Estimating the prevalence of stress among Indian students during the COVID-19 pandemic: A cross-sectional study from India

Abstract

Objective
Since December 2019, the COVID-19 pandemic has posed a substantial threat with its associated high mortality, infection, and risk of psychological stress. A large number of students are affected because of a prolonged break from academic activities and staying at home. The focus of this study is to understand the stress levels of Indian students, any psychological imbalances, and their major hurdles during the COVID-19 lockdown.

Methods
Using a snowball sampling method, an online survey of the Perceived Stress Scale (PSS) was conducted on students across India. Along with their demographic details, the participants also reported their study patterns and challenges during their confinement period. The statistical scores for the responses were calculated and the demographic variables analysed. The levels indicated by the PSS were compared, and variance and regression analyses were performed.

Results
We observed that students were generally stressed during lockdown and the pandemic. Females (mean = 3.03) were more stressed than males (mean = 2.61) as they were constantly under pressure because of stressful life events (OR = 0.752, 95% CI = 2.425–310.642) and apprehensive about their studies (RII = 0.67, OR = 2.168, 95% CI = 0.332–6.691).

Conclusion
During the pandemic, students’ mental health needs to be continually monitored as they are stressed owing to fear as well as about their studies and future careers.

Full text

Original Article
Estimating the prevalence of stress among Indian students during the
COVID-19 pandemic: A cross-sectional study from India
Bijoy Chhetri, M. Tech
a
, Lalit M. Goyal, PhD
a
, Mamta Mittal, PhD
b
and
Gopi Battineni, PhD
c
,
*
a
Department of CE, JC Bose University of Science and Technology, YMCA, Faridabad, India
b
Department of CSE, G B Pant Government Engineering College, Okhla, New Delhi, India
c
Department of Medical Informatics, School of Medicinal and Health Products Sciences, University of Camerino, Camerino,
Italy
Received 31 August 2020; revised 17 December 2020; accepted 21 December 2020; Available online 18 January 2021
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Abstract
Objective: Since December 2019, the COVID-19
pandemic has posed a substantial threat with its associ-
ated high mortality, infection, and risk of psychological
stress. A large number of students are affected because of
a prolonged break from academic activities and staying at
home. The focus of this study is to understand the stress
levels of Indian students, any psychological imbalances,
and their major hurdles during the COVID-19 lockdown.
Methods: Using a snowball sampling method, an online
survey of the Perceived Stress Scale (PSS) was conducted
on students across India. Along with their demographic
details, the participants also reported their study patterns
and challenges during their confinement period. The
statistical scores for the responses were calculated and the
demographic variables analysed. The levels indicated by
the PSS were compared, and variance and regression
analyses were performed.
Results: We observed that students were generally
stressed during lockdown and the pandemic. Females
(mean ¼3.03) were more stressed than males
(mean ¼2.61) as they were constantly under pressure
because of stressful life events (OR ¼0.752, 95%
CI ¼2.425e310.642) and apprehensive about their
studies (RII ¼0.67, OR ¼2.168, 95% CI ¼0.332
e6.691).
Conclusion: During the pandemic, students’ mental
health needs to be continually monitored as they are
stressed owing to fear as well as about their studies and
future careers.
*Corresponding address: School of Medicinal and Health Prod-
ucts Sciences, University of Camerino, Via Madonna Delle Carceri
9, Camerino, 62032, Italy.
E-mail: gopi.battineni@unicam.it (G. Battineni)
Peer review under responsibility of Taibah University.
Production and hosting by Elsevier
Taibah University
Journal of Taibah University Medical Sciences
www.sciencedirect.com
1658-3612 Ó2021 The Authors.
Production and hosting by Elsevier Ltd on behalf of Taibah University. This is an open access article under the CC BY license (http://
creativecommons.org/licenses/by/4.0/). https://doi.org/10.1016/j.jtumed.2020.12.012
Journal of Taibah University Medical Sciences (2021) 16(2), 260e267

