Stress-related to COVID-19, anxiety, and protective factors among middle-aged and older adults in the largest outbreak areas in South Korea

Abstract Many people have suffered from psychological distress in the form of stress, loneliness, and anxiety resulting from the COVID-19 epidemic (Havnen et al., 2020; Luchetti et al., 2020). Along with these factors, physical health (hereafter health), resilience, and living arrangements as protective factors were examined. The research aims were to investigate 1) factors affecting the association between COVID-19-related stress (hereafter stress) and anxiety, and 2) moderating effects of loneliness on this association. Data was collected on 450 middle-aged and older adults (ages 45 through 76) living in South Korea during COVID-19. A multi-group path analysis was employed. Measurement invariance was examined by comparing unconstrained and fully constrained models. Both models fit. Moderating effects of loneliness existed. Stress was negatively associated with health and living arrangements for people with both higher and lower levels of loneliness. Health was positively associated with resilience for both groups. Resilience was negatively associated with anxiety for both groups. For people with higher levels of loneliness only, stress and health were negatively associated with resilience and anxiety, respectively. The association between stress and anxiety was significant for both groups. However, the impact of stress on anxiety was significantly larger for people with higher levels of loneliness than for people with lower levels of loneliness. Health practitioners and service providers should develop programs to maintain and promote resilience, social support, and good health among middle-aged and older adults in South Korea to mitigate negative mental health consequences during the pandemic.

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Evolving Transmission Network Dynamics of COVID-19 Cluster Infections in South Korea: a descriptive study

10.1101/2020.05.07.20091769 ◽

2020 ◽

Cited By ~ 1

Author(s):

Yejin Kim ◽

Xiaoqian Jiang

Keyword(s):

Older Adults ◽

Nursing Home ◽

South Korea ◽

Transmission Dynamics ◽

Contact Tracing ◽

Transmission Network ◽

Middle Aged ◽

Reproduction Numbers ◽

Path Lengths ◽

Middle Aged Adults

AbstractBackgroundExtensive contact tracing and testing in South Korea allows us to investigate the transmission dynamics of the COVID-19 into diverse local communities.ObjectiveUnderstand the critical aspects of transmission dynamics in a different age, sex, and clusters with various activities.MethodsWe conducted a retrospective observational study with 3,127 confirmed cases’ contact tracing data from the Center for Disease and Prevention (CDC) of South Korea. We investigated network property concerning infected persons’ demographics and different infection clusters.FindingsOverall, women had higher centrality scores than men after week four, when the confirmed cases rapidly increased. Older adults have higher centrality than young/middle-aged adults after week 9. In the infection clusters, young/middle-aged adults’ infection clusters (such as religious gatherings and gym facilities) have higher average path lengths and diameter than older adult’s nursing home infection clusters.InterpretationSome women had higher reproduction numbers and bridged successive transmission than men when the confirmed cases rapidly increased. Similarly, some older adults (who were not residents of nursing homes) had higher reproduction numbers and bridged successive transmission than young/middle-aged adults after the peak has passed. The young/middle-aged adults’ religious gatherings and group workout have caused long successive transmissions. In contrast, the older adults’ nursing homes were a small world where the transmissions within a few steps can reach out to many persons.FundingUT Startup award, UT STARs award, and Cancer Prevention Research in Texas, and National Institute of General Medical SciencesResearch in contextEvidence before this study:On May 1, 2020, PubMed query (“COVID-19” OR “SARS-nCoV-2” OR “novel coronavirus” OR “nCoV”) AND (“transmission network” OR “transmission dynamics” OR “transmission pattern” OR “centrality”) AND (“cluster” OR “community”) yield eight peer-reviewed papers. These papers have provided an evolving epidemiology and transmission dynamics via estimated reproduction number. However, most of them have focused on the entire system in one location and there was no comparison between transmission dynamics of different clusters.Added value of this study:This study, to the best of our knowledge, is the first to compare the transmission dynamics of different cluster infections. We present the transmission dynamic with varying levels of granularity: entire country vs cluster infections as a longitudinal view. From the whole country-level analysis, we found that females have higher centrality (degree or betweenness) than males. From the cluster infection view, we found that young/middle-aged adults’ infection clusters (such as religious gatherings and gym facilities) have higher average path lengths and diameter than older adult’s nursing home infection clusters.Implications of all the available evidence:This study sheds light on different transmission dynamics concerning demographics (age and sex) and diverse behavior in cluster infections. These findings are essential for planning tailored policies to diverse communities. Our analysis code is publicly available to adapt to newly reported cases.

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