Factors Associated with Insomnia Symptoms in a Longitudinal Study among New York City Healthcare Workers during the COVID-19 Pandemic

Background: Few studies have examined the longer-term psychological impact of COVID-19 in healthcare workers (HCWs). Purpose: We examined the 10-week trajectory of insomnia symptoms in HCWs during the COVID-19 pandemic. Methods: HCWs completed a web-based survey at baseline (9 April–11 May 2020) and every 2 weeks for 10 weeks. The main outcome was the severity of insomnia symptoms in the past week. Multivariable-adjusted generalized estimating equation analyses examined factors associated with insomnia symptoms. Results: n = 230 completed surveys at baseline. n = 155, n = 130, n = 118, n = 95, and n = 89 completed follow-ups at weeks 2, 4, 6, 8, and 10, respectively. Prevalence of insomnia symptoms of at least moderate severity was 72.6% at baseline, and 63.2%, 44.6%, 40.7%, 34.7%, and 39.3% at weeks 2, 4, 6, 8, and 10, respectively. In multivariable analyses, factors significantly associated with increased odds of insomnia symptoms were younger age (OR: 0.98, 95% CI: 0.96–1.00), working in a COVID-facing environment (OR: 1.75, 95% CI: 1.15–2.67) and hours worked (OR: 1.16, 95% CI: 1.06–1.27). Conclusions: The initial high rates of insomnia symptoms improved as time passed from the peak of local COVID-19 cases but four out of ten HCWs still had moderate-to-severe insomnia symptoms ten weeks after baseline.

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Prevalence, Incidence, and Factors Associated with Posttraumatic Stress at Three-Month Follow-Up among New York City Healthcare Workers after the First Wave of the COVID-19 Pandemic

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph19010262 ◽

2021 ◽

Vol 19 (1) ◽

pp. 262

Author(s):

Ari Shechter ◽

Codruta Chiuzan ◽

Yimeng Shang ◽

Gavin Ko ◽

Franchesca Diaz ◽

...

Keyword(s):

New York ◽

Posttraumatic Stress ◽

Healthcare Workers ◽

Medical Center ◽

Estimating Equation ◽

Generalized Estimating Equation ◽

Ptsd Symptoms ◽

Factors Associated ◽

Increased Risk

Background: Prevalence, incidence, and factors associated with posttraumatic stress disorder (PTSD) symptoms at follow-up among healthcare workers after the first wave of the COVID-19 pandemic are unknown. Methods: A web survey invitation was sent to healthcare worker listservs at a NYC medical center (April, 2020). The Primary Care (PC)-PTSD questionnaire was used to screen for PTSD symptoms at baseline and then every 2 weeks for 10 weeks. Incidence and prevalence of PTSD symptoms were determined at each time point. Multivariable generalized estimating equation models were performed to investigate the factors associated with a positive PC-PTSD screen at follow-up. Results: Median age (interquartile range) of N = 230 participants was 36 (31–48) years; 79.6% were women; 82.6% worked in COVID-19-focused settings. The prevalence of PTSD symptoms decreased from 55.2% at baseline to 25.0% at 10 weeks (p < 0.001). Among participants who had a baseline negative screen for PTSD symptoms, the incidence of PTSD at 10 weeks was 12.2% (p-trend 0.034). In multivariable-adjusted analyses, being a nurse (odds ratio [OR]: 1.70, 95% confidence interval [CI]: 1.06–2.71), female (OR: 3.00, 95% CI: 1.59, 5.72), and working in a COVID-19-focused location (OR: 1.51, 95% CI: 1.02, 2.21) were associated with increased odds of PTSD symptoms at 10-weeks. Conclusions: PTSD symptoms improved over 3 months following the first wave of the COVID-19 pandemic. However, one out of four NYC healthcare workers still had an increased risk for PTSD at 10-weeks. Screening healthcare workers for PTSD symptoms should be considered during the COVID-19 pandemic.

