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Systematic Review

Mental health problems of entrepreneurs during the COVID-19 health crisis: Fear, anxiety, and stress. A systematic review

[version 1; peer review: 1 not approved]
Víctor Hugo Fernández-Bedoya
https://orcid.org/0000-0002-2464-6477
1, Monica Elisa Meneses-La-Riva
https://orcid.org/0000-0001-6885-9207
1, Josefina Amanda Suyo-Vega1, Johanna de Jesús Stephanie Gago-Chávez1
Víctor Hugo Fernández-Bedoya
https://orcid.org/0000-0002-2464-6477
1, Monica Elisa Meneses-La-Riva
https://orcid.org/0000-0001-6885-9207
1, Josefina Amanda Suyo-Vega1, Johanna de Jesús Stephanie Gago-Chávez1
PUBLISHED 31 Aug 2023
Author details Author details
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This article is included in the Society for Mental Health in Low- and Middle-Income Countries (SoMHiL) gateway.

Abstract

Background: The COVID-19 pandemic has had a global impact, affecting millions of people and causing various symptoms, leading to social distancing, and quarantine measures. This has impacted the global economy, employment, and education, resulting in widespread school and business closures. Entrepreneurs have had to face the difficult decision of whether to continue or pause their operations during the pandemic, which could result in mental health problems such as fear, anxiety, or stress. The primary objective of this research is to identify mental health issues faced by entrepreneurs during the pandemic, including the countries of origin, conclusions, and lessons learned.
Methods: A systematic review was conducted in the SCOPUS database, providing 93 initial results that were later filtered, resulting in 18 final records. These records allowed for the identification of scientific evidence detailing the mental health problems that entrepreneurs faced during the COVID-19 pandemic.
Results: We found that the COVID-19 pandemic has presented challenges for entrepreneurs, leading to increased stress and burnout. However, some have coped by seeking support, using digital technology, and adopting innovative business models. Entrepreneurship can positively impact well-being by allowing individuals to pursue meaningful work aligned with their values. Effective communication with customers is essential for maintaining businesses and building loyalty. The pandemic has highlighted the need for specialized psychological support tailored to entrepreneurs' unique challenges. Finally, entrepreneurship can address societal challenges with a focus on social impact and sustainability.
Conclusion: The COVID-19 pandemic has brought about significant challenges for entrepreneurs, resulting in heightened stress and burnout. Despite this, many entrepreneurs have adapted and coped by seeking support, leveraging digital technology, and embracing innovative business models.

Keywords

Mental health, entrepreneurship, COVID-19, business ventures, fear, anxiety, stress

Corresponding author: Víctor Hugo Fernández-Bedoya
Competing interests: No competing interests were disclosed.
Grant information: This study was carried out and funded by the Universidad César Vallejo, within the framework of the work plan outlined in RVI N° 435-2022-VI-UCV.
The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Copyright:  © 2023 Fernández-Bedoya VH et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
How to cite: Fernández-Bedoya VH, Meneses-La-Riva ME, Suyo-Vega JA and Stephanie Gago-Chávez JdJ. Mental health problems of entrepreneurs during the COVID-19 health crisis: Fear, anxiety, and stress. A systematic review [version 1; peer review: 1 not approved]. F1000Research 2023, 12:1062 (https://doi.org/10.12688/f1000research.139581.1) First published: 31 Aug 2023, 12:1062 (https://doi.org/10.12688/f1000research.139581.1) Latest published: 31 Aug 2023, 12:1062 (https://doi.org/10.12688/f1000research.139581.1)

Introduction

COVID-19 is an infectious disease caused by the SARS-CoV-2 virus, which was first detected in Wuhan, China in December 2019 (Yu et al., 2021). Since then, it has become a global pandemic that has affected millions of people worldwide (Wang et al., 2020a; Wu et al., 2020).