Keywords: COVID-19 epidemic; Demographics; Indian stu-
dents; Psychological stress; Snowball sampling
Ó2021 The Authors.
Production and hosting by Elsevier Ltd on behalf of Taibah
University. This is an open access article under the CC BY
license (http://creativecommons.org/licenses/by/4.0/).
Introduction
The novel coronavirus (that causes COVID-19) has for
many months been a global phenomenon. With its rapid
spread rate, it has caused major disruptions to the liveli-
hoods of people worldwide.
1,2
As of 30 November 2020, the
pandemic had caused nearly 1.46 million deaths of 63.1
million confirmed cases, and put people under
tremendous psychological pressure.
3
Specifically,
isolation, engaging in online classes, frequent network
failure, and peer and parental pressure have added to
students’ perceived stress. As expected, the pandemic has
influenced the psychological health of students
worldwide.
4
Therefore, a sufficient number of the around
3.4 million Indian students enrolled in higher education
may be a victim of such distress.
With more than 9.4 million confirmed cases including
more than 140,000 deaths, India is becoming the second-
highest country hit by the pandemic after the USA. Thus,
to control the spread of COVID-19, educational institutions
like colleges and universities are not opening to students,
thereby obstructing regular educational activities. Students
felt discontinuity during the lockdown even though the state
government issued various educational policies on con-
ducting virtual teaching sessions. Lack of routine student
engagement with their university or college resulted in
isolation, social media addiction, and no physical activities,
which lead to psychological imbalance.
Reportedly, the general public, patients, medical staff,
children, and older adults are highly vulnerable to psycho-
logical health issues during an epidemic.
5
Some studies
highlighted stress among students, although many global
universities are anticipated to have implemented serious
measures to prevent stress among staff and students.
6,7
Pandemics like COVID-19 not only affect daily life activ-
ities, but also create additional delays in academic activities,
which are positively correlated with stress and students’ level
of anxiety.
7
Many countries have encouraged medical students to
collaborate with national health workers in this prevailing
situation. These medical students are under high pressure
and stress because of direct contact with infected people.
8
Because of fear, stress, and anxiety added by COVID-19
infection, students are at high risk of experiencing psycho-
logical issues.
9
A study by Odriozola P. et al. (2020)
confirmed the stress and other severe psychological distress
due to the COVID-19 outbreak among students and
workers in Spanish universities.
10
However, no significant
study has highlighted the mental health of Indian students
during the current pandemic.
Common individual behavioural effects like anxiety,
stress, depression, anger, and post-traumatic stress are so-
cially available disorders affecting people globally. Addi-
tional attributes concerning students’ like substance abuse,
violation of guidelines, peer pressure, and technical glitches
during self-learning activities also affect their psychological
behaviour. Thus, the focus of this study was to bridge the gap
between understanding students’ stress parameters when
academic activities are limited and they are left in isolation.
The study is based on the 10-item Perceived Stress Scale
(PSS), but also considers other factors to proactively identify
the stress level of the student fraternity and reason therefor.
Materials and Methods
Participants
In this study, a survey on the student population was
conducted during the period of home isolation due to the
closure of universities and schools. A cross-sectional preva-
lence study using a simple and convenient snowball sampling
method was performed with a structured online question-
naire based on PSS. The authors developed a self-
constructed questionnaire to retrieve information on atti-
tudes towards stress caused by COVID-19. Information on
basic demographic data, stress prevalence, and attitude to-
wards the stressful event was collected using a Google form
circulated through social media platforms like Facebook,
WhatsApp, and email. When participants agreed and sub-
mitted their response, self-consent was acknowledged. The
criteria for participation in the survey were that participants
had to be aged at least 15 years and understand English well.
Students who did not meet these criteria were excluded. We
randomly selected five local colleges in the capital of Delhi
and surroundings and included students from different
provinces. Participants were asked to name their provinces to
identify the geographical area in which they were residing
when the survey was conducted. The online questionnaire
was delivered to 1536 students and responses were collected
over a period of 30 days.
Once participants submitted their responses using the
Google form along with their email address, they were
assumed to have given consent to participate in the study.
After a month, only 450 (29.3%) students had submitted
their responses to the survey. As per the responses received,
70% of the targeted sample did not respond; thus, they were
considered to have not consented to participate in the study.
Students’ personal information and colleges were kept
confidential after receiving their consent to participate.
Subject screening
The PSS, which is measured on a 10-item Likert scale, was
adopted to identify and screen candidates.
11
This tool has
been used to measure the degree of impact on individuals’
lives of the current situation of stressful events. Only
employing the PSS to measure the level of perceived stress
does not clarify whether stress is increasing because of
B. Chhetri et al. 261