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Self-efficacy and ability to read as factors associated with antiretroviral therapy adherence in an HIV-infected population

International Journal of STD & AIDS ◽

10.1177/0956462418776073 ◽

2018 ◽

Vol 29 (12) ◽

pp. 1154-1164 ◽

Cited By ~ 2

Author(s):

Mark S Dworkin ◽

Apurba Chakraborty ◽

Diana Zychowski ◽

Geri Donenberg ◽

Richard Novak ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Self Efficacy ◽

Cross Sectional Study ◽

Specific Knowledge ◽

Cross Sectional ◽

Antiretroviral Adherence ◽

Factors Associated ◽

The Past ◽

Antiretroviral Therapy Adherence ◽

Multivariable Analyses

Determining the barriers and facilitators of antiretroviral adherence among former and current substance users may be useful in the creation of successful interventions that target this hard-to-reach population. We performed a cross-sectional study of HIV-infected patients (N = 123) prescribed antiretroviral therapy at four Chicago healthcare venues. Bivariate and multivariable analyses were performed to determine factors associated with non-adherence based on definitions of non-adherence (any missed doses) within the past 4-day, 14-day, and 1-month time periods. Factors consistently associated with non-adherence in bivariate and multivariate analyses, regardless of duration of non-adherence definition, were lower confidence in taking medication consistently and less self-reported ability to read. These data reveal the importance of self-efficacy and ability to read (rather than specific knowledge of CD4 and viral load definitions) in the design of interventions in a population of HIV-infected persons with significant substance use.

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Worries and concerns among healthcare workers during the coronavirus 2019 pandemic: a web-based cross-sectional survey

10.1101/2020.06.09.20126045 ◽

2020 ◽

Author(s):

Yuki Sahashi ◽

Hirohisa Endo ◽

Tadafumi Sugimoto ◽

Takeru Nabeta ◽

Kimitaka Nishizaki ◽

...

Keyword(s):

Healthcare Workers ◽

Psychological Impact ◽

Emerging Infectious Diseases ◽

Social Contact ◽

Daily Basis ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Web Based ◽

Family Work ◽

Significant Difference

AbstractBackgroundHealthcare workers (HCWs) treating and caring for patients with emerging infectious diseases often experience psychological distress. However, the psychological impact and behavior change of the coronavirus disease 2019 (COVID-19) pandemic among HCWs are still unknown. This study aimed to investigate the worries and concerns of HCWs regarding the COVID-19 pandemic.MethodsIn this cross-sectional survey, a web-based questionnaire was distributed among HCWs working in hospitals or clinics across Japanese medical facilities from April 20 to May 1, 2020. The questionnaire comprised items on demographics, worries and concerns, perceptions regarding the sufficiency of information, and behavioral changes pertaining to the COVID-19 pandemic.ResultsA total of 4386 HCWs completed the survey; 1648 (64.7%) were aged 30-39 years, 2379 (54.2%) were male, and 782 (18.1%) were frontline HCWs, directly caring for patients with COVID-19 on a daily basis. 3500 HCWs (79.8%) indicated that they were seriously worried about the pandemic. The most frequent concern was the consequence of becoming infected on their family, work, and society (87.4%). Additionally, the majority (55.5%) had restricted social contact and almost all HCWs endorsed a shortage in personal protective equipment (median, 8/9 (interquartile range; 7-9) on a Likert scale). There was no significant difference in the degree of worry between frontline and non-frontline HCWs (8/9 (7-9) vs. 8/9 (7-9), p=0.25). Frontline HCWs, compared to non-frontline HCWs, were more likely to have the need to avoid contact with families and friends (24.8% vs. 17.8%, p<0.001) and indicated that they cannot evade their professional duty during the COVID-19 pandemic (9/9 (7-9) vs. 8/9 (6-9), p<0.001). Further, the extremely low proportion of frontline HCWs reported that they would take a leave of absence to avoid infection (1.2%).ConclusionsBoth frontline and non-frontline HCWs expressed comparable concerns regarding the COVID-19 pandemic. Because HCWs, especially frontline HCWs, reported that they cannot be obliged to do avoid their duty, effective mental health protection strategies should be developed and implemented for HCWs.

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Influenza Vaccination of Healthcare Workers in the United States, 1989-2002

Infection Control and Hospital Epidemiology ◽

10.1086/501538 ◽

2006 ◽

Vol 27 (3) ◽

pp. 257-265 ◽

Cited By ~ 77

Author(s):

Frances J. Walker ◽

James A. Singleton ◽

Pengjun Lu ◽

Karen G. Wooten ◽

Raymond A. Strikas

Keyword(s):

