{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T12:32:56Z","timestamp":1777984376524,"version":"3.51.4"},"update-to":[{"DOI":"10.12688\/f1000research.169634.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000}}],"reference-count":18,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>Background The aim of this study is to evaluate the long-term psychological impact of the COVID-19 pandemic on students and technical personnel at healthcare institutions, with a focus on levels of depression, anxiety, and stress. Methods A total of 250 participants were included, comprising 130 students from health sciences and 120 individuals from technical fields. In total, 164 participants were females, and 192 participants were aged \u226420 years. A cross-sectional study was conducted using a self-administered electronic questionnaire. The Depression, Anxiety, and Stress Scale (DASS-21), followed by the Impact of Event Scale-Revised (IES-R), was used to retrospectively assess psychological distress linked to the pandemic. The data were analysed via the chi-square test. Results DASS severity ratings revealed that 41.3% of participants aged \u226420 years experienced severe or extremely severe anxiety, which was statistically significant (p = 0.013). The stress scores were also significantly higher in this age group (p = 0.004). Binary logistic regression analysis indicated that younger age and female sex were significantly associated with increased odds of depression and stress. Males had comparatively lower odds of experiencing psychological distress. Participants from technical fields demonstrated higher odds of anxiety and stress, although not of depression. Conclusion The long-term psychological impact of the COVID-19 pandemic appears to be more pronounced among younger individuals, females, and technical staff in healthcare institutions. Although students may have greater awareness about the disease, this awareness may contribute to heightened psychological distress.<\/ns3:p>","DOI":"10.12688\/f1000research.169634.2","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T09:34:08Z","timestamp":1768383248000},"page":"862","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-term Psychological Impact of the COVID-19 Pandemic: A Cross-Sectional Survey among Students and Technical Staff in Health Care Institutions"],"prefix":"10.12688","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4996-448X","authenticated-orcid":false,"given":"Vignesh","family":"Kamath","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8056-906X","authenticated-orcid":false,"given":"Ann","family":"Sales","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2401-7467","authenticated-orcid":false,"given":"Umesh","family":"Pai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2686-0397","authenticated-orcid":false,"given":"Srikant","family":"N.","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abhinav","family":"Bhargava","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vaishnavi","family":"Jalaj","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e0238162","DOI":"10.1371\/journal.pone.0238162","article-title":"Depression and anxiety among university students during the COVID-19 pandemic in Bangladesh: A web-based cross-sectional survey.","volume":"15","author":"M Islam","year":"2020","journal-title":"PLoS One."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"779-788","DOI":"10.1016\/j.dsx.2020.05.035","article-title":"Psychosocial impact of COVID-19.","volume":"14","author":"S Dubey","year":"2020","journal-title":"Diabetes Metab. 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Psych."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"471-488","DOI":"10.1007\/s12626-021-00089-2","article-title":"Depression, anxiety, and stress during times of COVID-19: An analysis of youngsters studying in higher education in India.","volume":"15","author":"H Verma","year":"2021 Nov","journal-title":"The Review of Socionetwork Strategies."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"3744-3747","DOI":"10.1017\/S003329172000392X","article-title":"A repeated cross-sectional survey assessing university students\u2019 stress, depression, anxiety, and suicidality in the early stages of the COVID-19 pandemic in Poland.","volume":"52","author":"A Debowska","year":"2020","journal-title":"Psychol. 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We have addressed each point in detail below and revised the manuscript accordingly.  \n<b>1. Clarification of Population (PICO \u2013 Population)<\/b> \n<b>Reviewer comment:<\/b> The population should be clearly defined, including student categories, technical staff roles, and the nature of healthcare institutions. \n<b>Response:<\/b> We have revised the \n<i>Materials &amp; Methods<\/i> section to explicitly define the study population. Student participants are now clearly described as undergraduate students, postgraduate students, and interns. Technical staff are specified as laboratory technicians, clinical assistants, and administrative support personnel involved in healthcare education or delivery. Additionally, the participating institutions are described as healthcare-related academic institutions, and the limited institutional setting has been acknowledged as a factor affecting generalizability.  \n<b>2. Rationale for Use of DASS-21 and IES-R (Intervention)<\/b> \n<b>Reviewer comment:<\/b> A rationale should be provided for the concurrent use of DASS-21 and IES-R. \n<b>Response:<\/b> We have added a clear justification in the \n<i>Materials &amp; Methods<\/i> section explaining that DASS-21 was used to assess generalized emotional states (depression, anxiety, and stress), while the IES-R was employed to capture trauma-related distress linked specifically to the COVID-19 pandemic. The complementary nature of these instruments is now explicitly stated, highlighting their combined value in providing a comprehensive assessment of long-term psychological impact.  \n<b>3. Absence of Baseline Data and Confounders (Comparator)<\/b> \n<b>Reviewer comment:<\/b> The lack of pre-pandemic baseline data should be acknowledged, and potential confounders should be discussed. \n<b>Response:<\/b> We have explicitly acknowledged the absence of baseline pre-pandemic mental health data in both the \n<i>Materials &amp; Methods<\/i> and \n<i>Limitations<\/i> sections. The manuscript now clarifies that findings should be interpreted as indicative of persistent psychological symptoms rather than causal effects. We have also discussed unmeasured confounding factors, including prior mental health status, socioeconomic variables, and workload differences, and acknowledged their potential influence on outcomes.  \n<b>4. Sample Size, Generalizability, and Study Design (Outcome)<\/b> \n<b>Reviewer comment:<\/b> Limitations related to sample size, institutional setting, and cross-sectional design should be stated. \n<b>Response:<\/b> The manuscript has been revised to clarify that the sample size (n = 250) is adequate for a cross-sectional analysis but limits broader generalizability. The cross-sectional design and its inability to assess causality or longitudinal trends are now clearly discussed in the \n<i>Limitations<\/i> section.  \n<b>Overall Response<\/b> We believe that these revisions have improved the clarity, methodological transparency, and interpretative balance of the manuscript. The limitations are now explicitly acknowledged, the rationale for methodological choices is clearer, and the study\u2019s contribution to understanding long-term psychological effects of COVID-19 among healthcare-associated populations is more clearly articulated.","URL":"https:\/\/f1000research.com\/articles\/14-862\/v2#referee-comment-15237","order":2,"name":"referee-comment-15237","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.195093.r413192, Rachana Prabhu, Yenepoya Dental College, Mangaluru, Karnataka, 24 Jan 2026, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/14-862\/v2#referee-response-413192","order":3,"name":"referee-response-413192","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":4,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}