1International Ph.D. Program in Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
2Department of Psychiatry, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
3Institute of Oncology and Nuclear Medicine, Military Hospital, Ho Chi Minh, Vietnam
4School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan
5Department of Orthopedics, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam
6Director Office, Can Tho University of Medicine and Pharmacy Hospital, Can Tho, Vietnam
7Department of Infectious Diseases, Vietnam Military Medical University, Hanoi, Vietnam
8Department of Military Science, Vietnam Military Medical University, Hanoi, Vietnam
9Department of Psychiatry, Military Hospital 103, Hanoi, Vietnam
10Faculty of Public Health, Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
11Infectious and Tropical Diseases Department, Viet Tiep Hospital, Hai Phong, Vietnam
12Department of Pulmonary and Cardiovascular Diseases, Hai Phong University of Medicine and Pharmacy Hospital, Hai Phong, Vietnam
13Director Office, Thai Nguyen National Hospital, Thai Nguyen, Vietnam
14Training and Direction of Healthcare Activity Center, Thai Nguyen National Hospital, Thai Nguyen, Vietnam
15Biochemistry Department, Thai Nguyen National Hospital, Thai Nguyen, Vietnam
16President Office, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
17Department of Quality Control, Thai Nguyen National Hospital, Thai Nguyen, Vietnam
18Director Office, Gang Thep Hospital, Thai Nguyen, Vietnam
19Director Office, Hospital for Tropical Diseases, Hai Duong, Vietnam
20Infectious and Tropical Diseases Department, Viet Tiep Hospital, Hai Phong, Vietnam
21Department of Infectious Diseases, Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
22Director Office, Kien An Hospital, Hai Phong, Vietnam
23Training and Direction of Healthcare Activity Center, Kien An Hospital, Hai Phong, Vietnam
24School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
25President Office, Da Nang University of Medical Technology and Pharmacy, Da Nang, Vietnam
26Faculty of Medical Laboratory Science, Da Nang University of Medical Technology and Pharmacy, Da Nang, Vietnam
27Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
28Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh, Vietnam
29Department of Health Promotion, Faculty of Social and Behavioral Sciences, Hanoi University of Public Health, Hanoi, Vietnam
© 2024 Korea Disease Control and Prevention Agency.
This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Ethics Approval
The study was approved by the Institutional Ethical Review Committee of Hanoi School of Public Health in Vietnam (No: 400/2021/YTCC-HD3 and 45/2022/YTCC-HD3) and performed in accordance with the principles of the Declaration of Helsinki. Patients were informed about the study’s purpose and provided consent to complete the survey questionnaire. The survey was conducted anonymously.
Conflicts of Interest
The authors have no conflicts of interest to declare.
Funding
This study was supported by Thai Nguyen National Hospital, Military Hospital 103, Can Tho University of Medicine and Pharmacy, and Taipei Medical University (TMU108-AE1-B37).
Availability of Data
The datasets are not publicly available but are available from the corresponding author upon reasonable request.
Authors’ Contributions
Conceptualization: all authors; Data curation: HTV, TTMP, TTPN, TVD; Formal analysis: HTV, TVD; Funding acquisition: TVD; Investigation: all authors; Methodology: all authors; Project administration: TTPN and TVD; Resources: all authors; Software: TTPN, TVD; Supervision: TVD; Validation: all authors; Visualization: TVD; Writing–original draft: HTV, TVD; Writing–review & editing: all authors. All authors read and approved the final manuscript.
Additional Contributions
The authors express their gratitude towards the doctors, nurses, and medical students who assisted in data collection. We also extend our thanks to the board of directors and medical staff in the 18 hospitals and health centers for providing the list of COVID-19 patients and facilitating data collection. The authors acknowledge and appreciate the COVID-19 patients who willingly participated in the survey and provided complete information without any commercial interest. The hospitals and health centers supported us in collecting data, including Thai Nguyen National Hospital, Gang Thep Hospital, Thai Nguyen Tuberculosis, and Lung Disease Hospital (Thai Nguyen Province), Hospital for Tropical Disease (Hai Duong Province), Kien Thuy District Health Center, Viet Tiep Friendship Hospital, Kien An Hospital, Hai Phong University of Medicine and Pharmacy Hospital (Hai Phong City), Military Hospital 103 (Hanoi City), Trieu Phong District Health Center in Quang Tri Province, Thua Thien Hue Centralized Isolation Facility (T2F0, T3F0), CDC Da Nang, (Thu Duc City Health Center, Military Hospital 175 (Ho Chi Minh City), Field Hospital No.1, Field Hospital No.2, Binh Thuy Field Hospital, Tuberculosis and Lung Disease Can Tho Hospital (Can Tho City).