Symptoms of COVID-19 can range from mild to severe and include fever, cough, difficulty breathing, headache, fatigue, and loss of smell or taste (Çalıca Utku et al., 2020). The virus primarily spreads through respiratory droplets when an infected person coughs, sneezes, or talks (Esakandari et al., 2020).

The pandemic has had a significant impact on the global economy, causing many businesses to close temporarily or permanently due to decreased demand and supply chain disruptions (Alekseev et al., 2023; Fairlie et al., 2022; Fernández-Bedoya et al., 2021). It has also had a negative impact on employment, with many people losing their jobs or being required to work from home (Galanti et al., 2021; Kramer & Kramer, 2020; Russo et al., 2023; Suhariadi et al., 2023).

In addition, the pandemic has led to widespread school and university closures, resulting in an educational crisis (Gaikwad & Kulkarni, 2021; Ober & Kochmańska, 2022; Pazos et al., 2020; Suyo-Vega, Meneses-La-Riva, Fernández-Bedoya, Alarcón-Martínez, et al., 2022a). It has also had a negative impact on the mental health of many individuals due to social isolation, financial stress, or fear of contracting the virus (Becerra-Medina et al., 2022; Martínez Rodríguez et al., 2020; Meneses-La-Riva et al., 2023; Son et al., 2022; Valero Cedeño et al., 2020).

To prevent further spread of the virus, many countries have implemented social distancing and quarantine measures, such as border closures (De Beukelaer, 2021; Emeto et al., 2021; Grimée et al., 2022; Spennemann, 2021), the shutdown of non-essential businesses (Berg et al., 2021; Murillo VIllanueva et al., 2021; Song et al., 2021), and limitations on social gatherings (Ahmed & Memish, 2020; Guay et al., 2021; Moberly, 2020). Vaccination has also been a crucial tool in the fight against the pandemic (Dagan et al., 2021; Mathieu et al., 2021; Wang et al., 2020b).

Entrepreneurs, as widely recognized, are known for starting with an initial idea and taking the initiative and decisive action to pursue a business project that enables them to enter the market by manufacturing a product or providing a service (Campana Añasco & Chamorro Bacilio, 2022; Fernández-Bedoya, Meneses-La-Riva, Suyo-Vega, & Gago-Chávez, 2023c; Nicolás Martínez & Rubio Bañón, 2023; Rasvanis & Tselios, 2023; Salas Ruiz, 2019; Satar et al., 2023). They have faced the difficult decision of whether to continue, pause, or carry on with their operations throughout the pandemic (Anggadwita et al., 2023; Fernández-Bedoya et al., 2021; Maldonado-Cueva et al., 2023; Ngcongo & Ramraj, 2022; Sahi et al., 2023). These conditions, combined with the uncertain and challenging circumstances, could result in mental health problems, such as fear, anxiety or stress, for example (Khan et al., 2022).

Fear is a universal emotion that arises instinctively and serves a fundamental role in human survival (Ekman, 1992; LeDoux, 2014). This emotional response is triggered by the perception of danger, threat, or uncertainty, and can be evoked by a variety of stimuli, including unfamiliar situations, traumatic events, or physical threats (Lang, 1995). For instance, an entrepreneur may experience fear of failure or contracting COVID-19. This emotion is adaptive, as it facilitates individuals to avoid dangerous situations and take self-protective measures. Nonetheless, excessive fear or fear that occurs in the absence of real threat can become an emotional problem that impairs a person’s daily life (Shin & Liberzon, 2010).

Anxiety is a natural emotional response to perceived threatening or stressful situations (McHugh, 2019; Reddy & Tekulapally, 2022). It is commonly expressed as a feeling of worry, fear, apprehension, or restlessness, and is frequently accompanied by physical symptoms such as palpitations, sweating, tremors, and muscle tension (Stein & Sareen, 2015; Taylor et al., 1991). Anxiety can be evoked by various circumstances, including stressful events, uncertainty, fear of the future, or daily concerns (Blair et al., 2008; Shostak & Peterson, 1990). In contrast to fear, anxiety typically involves a more protracted emotional response over time, whereas fear is usually a more brief and intense reaction (Davis et al., 2011). Anxiety may present as a persistent sense of worry or restlessness, whereas fear is characterized by an intense emotional response that subsides once the danger is eliminated (Shostak & Peterson, 1990).

