anxiety, Fear, and Psychological Distress About COVID-19 Among University Students in the United Arab Emirates. Front Psychiatry. 2020; 11:582189. PMC: 7642490. DOI: 10.3389/fpsyt.2020.582189. View

16.

Moher D, Liberati A, Tetzlaff J, Altman D . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009; 6(7):e1000097. PMC: 2707599. DOI: 10.1371/journal.pmed.1000097. View

17.

Martinez-Lorca M, Martinez-Lorca A, Criado-Alvarez J, Armesilla M, Latorre J . The fear of COVID-19 scale: Validation in spanish university students. Psychiatry Res. 2020; 293:113350. PMC: 7396130. DOI: 10.1016/j.psychres.2020.113350. View

18.

Coelho C, Suttiwan P, Arato N, Zsido A . On the Nature of Fear and Anxiety Triggered by COVID-19. Front Psychol. 2020; 11:581314. PMC: 7680724. DOI: 10.3389/fpsyg.2020.581314. View

19.

Labrague L, De Los Santos J . Fear of COVID-19, psychological distress, work satisfaction and turnover intention among frontline nurses. J Nurs Manag. 2020; 29(3):395-403. PMC: 7537256. DOI: 10.1111/jonm.13168. View

20.

Konstantinov V, Berdenova S, Satkangulova G, Reznik A, Isralowitz R . COVID-19 Impact on Kazakhstan University Student Fear, Mental Health, and Substance Use. Int J Ment Health Addict. 2020; 20(2):888-894. PMC: 7651818. DOI: 10.1007/s11469-020-00412-y. View