Characteristic | Total | Non-PTSD (n=2,250, 50.4%) | PTSD (n2,213, 49.6%) | p | |
---|---|---|---|---|---|
Age (y)a) | <0.001b) | ||||
18–39 | 3,234 (72.5) | 1,657 (73.6) | 1,577 (71.3) | ||
40–59 | 852 (19.1) | 447 (19.9) | 405 (18.3) | ||
60–85 | 377 (8.4) | 146 (6.5) | 231 (10.4) | ||
Sex | 0.008b) | ||||
Male | 1,977 (44.3) | 1,041 (46.3) | 936 (42.3) | ||
Female | 2,486 (55.7) | 1,209 (53.7) | 1,277 (57.7) | ||
Marital status | 0.502b) | ||||
Never married | 1,852 (41.5) | 945 (42.0) | 907 (41.5) | ||
Ever married | 2,611 (58.5) | 1,305 (58.0) | 1,306 (58.5) | ||
Educational attainment | <0.001b) | ||||
High school or below | 1,238 (27.7) | 521 (23.2) | 717 (32.4) | ||
College or above | 3,225 (72.3) | 1,729 (76.8) | 1,496 (67.6) | ||
Ability to pay for medications | <0.001b) | ||||
Very or fairly difficult | 2,356 (52.8) | 1,041 (46.3) | 1,315 (59.4) | ||
Fairly or very easy | 2,107 (47.2) | 1,209 (53.7) | 898 (40.6) | ||
Social status | <0.001b) | ||||
Low | 551 (12.3) | 228 (10.1) | 323 (14.6) | ||
Middle | 3,683 (82.5) | 1,861 (82.7) | 1,822 (82.3) | ||
High | 229 (5.2) | 161 (7.2) | 68 (3.1) | ||
Healthcare workers | 0.392b) | ||||
No | 3,215 (72.0) | 1,608 (71.5) | 1,607 (72.0) | ||
Yes | 1,248 (28.0) | 642 (28.5) | 606 (28.0) | ||
Family members infected with COVID-19 | <0.001b) | ||||
1 Person | 938 (21.0) | 536 (23.8) | 402 (18.2) | ||
≥2 People | 3,525 (79.0) | 1714 (76.2) | 1,811 (81.8) | ||
Body mass index | 0.395b) | ||||
Underweight | 553 (12.4) | 276 (12.3) | 277 (12.5) | ||
Normal weight | 3,490 (78.2) | 1,749 (77.7) | 1,741 (78.7) | ||
Overweight | 420 (9.4) | 188 (10.2) | 195 (8.8) | ||
No. of COVID-19 infections | 0.054b) | ||||
First time | 4,354 (97.6) | 2,205 (98) | 2,149 (97.1) | ||
More than 1 time | 109 (2.4) | 45 (2.0) | 64 (2.9) | ||
Long COVID-19 symptoms | <0.001b) | ||||
No | 1,968 (44.1) | 1,187 (52.8) | 781 (35.3) | ||
≥1 | 2,495 (55.9) | 1,063 (47.2) | 1,432 (64.7) | ||
Comorbidities | <0.001b) | ||||
None | 3,207 (71.9) | 1,699 (75.5) | 1,508 (68.1) | ||
≥1 | 1,256 (28.1) | 551 (24.5) | 705 (31.9) | ||
Balanced mealsa) | <0.001b) | ||||
No | 2,658 (60.6) | 1,161 (53.2) | 1,497 (67.6) | ||
Yes | 1,727 (39.4) | 1,022 (46.8) | 705 (32) | ||
Physical activity (MET min/wk)a) | <0.001b) | ||||
Tertile 1 (MET <417) | 1,115 (25.0) | 395 (17.6) | 720 (32.6) | ||
Tertile 2 (417≤MET<2,208) | 2,230 (50.0) | 1,236 (54.9) | 994 (44.9) | ||
Tertile 3 (MET≥2,208) | 1,115 (25.0) | 619 (27.5) | 496 (22.4) | ||
Health literacy index | 31.23±8.54 | 32.76±8.62 | 29.67±8.18 | <0.001c) |
Model 1: simple logistic regression model; model 2: multiple logistic regression model after adjusted for age, sex, educational attainment, ability to pay for medications, social status, the family member with COVID-19 infection, BMI, number of COVID-19 infections, comorbidity, balanced meals, and physical activity.
COVID-19, coronavirus disease 2019; PTSD, posttraumatic stress symptoms; OR, odds ratio; CI, confidence interval; AOR, adjusted odds ratio; HL, health literacy; ref., reference.