United States ◽

Influenza Vaccination ◽

Healthcare Workers ◽

Pneumococcal Vaccination ◽

The United States ◽

Hepatitis B Vaccination ◽

Cross Sectional ◽

Factors Associated ◽

The Past ◽

History Of

Objectives.We sought to estimate influenza vaccination coverage among healthcare workers (HCWs) in the United States during 1989-2002 and to identify factors associated with vaccination in this group. The Advisory Committee on Immunization Practices (ACIP) recommends annual influenza vaccination for HCWs to reduce transmission of influenza to patients at high risk for serious complications of influenza.Design.Analysis of cross-sectional data from 1989-2002 surveys conducted by the National Health Interview Survey (NHIS). The outcome measure was self-reported influenza vaccination in the past 12 months. Bivariate and multivariate analysis of 2002 NHIS data.Setting.Household interviews conducted during 1989-2002, weighted to reflect the noninstitutionalized, civilian US population.Participants.Adults aged 18 years or older participated in the study. A total of 2,089 were employed in healthcare occupations or settings in 2002, and 17,160 were employed in nonhealthcare occupations or settings.Results.The influenza vaccination rate among US HCWs increased from 10.0% in 1989 to 38.4% in 2002, with no significant change since 1997. In a multivariate model that included data from the 2002 NHIS, factors associated with a higher rate of influenza vaccination among HCWs aged 18-64 years included age of 50 years or older (odds ratio [OR], 1.6; 95% confidence interval [CI], 1.1-2.1), hospital employee status (OR, 1.5; 95% CI, 1.2-1.9), 1 or more visits to the office of a healthcare professional in the past 12 months (OR, 1.5; 95% CI, 1.1-2.2), receipt of employer-provided health insurance (OR, 1.5; 95% CI, 1.1-2.1), a history of pneumococcal vaccination (OR, 3.9; 95% CI, 2.5-6.1), and history of hepatitis B vaccination (OR, 1.9; 95% CI, 1.4-2.4). Non-Hispanic black persons were less likely to be vaccinated (OR, 0.6; 95% CI, 0.5-0.9) than non-Hispanic white persons. There were no significant differences in vaccination levels according to HCW occupation category.Conclusions.Influenza immunization among HCWs reached a plateau during 1997-2002. New strategies are needed to encourage US HCWs to receive influenza vaccination to prevent influenza illness in themselves and transmission of influenza to vulnerable patients.

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Factors associated with COVID-19 vaccine receipt at two integrated healthcare systems in New York City: a cross-sectional study of healthcare workers

BMJ Open ◽

10.1136/bmjopen-2021-053641 ◽

2022 ◽

Vol 12 (1) ◽

pp. e053641

Author(s):

Kristin Oliver ◽

Anant Raut ◽

Stanley Pierre ◽

Leopolda Silvera ◽

Alexander Boulos ◽

...

Keyword(s):

New York ◽

New York City ◽

Healthcare Workers ◽

Primary Outcome ◽

Vaccine Safety ◽

Healthcare Systems ◽

Cross Sectional ◽

Integrated Healthcare ◽

Factors Associated ◽

Roll Out

ObjectivesTo examine the factors associated with COVID-19 vaccine receipt among healthcare workers and the role of vaccine confidence in decisions to vaccinate, and to better understand concerns related to COVID-19 vaccination.DesignCross-sectional anonymous survey among front-line, support service and administrative healthcare workers.SettingTwo large integrated healthcare systems (one private and one public) in New York City during the initial roll-out of the COVID-19 vaccine.Participants1933 healthcare workers, including nurses, physicians, allied health professionals, environmental services staff, researchers and administrative staff.Primary outcome measuresThe primary outcome was COVID-19 vaccine receipt during the initial roll-out of the vaccine among healthcare workers.ResultsAmong 1933 healthcare workers who had been offered the vaccine, 81% had received the vaccine at the time of the survey. Receipt was lower among black (58%; OR: 0.14, 95% CI 0.1 to 0.2) compared with white (91%) healthcare workers, and higher among non-Hispanic (84%) compared with Hispanic (69%; OR: 2.37, 95% CI 1.8 to 3.1) healthcare workers. Among healthcare workers with concerns about COVID-19 vaccine safety, 65% received the vaccine. Among healthcare workers who agreed with the statement that the vaccine is important to protect family members, 86% were vaccinated. Of those who disagreed, 25% received the vaccine (p<0.001). In a multivariable analysis, concern about being experimented on (OR: 0.44, 95% CI 0.31 to 0.6), concern about COVID-19 vaccine safety (OR: 0.39, 95% CI 0.28 to 0.55), lack of influenza vaccine receipt (OR: 0.28, 95% CI 0.18 to 0.44), disagreeing that COVID-19 vaccination is important to protect others (OR: 0.37, 95% CI 0.27 to 0.52) and black race (OR: 0.38, 95% CI 0.24 to 0.59) were independently associated with COVID-19 vaccine non-receipt. Over 70% of all healthcare workers responded that they had been approached for vaccine advice multiple times by family, community members and patients.ConclusionsOur data demonstrated high overall receipt among healthcare workers. Even among healthcare workers with concerns about COVID-19 vaccine safety, side effects or being experimented on, over 50% received the vaccine. Attitudes around the importance of COVID-19 vaccination to protect others played a large role in healthcare workers’ decisions to vaccinate. We observed striking inequities in COVID-19 vaccine receipt, particularly affecting black and Hispanic workers. Further research is urgently needed to address issues related to vaccine equity and uptake in the context of systemic racism and barriers to care. This is particularly important given the influence healthcare workers have in vaccine decision-making conversations in their communities.

