Anxiety and depression among home-quarantined COVID-19 patients: findings from a North African population
6 affiliations
- 1Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, Monastir, Tunisia
- 2Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- 3Technology and Medical Imaging Research Laboratory - LTIM - LR12ES06, University of Monastir, Monastir, Tunisia
- 4Unit of Family Medicine, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- 5Department of Emergency Medicine, Taher Sfar University Hospital, Mahdia, Tunisia
- 6Hygiene Department, Regional Hospital of Ksar Hellal, Faculty of Medicine of Monastir, Monastir, Tunisia
Abstract
Background: The psychological impact of COVID-19 has been widely reported. Although quarantine limited viral spread, it was associated with increased mental health problems. The aim of our study was to estimate the prevalence of anxiety and depression during the COVID-19 quarantine in Monastir and identify their associated factors to better prevent these disorders in future epidemics.
Methods: We conducted a cross-sectional study among COVID-19 patients recruited from the COVID-19 triage unit at Fattouma Bourguiba Hospital in Monastir between February and June 2021. Patients aged 18 years or older diagnosed with COVID-19 and quarantined at home were included. Patients unreachable by phone or unable to complete the telephone questionnaire were excluded. Demographic and clinical data were collected at the triage unit. Ten days after diagnosis, patients were contacted by telephone to assess anxiety and depressive symptoms using the Hospital Anxiety and Depression Scale (HADS) and to report symptom duration and complications.
Results: A total of 383 patients were included in the current study. For anxiety, 6.5% of participants had borderline symptoms, and 13.3% had significant anxiety symptoms. For depression, 8.4% of participants had borderline symptoms, and 16.4% had significant depressive symptoms. Significant anxiety (HADS-A score ≥ 11) was independently associated with female gender (OR = 3.58; 95% CI: 1.42–9.00), persistent symptoms at day 10 (OR = 2.70; 95% CI: 1.25–5.87), fever (OR = 2.64; 95% CI: 1.25–5.57), history of anxiety (OR = 3.32; 95% CI: 1.46–7.53), and oxygen requirement (OR = 5.22; 95% CI: 1.57–17.44). Significant depression (HADS-D score ≥ 11) was independently associated with persistent symptoms at day 10 (OR = 3.26; 95% CI: 1.62–6.58), fever (OR = 2.38; 95% CI: 1.22–4.66), history of depression (OR = 3.97; 95% CI: 1.99–7.91), oxygen requirement (OR = 3.51; 95% CI: 1.07–11.52), health professional status (OR = 2.28; 95% CI: 1.02–5.12), and quarantine with family (OR = 3.16; 95% CI: 1.28–7.82).
Conclusion: Whether during the COVID-19 pandemic or future infectious outbreaks, strict quarantine measures contribute to an increased risk of mental health issues. Multiple risk factors play a role in this phenomenon. These findings highlight the importance of considering mental health in epidemic response strategies to enable early intervention and protect the psychological well-being of quarantined patients.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12879-026-14098-5.
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BibTeX
@article{zemni2026anxiety,
title = {{Anxiety and depression among home-quarantined COVID-19 patients: findings from a North African population}},
author = {Imen Zemni and Amal Elfekih and Syrine Doghri and Amani Maatouk and Meriem Kacem and Cyrine Bennasrallah and Wafa Dhouib and Rafika Ayed and Hadhba Nasraoui and Hela Abroug and Manel Ben Fredj and Inès Bouanene and Asma Sriha Belguith},
journal = {BMC Infectious Diseases},
year = {2026},
month = aug,
doi = {10.1186/s12879-026-14098-5},
url = {https://doi.org/10.1186/s12879-026-14098-5},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Anxiety and depression among home-quarantined COVID-19 patients: findings from a North African population
AU - Imen Zemni
AU - Amal Elfekih
AU - Syrine Doghri
AU - Amani Maatouk
AU - Meriem Kacem
AU - Cyrine Bennasrallah
AU - Wafa Dhouib
AU - Rafika Ayed
AU - Hadhba Nasraoui
AU - Hela Abroug
AU - Manel Ben Fredj
AU - Inès Bouanene
AU - Asma Sriha Belguith
PY - 2026
DA - 2026/08/11
JO - BMC Infectious Diseases
DO - 10.1186/s12879-026-14098-5
UR - https://doi.org/10.1186/s12879-026-14098-5
AB - Background: The psychological impact of COVID-19 has been widely reported. Although quarantine limited viral spread, it was associated with increased mental health problems. The aim of our study was to estimate the prevalence of anxiety and depression during the COVID-19 quarantine in Monastir and identify their associated factors to better prevent these disorders in future epidemics. Methods: We conducted a cross-sectional study among COVID-19 patients recruited from the COVID-19 triage unit at Fattouma Bourguiba Hospital in Monastir between February and June 2021. Patients aged 18 years or older diagnosed with COVID-19 and quarantined at home were included. Patients unreachable by phone or unable to complete the telephone questionnaire were excluded. Demographic and clinical data were collected at the triage unit. Ten days after diagnosis, patients were contacted by telephone to assess anxiety and depressive symptoms using the Hospital Anxiety and Depression Scale (HADS) and to report symptom duration and complications. Results: A total of 383 patients were included in the current study. For anxiety, 6.5% of participants had borderline symptoms, and 13.3% had significant anxiety symptoms. For depression, 8.4% of participants had borderline symptoms, and 16.4% had significant depressive symptoms. Significant anxiety (HADS-A score ≥ 11) was independently associated with female gender (OR = 3.58; 95% CI: 1.42–9.00), persistent symptoms at day 10 (OR = 2.70; 95% CI: 1.25–5.87), fever (OR = 2.64; 95% CI: 1.25–5.57), history of anxiety (OR = 3.32; 95% CI: 1.46–7.53), and oxygen requirement (OR = 5.22; 95% CI: 1.57–17.44). Significant depression (HADS-D score ≥ 11) was independently associated with persistent symptoms at day 10 (OR = 3.26; 95% CI: 1.62–6.58), fever (OR = 2.38; 95% CI: 1.22–4.66), history of depression (OR = 3.97; 95% CI: 1.99–7.91), oxygen requirement (OR = 3.51; 95% CI: 1.07–11.52), health professional status (OR = 2.28; 95% CI: 1.02–5.12), and quarantine with family (OR = 3.16; 95% CI: 1.28–7.82). Conclusion: Whether during the COVID-19 pandemic or future infectious outbreaks, strict quarantine measures contribute to an increased risk of mental health issues. Multiple risk factors play a role in this phenomenon. These findings highlight the importance of considering mental health in epidemic response strategies to enable early intervention and protect the psychological well-being of quarantined patients. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12879-026-14098-5.
SN - 1471-2334
ER -