COVID-19 or for other reasons unless separate information
is sought regarding attitude towards the pandemic. There-
fore, we included a few additional questions to understand
students’ attitudes in terms of fear, worry, problems faced
during the period, and why such perceived stress is occurring.
These responses were correlated with the PSS factors and
analysed based on the overall observation.
The PSS includes several direct questions about the cur-
rent level of experienced stress and perceived psychometric
evidence regarding personality and social support.
12
All
questionnaire items are reliable in predicting participants’
level of stress. Though the PSS is temporal and its
predictive validity may decrease over time, it can be used
to determine daily activities, events, and changes in a
situation. PSS scores are obtained by reversing responses
(e.g., 0 ¼4, 1 ¼3, 2 ¼2, 3 ¼1,&4¼0) to the four
positively stated items (items 4, 5, 7, & 8) and then
summing all scale items. The total score of the PSS-10
ranges from 0 to 40, and a higher score indicates a higher
level of perceived stress. Some studies have already proven
that it is reliable and consistent in terms of internal consis-
tency and test-retest reliability across various trial pop-
ulations.
13e15
The Cronbach’s alpha coefficients range from
0.67 to 0.91.
Online questionnaire
In addition to the PSS questionnaire, an online self-
reported questionnaire was used. The prevalence of stress
factors among students was determined though the PSS, but
this measurement did not satisfy our need to know the cor-
relation of the level of stress with the current pandemic sit-
uation. Therefore, a separate assessment in relation to
COVID-19 was performed by seeking additional informa-
tion from the participants. The authors named this attitude
towards COVID-19. The motive was to understand the
reason behind the perceived level of stress based on the
current pandemic and its effects such as institutional clo-
sures, online modes of learning, fear of infection, and so on.
The questionnaire included items to elicit information on
attitude towards COVID-19, willingness towards e-learning,
and major hurdles experienced during the lockdown period,
as shown in Table 1. The PSS scale measured the level of
stress perceived in terms of low, mild, and high. However,
understanding why stress is increasing was examined
through the questionnaire based on the attitude parameters
regarding the pandemic.
These parameters were included to correlate participants’
health status with a stressful life due to COVID-19 and the
sudden change in educational activities.
Statistical and factor analysis
Statistical analysis was performed to describe the co-
efficients to summarise the response data. The mean, median,
and modes were measured to indicate the centroid along with
a variability test using the standard deviation. The Statistical
Package for the Social Sciences (SPSS) version 25 was used
for data analysis. The threshold level of parametric signifi-
cance was p <0.05. Level of perceived stress was classified as
low, mild, and severe.
A factor analysis was performed to identify the positive
and negative psychological aspects of the current pandemic
situation. Regarding reliability, Cronbach’s alpha was higher
than 0.7 after deleting a factor that decreased the impact of
the inter-item relationship. The Relative Importance Index
(RII) was employed for the response variables to rank stress-
related items in the self-reported questionnaire on attitude
towards COVID-19 and academic setbacks due to the
pandemic. In addition, a correlation analysis was conducted
to evaluate the relationship between students’ problems and
the reasons underlying their perceived stress. Along with a
logistic regression, a one-way ANOVA was performed to
check the variance of socio-demographic details, which was
compared with its statistical significance.
Results
Demographic characteristics of participants
Table 2 presents the demographic details of participating
students. Of the sample, 411 (91.33%) students responded to
all questions in the survey. The mean and standard deviation
(SD) of their age is 23.87 5.51 years (range 15e33 years).
Of 411 students, 362 (88.07%) are aged between 19 and 25
years. In addition, 262 (63.7%) are male and 149 (36.3%)
are female. In total, 99% of the students agreed to follow
the health guidelines issued by the government, and 98.7%
were confined at home. The most participants responded
from Sikkim (42%), followed by Delhi (29%), Haryana
(12%), and from other states (17%). Furthermore, 358
(87%) reported being interested in attending online
academic activities and 372 (90%) refrained from the
consumption of licit or illicit drugs during the pandemic.
Table 1: Self-reported questionnaire to determine student
attitude towards the pandemic.
Purpose Questionnaire Item Type of Scale
Fear 1. Are you scared/
stressed by the
COVID-19
pandemic?
Rating Scale (0e4)
Worry 2. Are you worried
about your studies
during this confine-
ment period and
post-opening of the
institution?
Rating Scale (0e4)
Problem 3. What was the major
hurdle during the
COVID-19
lockdown period?
Items (P1: Online Classes,
P2: Food, or P3: Self-
Management)
WHY? 4. Do you think the
above PSS stress
(questions 1e10) is
due to the following:
Likert scale for items
(WHY1: Medical reason,
WHY2: Greater
vulnerability to stressful
life-event elicited
depressive symptoms,
WHY3: Drug & Alcohol,
WHY4: E-learning system,
WHY5: Any other)
Indian student behaviour during COVID-19262