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Comparing age and sex trends of chlamydia, gonorrhoea, hepatitis and syphilis infections in Samoa in 2012 and 2017

Western Pacific Surveillance and Response ◽

10.5365/wpsar.2019.10.2.004 ◽

2020 ◽

Vol 11 (1) ◽

pp. 1-6

Author(s):

Robert Carney ◽

Michaela Howells ◽

Aaone Tanumafili ◽

Athena Matalavea ◽

Judith Gafa ◽

...

Keyword(s):

Hepatitis B ◽

Age Groups ◽

Older Age ◽

Chlamydia Infection ◽

Prevention Programming ◽

Sexually Transmitted ◽

Factors Associated ◽

The Past ◽

Younger Age ◽

Older Populations

In Samoa, the seroprevalence rates of sexually transmitted infections other than HIV have been endemically high over the past decade, despite years of prevention programming. Odds ratio and χ2 tests were conducted to compare the rates of positivity of chlamydia, gonorrhoea, hepatitis B and C, and syphilis across age groups from 2012 and 2017 surveillance data in Samoa. Young people aged 15–19 years were significantly more likely to have a chlamydia infection compared to all other age groups in both 2012 and 2017. Hepatitis B infections were more common in males and those aged 30 and above in both 2012 and 2017. Hepatitis C had no significant differences in age, but it was more common in males in 2012 and more common in females in 2017. Older age groups (aged 45 and above) were more likely to have a positive syphilis test in both 2014 and 2017 when compared to those aged 15–24 years. The results of this analysis confirm previously observed trends in Samoa for younger age groups’ prevalence of chlamydia and gonorrhoea, and for older age groups’ prevalence of hepatitis B and C. But the analysis also unexpectedly found that older age groups (aged 45 and above) are more likely to test positive for syphilis (for years 2014 and 2017). Further studies are needed to assess behavioural risk factors associated with older populations in order to explain the increase in risk and to design interventions suited to this demographic.

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Factors associated with COVID-19 vaccine receipt at two integrated healthcare systems in New York City: A Cross sectional study of healthcare workers

10.1101/2021.03.24.21253489 ◽

2021 ◽

Author(s):

Kristin Oliver ◽

Anant Raut ◽

Stanley Pierre ◽

Leopolda Silvera ◽

Alexander Boulos ◽

...

Keyword(s):