Characteristic | Total | Non-PTSD (n=2,250, 50.4%) | PTSD (n2,213, 49.6%) | p | |
---|---|---|---|---|---|
Age (y) |
<0.001 |
||||
18–39 | 3,234 (72.5) | 1,657 (73.6) | 1,577 (71.3) | ||
40–59 | 852 (19.1) | 447 (19.9) | 405 (18.3) | ||
60–85 | 377 (8.4) | 146 (6.5) | 231 (10.4) | ||
Sex | 0.008 |
||||
Male | 1,977 (44.3) | 1,041 (46.3) | 936 (42.3) | ||
Female | 2,486 (55.7) | 1,209 (53.7) | 1,277 (57.7) | ||
Marital status | 0.502 |
||||
Never married | 1,852 (41.5) | 945 (42.0) | 907 (41.5) | ||
Ever married | 2,611 (58.5) | 1,305 (58.0) | 1,306 (58.5) | ||
Educational attainment | <0.001 |
||||
High school or below | 1,238 (27.7) | 521 (23.2) | 717 (32.4) | ||
College or above | 3,225 (72.3) | 1,729 (76.8) | 1,496 (67.6) | ||
Ability to pay for medications | <0.001 |
||||
Very or fairly difficult | 2,356 (52.8) | 1,041 (46.3) | 1,315 (59.4) | ||
Fairly or very easy | 2,107 (47.2) | 1,209 (53.7) | 898 (40.6) | ||
Social status | <0.001 |
||||
Low | 551 (12.3) | 228 (10.1) | 323 (14.6) | ||
Middle | 3,683 (82.5) | 1,861 (82.7) | 1,822 (82.3) | ||
High | 229 (5.2) | 161 (7.2) | 68 (3.1) | ||
Healthcare workers | 0.392 |
||||
No | 3,215 (72.0) | 1,608 (71.5) | 1,607 (72.0) | ||
Yes | 1,248 (28.0) | 642 (28.5) | 606 (28.0) | ||
Family members infected with COVID-19 | <0.001 |
||||
1 Person | 938 (21.0) | 536 (23.8) | 402 (18.2) | ||
≥2 People | 3,525 (79.0) | 1714 (76.2) | 1,811 (81.8) | ||
Body mass index | 0.395 |
||||
Underweight | 553 (12.4) | 276 (12.3) | 277 (12.5) | ||
Normal weight | 3,490 (78.2) | 1,749 (77.7) | 1,741 (78.7) | ||
Overweight | 420 (9.4) | 188 (10.2) | 195 (8.8) | ||
No. of COVID-19 infections | 0.054 |
||||
First time | 4,354 (97.6) | 2,205 (98) | 2,149 (97.1) | ||
More than 1 time | 109 (2.4) | 45 (2.0) | 64 (2.9) | ||
Long COVID-19 symptoms | <0.001 |
||||
No | 1,968 (44.1) | 1,187 (52.8) | 781 (35.3) | ||
≥1 | 2,495 (55.9) | 1,063 (47.2) | 1,432 (64.7) | ||
Comorbidities | <0.001 |
||||
None | 3,207 (71.9) | 1,699 (75.5) | 1,508 (68.1) | ||
≥1 | 1,256 (28.1) | 551 (24.5) | 705 (31.9) | ||
Balanced meals |
<0.001 |
||||
No | 2,658 (60.6) | 1,161 (53.2) | 1,497 (67.6) | ||
Yes | 1,727 (39.4) | 1,022 (46.8) | 705 (32) | ||
Physical activity (MET min/wk) |
<0.001 |
||||
Tertile 1 (MET <417) | 1,115 (25.0) | 395 (17.6) | 720 (32.6) | ||
Tertile 2 (417≤MET<2,208) | 2,230 (50.0) | 1,236 (54.9) | 994 (44.9) | ||
Tertile 3 (MET≥2,208) | 1,115 (25.0) | 619 (27.5) | 496 (22.4) | ||
Health literacy index | 31.23±8.54 | 32.76±8.62 | 29.67±8.18 | <0.001 |
Factor | PTSD |
|||
---|---|---|---|---|
Model 1 |
Model 2 |
|||
OR (95% CI) | p | OR (95% CI) | p | |
Age (y) | ||||
18–39 | Ref. | Ref. | ||
40–59 | 0.952 (0.818–1.107) | 0.523 | 0.815 (0.686–0.967) | 0.019 |
60–85 | 1.662 (1.336–2.068) | <0.001 | 0.942 (0.718–1.234) | 0.664 |
Sex | ||||
Male | Ref. | Ref. | ||
Female | 1.175 (1.044–1.322) | 0.008 | 1.038 (0.910–1.184) | 0.58 |
Marital status | ||||
Never married | Ref. | |||
Ever married | 1.043 (0.926–1.175) | 0.491 | ||
Educational attainment | ||||
High school or below | Ref. | Ref. | ||
College or above | 0.629 (0.551–0.718) | <0.001 | 0.843 (0.721–0.987) | 0.033 |
