Objective The aim of this study was to assess COVID-19-related knowledge, attitudes, and preventive practices of two Pakistani university populations. Methods A cross-sectional study was conducted among students and employees of two higher education institutions in Lahore, Pakistan, namely the University of Lahore and the Gulab Devi Educational Complex. Participants were recruited using a convenient sampling method. A validated 45-item, self-administered questionnaire was used to collect data. Total possible scores were 0-14 for knowledge (scores < 7, 7-10 and > 10 were considered to indicate poor, moderate and good knowledge, respectively); 0-7 for attitude (scores > 5 were considered to indicate a good attitude); and 0-18 for COVID-19 preventative practices (scores > 12 were considered to indicate good preventative practices). Results Of the 417 enrolled participants, 416 reported that they were aware of COVID-19 and social media was the major source of their information. Mean scores were 10.12 ± 2.20 for knowledge (good, moderate and poor knowledge in 50.2%, 42.8% and 7.0% of participants, respectively); 5.74 ± 1.28 for attitude (65.4% of individuals had a positive attitude); and 11.04 ± 3.34 for COVID-19 preventative practices (only 36.5% of participants had good preventive practices). Conclusion Pakistani university students and employees have good knowledge and attitudes regarding COVID-19, but unsatisfactory preventive practices. Therefore, health regulators should use multiple communication approaches, such as electronic, print and social media, phone messages, etc., to increase awareness and improve practices related to COVID-19. I use a face mask in the crowds and when I visit healthcare settings nowadays 148 (35.6) 88 (21.2) 104 (25.0) 76 (18.3)

Background: COVID-19 is spreading quickly, causing great deal of fear and unrest in the public. We aimed to assess the psychological impact of COVID-19 on university students and their coping strategies. Methods: This web-based, cross-sectional study was conducted among students of four Pakistani higher education institutions. Google forms were used to disseminate the online questionnaire to assess anxiety (GAD-7), depression (PHQ-9), sources of distress (14-items) and the coping strategies (Brief-COPE). Results: A total of 1134 responses (age 21.7 ± 3.5 years) were included. The frequency of students having moderate-severe anxiety and depression (score ≥ 10) were ≈ 34% and 45%, respectively. The respondents′ aged ≥ 31 years had significantly lower depression score than those below 30 years. Males had significantly less anxiety and depression scores than females. Additionally, those having a family member, friend or acquaintance infected with the disease had significantly higher anxiety score. The main sources of distress were the changes in daily life due to the ongoing pandemic. Regarding coping strategies, majority of respondents were found to have adopted religious/spiritual coping (6.45 ± 1.68) followed by acceptance (5.58 ± 1.65). Conclusions: COVID-19 have significant adverse impact on students′ mental health. The most frequent coping strategy adopted by them are religious/spiritual coping, acceptance, self-distraction and active coping. It is suggested that mental health of students should not be neglected during epidemics.

High levels of stress are expected when crises affect people’s lives. Therefore, this web-based, cross-sectional study was conducted among university students from Pakistan to investigate the psychological impairment and coping strategies during COVID-19 pandemic. Google forms were used to disseminate the online questionnaire to assess anxiety (Generalized Anxiety disorder-7), depression (Patient Health Questionnaire-9) and the coping strategies (Brief-COPE). A total of 1134 responses (age 21.7±3.5 years) were included. The frequency of students having moderate-severe anxiety and depression (score ≥ 10) were ≍ 34% and 45%, respectively. The respondents’ aged ≥ 31 years had significantly lower depression score than those ≤ 20 years (p = 0.047). Males had significantly less anxiety (6.62 ± 5.70 vs 7.84 ± 5.60, p = 0.001) and depression (8.73 ± 6.84 vs 9.71 ± 7.06, p = 0.031) scores. Those having family member, friend or acquaintances infected with disease had significantly higher anxiety score (8.89 ± 5.74 vs 7.09 ± 5.56, p < 0.001). Regarding coping strategies, majority of respondents were found to have adopted religious/spiritual coping (6.45 ± 1.68) followed by acceptance (5.58 ± 1.65), self-distraction (4.97 ± 1.61) and active coping (4.81 ± 1.57). In conclusion, COVID-19 cause significant impairment on mental health of the students. The most frequent coping strategy adopted by students were religious/spiritual and acceptance coping. During epidemics mental health of students should not be neglected.

Introduction: Considering health professionals among high-risk individuals, we aimed to evaluate their knowledge, attitude and practices (KAP) regarding COVID-19. Methodology: This cross-sectional study was conducted among the health professionals (medical doctors, nurses, pharmacists, physiotherapists, hospital technicians and technologists) providing services at seven hospitals of Punjab province of Pakistan. A self-administered questionnaire was used to evaluate knowledge, attitude and practices regarding COVID-19. Results: All of the participants (N = 429) reported that they were aware of COVID-19 and social media was the major source (65%) of this information. Mean knowledge score was 12 ± 2.1, with 75.5% of participants having satisfactory knowledge. Doctors were found to have significantly better knowledge scores than the other health professionals (p = 0.001). Mean attitude score was 8.0 ± 1.2, with a wide majority of health professionals (86.5%) having positive attitudes. Regarding preventive practices, around 64% reported of always covering nose and mouth with a tissue paper during sneezing or coughing and nearly 65% disposed of the dirty tissue paper in trash bin. Only 40% of the participants reported that ‘if they do not have tissue, they cough or sneeze into upper sleeves’. Around 45% reported that they used face mask during their working hours in hospitals nowadays. Mean practice score was 23.3 ± 3.6, with 73.4% of health professionals having satisfactory practices. Conclusions: The overall COVID-19 related KAP of Pakistani health professionals are satisfactory, however some misperceptions and malpractices uncovered in the present study must be addressed to effectively combat COVID-19.

Background: High level stress is expected when crises starts affecting people's lives and communities which is witnessed in the past epidemics. Infectious diseases outbreaks like the ongoing COVID19 pandemic have negative impact on healthcare workers' (HCWs) mental health, which needs to be investigated. Therefore, we aimed to assess the psychological impact of COVID-19 on frontline HCWs and their coping strategies. Methods: A web-based, cross-sectional study was conducted among HCWs of the Punjab province of Pakistan. The generalized anxiety scale (GAD-7), patient health questionnaire (PHQ-9) and Brief-COPE were used to assess anxiety, depression and coping strategies of the respondents. Results: The mean age of respondents (N = 398) was 28.67 ± 4.15 years, with majority of medical doctors (52%). The prevalence of anxiety and depression were 21.4% and 21.9%, respectively. There was no significant difference of anxiety and depression scores among doctors, nurses and pharmacists. Females had significantly higher anxiety (p = 0.003) and depression (p = 0.001) scores than males. Moreover, HCWs performing duties in COVID-19 ICU had significantly higher anxiety score than those from isolation wards (p = 0.020) and other departments (p = 0.014). Depression, not anxiety, score were higher among those who did not receive the infection prevention training. Most frequently adopted coping strategy was religious coping (5.98 ± 1.73) followed by acceptance (5.59 ± 1.55) and coping planning (4.91 ± 1.85). Conclusion: A considerable proportion of HCWs are having generalized anxiety and depression during the ongoing COVID-19 pandemic. Our findings call for interventions to mitigate mental health risks in HCWs.