A ManneWhitney U-test was performed to analyse stu-
dents’ psychological concerns during lockdown. An inde-
pendent hypothesis on equal probabilities of all items in the
PSS and other parameters were excluded by the ChieSquare
test, the results of which were highly significant. A null hy-
pothesis was accepted with no difference regarding fear of
COVID-19, and a non-significant difference (p >0.001) was
found for gender. Of the sample, females experienced more
stress (2.36 1.31) than males (2.32 2.01). In addition,
female students are more worried (mean ¼3.03; p <0.001)
about their studies than male students (mean ¼2.61;
p<0.001).
PSS influencing factors and their demographic comparison
Based on the cumulative PSS score, a significant per-
centage of the sample have high and mild stress, although
many have a low level of stress as well. The responses to the
self-reported questionnaire were analysed to identify the level
of fear and concerns due to COVID-19 and online classes, as
shown in Figure 1. The most important factor increasing
students’ level of stress was identified using RII. With [P1:
Online class] as the major hurdle (RII ¼0.67) and [P3:
Self-management (RII ¼0.65)] followed by other essentials
like food and medicine, and the similar approach was applied
to calculate the understanding of WHY. The most often
[WHY2: Greater vulnerability to stressful life-event elicited
depressive symptoms] and [WHY4: Failure to accept E-
learning] were ranked highest, while other factors were not
found to be significant. Considering these factors, students
with mild to high stress can be classified in the 18e25 year
age group (Mean SD ¼2.0141 0.610; CI ¼1.95e2.07).
PSS is a multi-item questionnaire that includes positive
items like ‘how often have you felt confident about your
ability to handle your problems’ and negative items like ‘how
often have you found that you could not cope with all the
things that you had to do?’ Therefore, to identify the sum of
the impact of the variables, a factor analysis of the 10-item
PSS questions was performed using a Principal Component
Analysis (PCA) and Varimax with the Kaiser normalisation
rotation method (KMO). KMO and Bartlett’s Test (0.81)
were conducted before the factor analysis. The analysis cat-
egorised the 10 points into 2 major components: perceived
positive impact (PSS4, PSS5, PSS7, PSS8) with factor
(0.297, 0.065, 0.336, 0.231) and perceived negative
impact of the factor ranking. The final positive and negative
PSS items are correlated (0.967, 0.256) between the two
categories.
To understand the association of attitude variables with
the PSS, a correlation analysis was performed. A strong
positive relationship with the problems of P1: Online classes
(r ¼0.192, p <.001) and P3: Self-management (r ¼0.237,
p<0.001) was observed, as shown in Table 3. The table also
highlights the relationship between the PSS values and
reasons behind perceiving WHY these stress levels are
perceived.
A one-way ANOVA with significant model fit (p <0.05)
and goodness of fit (Pearson Significance: p >0.05) was
obtained through the comparison of PSS by age group and
major hurdles in terms of P1 and P3 along with factors
WHY2 & WHY4. Table 4 shows the significant F values and
mean square values.
A multiple ordinal logistic regression analysis was per-
formed with stress level as the dependent variable, and age
and relative hurdles (P1, P3) as covariate factors. A higher
level of stress was associated with students in the age group
18e25 years with the goodness of fit to observed data
(
c
2¼138.378, p <0.001). The tests on parallel lines were
47
65
49
45
6
0
10
20
30
40
50
60
70
Fear Worries Low Stress Mild Stress High Stress
Figure 1: Distribution of students’ mental state.
Table 2: Socio-demographic details of participants.
Socio-demographic variables N %
Sex
Male 262 63.7
Female 149 36.3
Age Category
15e18 years 35 8.5
19e25 years 362 88.1
26e33 years 14 3.4
Where are they studying?
College 296 72.0
University 104 25.3
School 11 2.7
State of residence
Sikkim 170 41.0
Delhi 122 29.0
Haryana 52 12.0
Services involved in during lockdown
Home confinement 350 85.2
Social services 36 8.8
Essential services 20 4.9
Online class activities
Yes 358 87.1
No 17 4.1
No response 36 8.8
Attempts to take licit/illicit drugs?
Never 372 90.5
Not often 21 5.1
Policy violation
No 384 93.4
Yes 27 6.6
B. Chhetri et al. 263