Stress is also a physiological and emotional response of the body to a situation perceived as a threat or challenge (Chan et al., 2022; Rijal et al., 2023; Suyo-Vega, Meneses-La-Riva, Fernández-Bedoya, Polonia, et al., 2022b). It can be triggered by various factors, such as work pressure (Lovallo et al., 1986; Smith et al., 2019), tight deadlines (Bowen et al., 2013, 2014; Herrero et al., 2012), financial uncertainty (Apouey et al., 2020; Caggiano et al., 2021), market competition (Amable, 2004; Pandey & Sharma, 2016), among others, which are exacerbated during times of COVID-19. In the case of an entrepreneur, stress can result from multiple tasks and responsibilities, such as making important decisions, managing limited resources, and the need to innovate and adapt to rapid and constant changes in the business environment (Fernández-Bedoya, Meneses-La-Riva, Suyo-Vega, Grijalva-Salazar, et al., 2023b; Mark et al., 2008; Vasilescu et al., 2016). Stress in an entrepreneur can develop gradually as pressure increases and responsibilities become more demanding (Cardon & Patel, 2015). The entrepreneur may experience physical and emotional symptoms, such as fatigue, insomnia, irritability, difficulties in concentrating, and an increase in alcohol or tobacco consumption (Palmer et al., 2021). These symptoms can have a negative impact on their cognitive abilities, interpersonal relationships, and ability to perform everyday tasks effectively (Mäkiniemi et al., 2021).

The primary objective of this research was to identify studies that delineate the mental health issues that entrepreneurs faced during the COVID-19 era. The specific objectives were to determine the countries from which these investigations originated, to elaborate on their conclusions and extract the lessons learned in each case.

Methods

In order to achieve the proposed objectives, we conducted a systematic review (Moher et al., 2009). We searched for all scientific research that details the mental health problems that entrepreneurs may have experienced during the health crisis caused by the COVID-19 virus.

The search was conducted on the Scopus database, which is considered to be of high quality and contains information from around the world (Baas et al., 2020). The search was carried out on March 15, 2023, approximately three years after the alert issued by the World Health Organization, which led to the suspension of non-essential businesses worldwide. It is important to note that access to the Scopus database was granted through our credentials provided by Universidad César Vallejo.

In particular, we conducted four search equations, which are detailed in Table 1.

Table 1. Searches.

CodeSearch queryInitial results
S1TITLE-ABS-KEY (entrepreneur AND “mental health” AND COVID-19)20
S2TITLE-ABS-KEY (entrepreneur AND “fear” AND COVID-19)23
S3TITLE-ABS-KEY (entrepreneur AND “anxiety” AND COVID-19)17
S4TITLE-ABS-KEY (entrepreneur AND “stress” AND COVID-19)33

Search Equation 1: TITLE-ABS-KEY (entrepreneur AND “mental health” AND COVID-19). This search resulted in 20 initial records, of which 11 were downloaded directly from Scopus, while 3 had to be downloaded from the journal’s website. 6 records could not be accessed due to various restrictions.

Search Equation 2: TITLE-ABS-KEY (entrepreneur AND “fear” AND COVID-19). The initial results were 23, of which 9 were downloaded directly and 3 through the journal’s website. 11 records could not be accessed due to various restrictions.

Search Equation 3: TITLE-ABS-KEY (entrepreneur AND “anxiety” AND COVID-19). The initial results were 17 documents, 7 of which were downloaded directly from Scopus, and 4 through the journal’s website. 6 records could not be accessed due to various restrictions.