New York ◽

New York City ◽

Healthcare Workers ◽

Vaccine Safety ◽

List Type ◽

Cross Sectional ◽

Systemic Racism ◽

Integrated Healthcare ◽

Factors Associated ◽

Vaccine Confidence

ABSTRACTObjectivesTo examine factors associated with COVID-19 vaccine receipt among healthcare workers, including healthcare worker job type, race, and gender, as well as the role of vaccine confidence in decisions to vaccinate, and to better understand specific concerns related to COVID-19 vaccination among healthcare workers.DesignCross-sectional anonymous survey among front-line, support service, and administrative healthcare workers.SettingTwo large integrated healthcare systems (one private and one public) in New York City during the initial rollout of the COVID-19 vaccine among healthcare workers.Participants1,933 healthcare workers, including nurses, physicians, allied health professionals, environmental services staff, researchers, and administrative staff.Main Outcome MeasuresThe primary outcome was COVID-19 vaccine receipt during the initial rollout of the vaccine among healthcare workers.ResultsAmong 1,933 healthcare workers who had been offered the vaccine, 81% had received the vaccine at the time of the survey. Receipt was lower among Black (58%) compared with White (91%) healthcare workers; and lower among Hispanic (69%) compared with non-Hispanic (84%) healthcare workers. Among healthcare workers with concerns about COVID-19 vaccine safety, 65% received the vaccine. Among healthcare workers who agreed with the statement that the vaccine is important to protect family members, 86% were vaccinated. Of those who disagreed, 25% received the vaccine. Across all participants, 27% expressed concern about being experimented on with the COVID-19 vaccine. In a multivariable analysis, concern about being experimented on with the COVID-19 vaccine, concerns about COVID-19 vaccine safety, lack of influenza vaccine receipt, disagreeing that COVID-19 vaccination is important to protect family members, and Black race were independently associated with COVID-19 vaccine non-receipt. Over 70% of all healthcare workers responded that they had been approached for vaccine advice multiple times by family, community members, and patients.ConclusionsOur data demonstrated high overall receipt among healthcare workers. Even among healthcare workers with concerns about COVID-19 vaccine safety, side effects, or being experimented on, over 50% received the vaccine. Attitudes around the importance of COVID-19 vaccination to protect others played a large role in healthcare workers’ decisions to vaccinate. We observed striking inequities in COVID-19 vaccine receipt, particularly affecting Black and Hispanic workers. Further research is urgently needed in developing strategies with healthcare workers to address issues related to vaccine equity and uptake in the context of systemic racism and barriers to care. This is particularly important given the influence healthcare workers have in vaccine decision-making conversations in their communities.SUMMARY BOXESWhat is already known?High uptake of effective COVID-19 vaccines among healthcare workers is critical to pandemic response.In studies of potential COVID-19 vaccine acceptance prior to COVID-19 vaccine availability, people who identified as Black were less likely to indicate they would accept the vaccine.Understanding reasons why some healthcare workers chose not to get the COVID-19 vaccine will help us develop interventions to improve COVID-19 vaccine confidence among healthcare workers and in their communities.What this study addsWe demonstrate high receipt of COVID-19 vaccines in the initial rollout among healthcare workers.Attitudes around the importance of COVID-19 vaccination to protect others played a large role in healthcare workers’ decisions to vaccinate.We observed substantially lower rates of receipt among Black and Hispanic healthcare workers, independent of differences in vaccine-related beliefs. A quarter of healthcare workers expressed concerns about being experimented on. These results suggest systemic racism may be a critical barrier to equitable vaccination.Our results highlight that healthcare workers of all types, including those with non-patient-facing roles, play an important role as sources of COVID-19 vaccine information in their communities.

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Factors Associated With Healthcare Workers' Insomnia Symptoms and Fatigue in the Fight Against COVID-19, and the Role of Organizational Support

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.652717 ◽

2021 ◽

Vol 12 ◽

Author(s):

Xia Zou ◽

Shaokun Liu ◽

Jie Li ◽

Wen Chen ◽

Jiali Ye ◽

...

Keyword(s):

Risk Factors ◽

Organizational Support ◽

Healthcare Workers ◽

Organizational Level ◽

Point Scale ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Factors Associated ◽

Positive Effects ◽

Insomnia Symptoms

Background: Healthcare workers (HCWs) have been exposed to increased risks of insomnia and fatigue during the COVID-19 pandemic. In this study, we identify important risk factors associated with insomnia symptoms and fatigue among HCWs, and evaluate the effect of organizational support on insomnia and fatigue symptoms.Methods: This is an online cross-sectional survey of HCWs in China administered during the COVID-19 epidemic (from February 27, 2020 to March 12, 2020). We employed the AIS-8 scale for insomnia screening, and a self-reported ten-point scale to evaluate subjects' degrees of fatigue. We also designed a four-point scale to assess the degree of social support provided on an organizational level. Additionally, we conducted logistic regression analysis to identify risk factors.Results: This study included a total of 3,557 participants, 41% of which consisted of non-frontline HCWs and 59% of which was frontline HCWs. Of the non-frontline HCWs, 49% reported insomnia symptoms, and 53.8% reported a moderate to high degree of fatigue. Meanwhile, among the frontline HCWs, the percentages for insomnia and moderate to high fatigue were 63.4% and 72.2%, respectively. Additionally, frontline HCWs and HCWs employed at Centers for Disease Control and Prevention (CDCs) had elevated risks of insomnia and fatigue. However, with increased organizational support, insomnia symptoms decreased among frontline HCWs. Also, organizational support mitigated the positive correlation between daily working hours and degree of fatigue among HCWs.Conclusion: Frontline HCWs and staff in Chinese CDCs have been at a high risk of insomnia symptoms and fatigue during the fight against COVID-19. This study provides evidence for the positive effects of organizational support in relation to insomnia and fatigue among HCWs. This sheds light on government responses to the COVID-19 epidemic for other countries.