Table 4: One-way ANOVA for factors influencing the PSS scale.
Predictors Items F Mean Square df p
P1: Hurdle of online classes Never 14.829 491.717 2 <0.001
To some extent
P3: Self-management Too much 26.877 844.692 2 <0.001
WHY 2: Greater vulnerability to a stressful life Never 22.432 656.677 4 <0.001
Almost never
WHY 4: Failure to accept E-learning Sometimes 16.077 496.064 4 <.0001
Fairly often
Very often
Age Group <18
18e25 1.038 0.367 2 >0.05
>26
Table 3: Correlation between PSS and attitude variables.
P1 P3 WHY2 WHY4
P1 Correlation Coefficient 0.112*
Sig. (2-tailed) 0.012
P3 Correlation Coefficient 0.121*1.000
Sig. (2-tailed) 0.014
WHY2 Correlation Coefficient 0.064 0.161** 1.000
Sig. (2-tailed) 0.193 0.001
WHY4 Correlation Coefficient 0.418** 0.237** 0.285** 1.000
Sig. (2-tailed) 0.000 0.000 0.000
PSS scale of Mild to High Stress Correlation Coefficient 0.192** 0.237** 0.329** 0.325**
An asterisk indicates significance at p <0.05.
Table 5: Logistic regression to estimate the prevalence of stress among students.
PSS_Grp
a
SE Sig. Exp(B) 95% CI
LOW Age_grp 1.043 0.206 0.267 [0.035e2.067]
[P1eP3] 0.945 0.203 3.329 [0.522e21.232
0.716 0.000 3.826 [0.941e15.564
0.786 0.091 3.775 [0.809e17.625
0.649 0.145 2.573 [0.721e9.174
[WHY2 & WHY4] 1.231 0.000 101.689 [9.109e1135.179
1.542 0.000 365.327 [17.797e7499.227
1.293 0.001 75.197 [5.962e948.369
1.304 0.105 8.296 [0.644e106.837
1.011 0.128 4.652 [0.641e33.743]
1.032 0.108 5.257 [0.696e39.707]
1.303 0.000 23.473 [1.828e301.490]
0.976 0.672 0.662 [0.098e4.484]
Mild Age_grp 1.039 0.191 0.257 [0.033e1.968]
[P1eP3] 0.932 0.408 2.162 [0.348e13.436]
0.691 0.243 2.239 [0.578e8.675]
0.766 0.603 1.490 [0.332e6.691]
0.621 0.494 1.529 [0.453e5.167]
[WHY2 & WHY4] 0.758 0.000 6.792 [1.538e29.987]
1.192 0.000 24.101 [2.330e249.291]
0.835 0.000 13.256 [2.578e68.165]
0.837 0.833 1.193 [0.231e6.147]
0.952 0.393 2.255 [0.349e14.571]
0.959 0.214 3.292 [0.503e21.560]
1.238 0.000 27.446 [2.425e310.642]
0.835 0.887 1.126 [0.219e5.790]
Bold value presents parameters with no significance.
a
The reference category is high; Nagelkerke pseudo R
2
: 0.34.
Indian student behaviour during COVID-19264