Ability to pay for medications | ||||
Very/fairly difficult | Ref. | Ref. | ||
Fairly or very easy | 0.588 (0.522–0.662) | <0.001 | 0.765 (0.669–0.875) | <0.001 |
Social status | ||||
Low | Ref. | Ref. | ||
Middle | 0.691 (0.576–0.829) | <0.001 | 0.931 (0.765–1.132) | 0.473 |
High | 0.298 (0.214–0.415) | <0.001 | 0.590 (0.411–0.847) | 0.004 |
Healthcare workers | ||||
No | Ref. | |||
Yes | 0.945 (0.829–1.076) | 0.392 | ||
Family members infected with COVID-19 | ||||
1 person | Ref. | Ref. | ||
≥2 people | 1.409 (1.218–1.629) | <0.001 | 1.238 (1.058–1.449) | 0.008 |
Body mass index | ||||
Normal weight | Ref. | Ref. | ||
Underweight | 1.008 (0.843–1.206) | 0.929 | 0.953 (0.783–1.159) | 0.628 |
Overweight | 0.871 (0.711–1.067) | 0.181 | 0.949 (0.756–1.169) | 0.579 |
No. of COVID-19 infections | ||||
First time | Reference | Ref. | ||
More than 1 time | 1.459 (0.992–2.147) | 0.055 | 1.391 (0.920–2.105) | 0.118 |
Long COVID-19 symptoms | ||||
None | Ref. | Ref. | ||
≥1 | 2.047 (1.816–2.309) | <0.001 | 1.860 (1.633–2.120) | <0.001 |
Comorbidities | ||||
None | Ref. | Ref. | ||
≥1 | 1.442 (1.264–1.644) | <0.001 | 1.124 (0.970–1.304) | 0.121 |
Balanced meals | ||||
No | Ref. | Ref. | ||
Yes | 0.535 (0.473–0.605) | <0.001 | 0.575 (0.503–0.657) | <0.001 |
Physical activity, MET (min/wk) | ||||
Tertile 1 | Ref. | Ref. | ||
Tertile 2 | 0.441 (0.380–0.512) | <0.001 | 0.534 (0.456–0.626) | <0.001 |
Tertile 3 | 0.440 (0.371–0.521) | <0.001 | 0.575 (0.479–0.691) | <0.001 |
Health literacy index | 0.957 (0.950–0.964) | <0.001 | 0.979 (0.970–0.987) | 0.001 |
PTSD |
||||
---|---|---|---|---|
Model 1 |
Model 2 |
|||
OR (95% CI) | p | AOR (95% CI) | p | |
Without long COVID-19 and lowest HL index | Ref. | Ref. | ||
With long COVID-19 and lowest HL index | 6.523 (3.984–10.681) | <0.001 | 4.440 (2.641–7.464) | <0.001 |
Without long COVID-19 and HL index, 1-score increment | 0.982 (0.971–0.993) | 0.001 | 0.992 (0.981–1.004) | 0.198 |
With long COVID-19 and HL index, 1-score increment | 0.961 (0.947–0.976) | <0.001 | 0.973 (0.958–0.988) | 0.001 |
Data are presented as PTSD, posttraumatic stress disorder; COVID-19, coronavirus disease 2019; MET min/wk, metabolic equivalents of task in minutes per week. Missing cases. Results of the chi-square test. Results of Mann-Whitney U test.
Model 1: simple logistic regression model; model 2: multiple logistic regression model. PTSD, posttraumatic stress symptoms; OR, odds ratio; CI, confidence interval; ref., reference; COVID-19, coronavirus disease 2019; MET min/wk, metabolic equivalent of task in minutes per week.
Model 1: simple logistic regression model; model 2: multiple logistic regression model after adjusted for age, sex, educational attainment, ability to pay for medications, social status, the family member with COVID-19 infection, BMI, number of COVID-19 infections, comorbidity, balanced meals, and physical activity. COVID-19, coronavirus disease 2019; PTSD, posttraumatic stress symptoms; OR, odds ratio; CI, confidence interval; AOR, adjusted odds ratio; HL, health literacy; ref., reference.