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Molecular epidemiology of tuberculosis after declining incidence, New York City, 2001–2003

Epidemiology and Infection ◽

10.1017/s0950268806007278 ◽

2006 ◽

Vol 135 (4) ◽

pp. 634-643 ◽

Cited By ~ 16

Author(s):

C. R. DRIVER ◽

B. KREISWIRTH ◽

M. MACARAIG ◽

C. CLARK ◽

S. S. MUNSIFF ◽

...

Keyword(s):

United States ◽

New York ◽

New York City ◽

York City ◽

The United States ◽

Recent Infection ◽

Factors Associated ◽

Younger Age ◽

Genotype Clustering ◽

Active Disease

SUMMARYTuberculosis incidence in New York City (NYC) declined between 1992 and 2000 from 51·1 to 16·6 cases per 100 000 population. In January 2001, universal real-time genotyping of TB cases was implemented in NYC. Isolates from culture-confirmed tuberculosis cases from 2001 to 2003 were genotyped using IS6110and spoligotype to describe the extent and factors associated with genotype clustering after declining TB incidence. Of 2408 (91·8%) genotyped case isolates, 873 (36·2%) had a pattern indistinguishable from that of another study period case, forming 212 clusters; 248 (28·4%) of the clustered cases had strains believed to have been widely transmitted during the epidemic years in the early 1990s in NYC. An estimated 27·4% (873 minus 212) of the 2408 cases were due to recent infection that progressed to active disease during the study period. Younger age, birth in the United States, homelessness, substance abuse and presence of TB symptoms were independently associated with greater odds of clustering.

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The Italian Covid-19 Psychological Research Consortium ( IT C19PRC): General Overview and Replication of the UK study

10.31234/osf.io/cu6fk ◽

2020 ◽

Author(s):

Giovanni Bruno ◽

Anna Panzeri ◽

Umberto Granziol ◽

Fabio Alivernini ◽

Andrea Chirico ◽

...

Keyword(s):

Psychological Health ◽

Traumatic Stress ◽

Psychological Impact ◽

Psychological Research ◽

Factors Associated ◽

Younger Age ◽

Research Consortium ◽

The Uk ◽

Anxiety Depression ◽

The Relationship

Background: The Covid-19 pandemic represents a major stressor for the psychological health of people worldwide. In the UK, the Covid19-Psychological Research Consortium Study (C19PRC) launched to evaluate the psychological impact of Covid-19 in the general population and its implications. The project was then extended to Italy and several other countries.Purpose: this article provides an overview of the Italian C19PRC study and its replication of two specific findings from the UK C19PRC. In the first part, the relationship between anxiety and somatic symptomatology is examined. In the second part, we analyse the association between several factors and psychological health outcomes: depression/anxiety, traumatic stress, Covid-19 anxiety. Methods: in line with the study conducted in the UK, an online survey was administered to the adult Italian general population. The sample included 1038 respondents (age, mean = 49.94, SD = 16.14; 51.15% females) taken from four regions: Lombardia, Veneto, Lazio e Campania. The relationship between predictors and outcomes was evaluated by means of logistic regression models.Results: somatic indices showed a positive association with anxiety, worse somatic symptoms were associated with having had losses due to Covid-19 and with precarious health conditions. Females showed a higher incidence of psychological issues. No differences in anxiety, depression, and traumatic stress were found across regions but the Campania region showed the most severe somatic symptomatology. In the second analysis, the factors associated with more severe psychological outcomes (i.e., anxiety and/or depression, traumatic stress, and Covid-19 Related Anxiety) were younger age, the presence of minors in the household, traumatic stressors, and precarious health conditions. No differences across regions emerged.Discussions and conclusions: The Italian results correspond to the UK findings for anxiety, depression, and traumatic stress 1. Both in the UK and Italy, the factors associated with worse psychological health were gender (female), younger age, having children, pre-existing health issues (both for oneself or someone close), and the moderate/high perceived risk of contracting Covid-19 within one month. In Italy, unlike the UK, lower household income and having (had) Covid-19 were not associated with poorer mental health. The psychological impact of Covid-19 can last for months; future research should explore all aspects of the psychological burden of Covid-19 in order to implement psychological interventions and promote psychological health.

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