insignificant, and pseudo R square values indicated a 35%
variability. Table 5 provides the results of the regression
analysis. The logistic regression indicates that people with
more anxiety towards online classes (P1) experience mild to
high stress on the PSS (OR ¼2.168, 95% CI ¼0.332e
6.691). The instability due to a problem in managing the
situation (P3) by students (OR ¼23.473, 95%
CI ¼1.828e301.490) is also a factor that increases the
level of stress. In addition, the factors identified by the
PCA and ANOVA are failure to accept E-learning
(OR ¼13.256, 95% CI ¼2.578e68.165) and greater
vulnerability to stressful life events (OR ¼0.752, 95%
CI ¼2.425e310.642), which are also relative risk factors.
Discussion
The study was conducted on Indian students during the
COVID-19 outbreak to assess the factors associated with
psychological disorders during a pandemic situation, stress
in particular. The results show that fear of vulnerability, self-
management, and failure to accept virtual learning impact
the PSS score. Common individual behavioural effects like
anxiety, stress, depression, anger, and post-traumatic stress
are socially available disorders that affect students.
16
The
information and perseverance needed to manage these are
influenced by additional attitude factors including fear and
worries along with violation of guidelines, high pressure,
and technical glitches during academic activities. All these
factors affect students’ psychological behaviour and may
lead to an uncontrollable situation.
Some studies highlighted that any pandemic has its course
of completion, but leaves survivors with distress and asso-
ciated factors like poverty, anxiety, and fear.
17
Therefore, the
authors assessed the level of stress among the student
fraternity its influencing factors. Stress may even lead to
some losing their lives. Moreover, a student who at a
young age is more vulnerable to such a traumatic event
may ultimately do exceptionable things. The survey
indicated that about 25% of students are negatively
affected by the outbreak and have experienced an above
average level of stress. Of these students, 6% have
experienced severe stress, and around 45% mild stress.
The items in the PSS were found to be significantly related
to the factors that led to stress among the students in this
study. The results of the correlation analysis showed that
factors such as being unable to cope with the new paradigm
of teaching-learning and ability to withstand vulnerability to
situations like the recent pandemic are positively related.
This suggests a change in the existing curriculum to ensure an
appropriate fit with the online mode of teaching as well as the
provision of enhanced counselling and guidance regarding
the current situation. However, consuming alcohol and
violation of policies are negatively correlated. With limited
resources available concerning the impact on students’ life
because of COVID-19, the present study also found the
prevalence of stress due to the pandemic. The one-way
ANOVA and multiple logistic regression confirmed the as-
sociation of the PSS with routine academic studies and
confinement due to COVID-19. Previous studies reported
that mental and psychological episodes such as stress and
fear affect the efficacy of life.
12,18
Aligned with the hypothesis of this study,
selfmanagement problems, ongoing academic activities, and
the non-opening of educational institutions were all related
to stress. Similar studies by
7,19
on Chinese students also
reported a psychological imbalance among university
students due to the COVID-19 outbreak. An Italian
study
20
sought to understand how students are coping with
the situation. In some situations, parents are also stressed
by the payment of tuition fees after losing their jobs, which
exacerbates students’ stress.
12
Social support during this
health emergency is thus crucial.
21,22
In this study, students
reported their interest in engaging with social activities that
would help them overcome their fear and anxiety.
College students’ stress regarding COVID-19 may be
related to the effect of the virus on their studies and not being
able to handle the consequences of infection.
23
On the other
hand, their stress may have been caused by gradually losing
attention in their online classes during the confinement
period. It is known that stress and anger may lead to other
negative psychological behaviour and mental illness.
24
This
indicates that the increasing number of days in lockdown
and other government policies could cause students to
worry about their education, growth, and careers, which
further increases their anxiety and fear.
25,26
Furthermore, it
has been seen that in addition to a fear of COVID-19, stu-
dents are also worried about their studies, especially female
students.
27,28
Conclusion
The study focused on the prevalence of stress among
students due to the closure of educational institutions and
prolonged online teaching and learning. Students are worried
about their studies and the difficulties they experience in
managing themselves during the pandemic. The study found
that female students are more concerned about their aca-
demic activities, and that students aged 18e25 years are
more vulnerable to the impact of lockdown. They are
stressed because of the inability to accept the paradigm shift
in academic activities and prolonged period of COVID-19
restrictions. The intention behind the present work was to
provide early evidence of disruptive episodes in terms of
stress due to the closure of universities or colleges that im-
pacts the general health of the people living in such
confinement situations.
Recommendations
During this unwanted pandemic situation, people are
suffering from mental stress and students are among the
worst-hit groups.
29
Since the outbreak, their studies have
been hampered because all educational institutions were
closed and limited to virtual classes. Specifically, it is
recommended that for engineering or medical students,
both oral sessions and practical knowledge are important.
However, confinement at home has meant that practical
sessions are not taking place, leading to a lack of
B. Chhetri et al. 265

motivation regarding academic studies. These factors result
in psychological pressure including depression, stress,
phobia, fear, social disconnection, and so on.
Source of funding
This research did not receive any specific grant from
funding agencies in the public, commercial, or not-for-profit
sectors.
Conflicts of interest
The authors have no conflicts of interest to declare.
Ethical approval
This article does not contain any experimental studies
with human participants or animals performed by any of the
authors. Ethical approval was exempted.
Authors’ contributions
BC, LMG, and MM: Conceived and designed the study,
conducted research, provided research materials, and
collected and organised the data. BC, LMG: Analysed and
interpreted the data. BC, GB: Wrote the initial and final draft
of the article and provided logistic support. All authors have
critically reviewed and approved the final draft and are
responsible for the content and similarity index of the
manuscript.
Acknowledgments
We extend our special thanks to all the students who
participated and helped us in the data collection process.
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How to cite this article: Chhetri B, Goyal LM, Mittal M,
Battineni G. Estimating the prevalence of stress among
Indian students during the COVID-19 pandemic: A cross-
sectional study from India. J Taibah Univ Med Sc
2021;16(2):260e267.
B. Chhetri et al. 267