Global Prevalence of Posttraumatic Stress Disorder (PTSD) during and after Coronavirus Pandemic: A Study Protocol for a Systematic Review and Meta-Analysis


Objective: Studies conducted on severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and COVID-19 epidemics have shown PTSD can occur during and after infectious diseases. However, more studies are needed to explore PTSD during and after COVID-19 outbreak. The objective of this study is to provide a protocol of systematic review and meta-analysis to report the global prevalence of PTSD during and after coronavirus pandemics among general population, health care workers, survivors, or patients with coronaviruses.
Method: We include all studies that reported the prevalence of PTSD during and after coronavirus pandemics and search databases, including Web of Science, PubMed, Scopus, Embase, and Google Scholar from first of November 2002 to May 18, 2020. Two authors independently use relevant checklists to quality assessment of the included studies and extract data. We use the graphical methods and fixed or random effect models to aggregate prevalence estimates. Also, we will assess heterogeneity between the included studies using the I2 heterogeneity statistic and use subgroup and sensitivity analysis to assess the sources of heterogeneity.
Discussion: We infer that PTSD is a common experience during and after infectious disease pandemics, especially COVID-19. The findings of this study can be used by health policymakers and other stakeholders and will provide a path to future studies.

1. Severance EG, Dickerson FB, Viscidi RP, Bossis I, Stallings CR, Origoni AE, et al. Coronavirus immunoreactivity in individuals with a recent onset of psychotic symptoms. Schizophr Bull. 2011;37(1):101-7.
2. McIntosh K, Perlman S. Coronaviruses, Including Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases: Elsevier Inc.; 2014.
3. Boyraz G, Legros DN. Coronavirus Disease (COVID-19) and Traumatic Stress: Probable Risk Factors and Correlates of Posttraumatic Stress Disorder. J Loss Trauma. 2020:1-20.
4. Mahase E. Coronavirus covid-19 has killed more people than SARS and MERS combined, despite lower case fatality rate. BMJ. 2020;368:m641.
5. COVID-19 CORONAVIRUS PANDEMIC 2020 [2020/03/06]. Available from:
6. Dutheil F, Mondillon L, Navel V. PTSD as the second tsunami of the SARS-Cov-2 pandemic. Psychol Med. 2020:1-2.
7. Shuja KH, Aqeel M, Jaffar A, Ahmed A. COVID-19 Pandemic and Impending Global Mental Health Implications. Psychiatr Danub. 2020;32(1):32-5.
8. Lee SH, Shin HS, Park HY, Kim JL, Lee JJ, Lee H, et al. Depression as a Mediator of Chronic Fatigue and Post-Traumatic Stress Symptoms in Middle East Respiratory Syndrome Survivors. Psychiatry Investig. 2019;16(1):59-64.
9. Lee SM, Kang WS, Cho AR, Kim T, Park JK. Psychological impact of the 2015 MERS outbreak on hospital workers and quarantined hemodialysis patients. Compr Psychiatry. 2018;87:123-7.
10. Wu P, Fang Y, Guan Z, Fan B, Kong J, Yao Z, et al. The psychological impact of the SARS epidemic on hospital employees in China: exposure, risk perception, and altruistic acceptance of risk. Can J Psychiatry. 2009;54(5):302-11.
11. Mak IW, Chu CM, Pan PC, Yiu MG, Chan VL. Long-term psychiatric morbidities among SARS survivors. Gen Hosp Psychiatry. 2009;31(4):318-26.
12. Hong X, Currier GW, Zhao X, Jiang Y, Zhou W, Wei J. Posttraumatic stress disorder in convalescent severe acute respiratory syndrome patients: a 4-year follow-up study. Gen Hosp Psychiatry. 2009;31(6):546-54.
13. Lancee WJ, Maunder RG, Goldbloom DS. Prevalence of psychiatric disorders among Toronto hospital workers one to two years after the SARS outbreak. Psychiatr Serv. 2008;59(1):91-5.
14. Su TP, Lien TC, Yang CY, Su YL, Wang JH, Tsai SL, et al. Prevalence of psychiatric morbidity and psychological adaptation of the nurses in a structured SARS caring unit during outbreak: a prospective and periodic assessment study in Taiwan. J Psychiatr Res. 2007;41(1-2):119-30.
15. Lee AM, Wong JG, McAlonan GM, Cheung V, Cheung C, Sham PC, et al. Stress and psychological distress among SARS survivors 1 year after the outbreak. Can J Psychiatry. 2007;52(4):233-40.
16. Kwek SK, Chew WM, Ong KC, Ng AW, Lee LS, Kaw G, et al. Quality of life and psychological status in survivors of severe acute respiratory syndrome at 3 months postdischarge. J Psychosom Res. 2006;60(5):513-9.
17. Wu KK, Chan SK, Ma TM. Posttraumatic stress, anxiety, and depression in survivors of severe acute respiratory syndrome (SARS). J Trauma Stress. 2005;18(1):39-42.
18. Wu KK, Chan SK, Ma TM. Posttraumatic stress after SARS. Emerg Infect Dis. 2005;11(8):1297-300.
19. Lau JT, Yang X, Pang E, Tsui HY, Wong E, Wing YK. SARS-related perceptions in Hong Kong. Emerg Infect Dis. 2005;11(3):417-24.
20. Hawryluck L, Gold WL, Robinson S, Pogorski S, Galea S, Styra R. SARS control and psychological effects of quarantine, Toronto, Canada. Emerg Infect Dis. 2004;10(7):1206-12.
21. Liu N, Zhang F, Wei C, Jia Y, Shang Z, Sun L, et al. Prevalence and predictors of PTSS during COVID-19 outbreak in China hardest-hit areas: Gender differences matter. Psychiatry Res. 2020;287:112921.
IssueVol 15 No 3 (2020) QRcode
No Keywords Keywords

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Salmanian M, Salehi M, Hooshyari Z. Global Prevalence of Posttraumatic Stress Disorder (PTSD) during and after Coronavirus Pandemic: A Study Protocol for a Systematic Review and Meta-Analysis. Iran J Psychiatry. 15(3):252-255.