The Association between Stress and Illness Anxiety during Corona-Virus Disease 2019(COVID-19) Outbreak in China

Background: The Corona-virus (COVID-19) outbreak in China in 2019 can cause psychological traumatic reaction; it can be a risk factor for illness anxiety. The predictors of severe illness anxiety have not yet been explored. Methods: The present research was a cross-sectional study. The Impact of Event Scale-Revised (IES-R) was used to evaluate stress reaction, and Whiteley Index-7 (WI-7) was applied to measure illness anxiety. Participants with scores above the median WI-7 score were defined as severe illness anxiety and who scored lower than the median WI-7 score were defined as not severe illness anxiety. Logistic regression was used to calculate the odds ratio (OR) and 95% CI. Stress level was divided into mild-, moderate, and severe, which was included in the logistic model to estimate the association of stress and illness anxiety.. Results: After adjusting for covariates, the OR of mild, moderate, and severe stress reaction level was 3.32 (95% CI: 2.21, 4.99), 6.01 (95% CI: 2.99, 12.05), and 14.54 (95% CI: 7.99, 26.47), respectively. The P for trend was less than 0.001 across the levels of stress reaction. Conclusion: The severe stress reaction is associated with severe illness anxiety during the outbreak of COVID-19 in China. The corona crisis intensifies the experience of personal stress that increases the fear of illness through COVID-19 in China. Further qualitative and follow-up studies are essential to illustrate the development of illness anxiety.