Search Equation 4: TITLE-ABS-KEY (entrepreneur AND “stress” AND COVID-19). This search resulted in 33 initial records, of which 10 were downloaded from Scopus and 4 from the original source. 19 studies could not be downloaded due to lack of access.

Subsequently, some inclusion and exclusion criteria were applied. This allowed us to filter out the records that we intended to evaluate. Regarding the type of scientific evidence, we decided to use only original research, excluding editorials, protocols, and even other review articles. In terms of language, we worked with scientific evidence in English. Specifically, we searched for records that detail mental health problems in entrepreneurs worldwide, so articles that did not meet this condition were excluded. The applied filters resulted in a preliminary result of 26 records. After removing duplicate records, the final result was 18 records.

Four experienced reviewers formed the team responsible for the inclusion criteria screening process in this systematic review. Initially, the team performed a comprehensive assessment of titles and abstracts from all identified records obtained through selected databases and other sources. Subsequently, they obtained full-text reports of potentially relevant records identified during the initial screening. The reviewers meticulously analysed these full-text reports to determine whether they aligned with the predetermined inclusion criteria. To enhance the accuracy and consistency of the screening process, a random sample of records screened by each reviewer underwent verification by another reviewer. This quality assurance measure aimed to identify and address any discrepancies or inconsistencies. The entire screening process, including the total number of records identified, screened, and ultimately included in the review, was thoroughly documented. For clarity and transparency, this information was presented in a PRISMA flow diagram—a visual representation illustrating the systematic progression from record identification to the final inclusion of relevant studies in the review (see Figure 1).

9f17aaa2-113d-4f9b-ac9d-4452516ec420_figure1.gif

Figure 1. Prisma flow chart.

Results

Table 2 displays the 18 identified records, which are indicated by their respective internal codes, citations, original titles, and the scientific journals of publication.

Table 2. Articles identified.

CodeCitationTittleJournal
A1(Messabia et al., 2022)Managing restaurants during the COVID-19 crisis: Innovating to survive and prosperJournal of Innovation & Knowledge
A2(Megat Tajudin et al., 2021)Weathering the Economic Impact of COVID-19: Challenges Faced by Microentrepreneurs and Their Coping Strategies during Movement Control Order (MCO) in MalaysiaPertanika Journal of Social Science and Humanities
A3(Lathabhavan, 2022)COVID-19 and Mental Health Concerns Among Business Owners: a Cross-Sectional Study from IndiaInternational Journal of Mental Health and Addiction
A4(Eib & Bernhard-Oettel, 2023)Entrepreneurial action and eudaimonic well-being in a crisis: Insights from entrepreneurs in Sweden during the COVID-19 pandemicJournal of Affective Disorders
A5(Chandra & Yagnik, 2022)Experience of Perceived Stress and Impact of Health Locus of Control During COVID-19 Pandemic: Investigating Entrepreneurs and Corporate EmployeesSouth Asian Journal of Human Resources Management
A6(Mustafa et al., 2021)Exploring the impact of COVID-19 pandemic on women entrepreneurs in PakistanInternational Journal of Gender and Entrepreneurship
A7(Sornsenee et al., 2022)Factors Associated with Anxiety and Depression Among Micro, Small, and Medium Enterprise Restaurant Entrepreneurs Due to Thailand’s COVID-19-Related Restrictions: A Cross-Sectional StudyRisk Management and Healthcare Policy
A8(Li et al., 2022)How does COVID-19 pandemic affect entrepreneur anxiety? The role of threat perception and performance pressureFrontiers in Psychology
A9(Hwang & Choi, 2021)How Do Failed Entrepreneurs Cope with Their Prior Failure When They Seek Subsequent Re-Entry into Serial Entrepreneurship? Failed Entrepreneurs’ Optimism and Defensive Pessimism and Coping Humor as a ModeratorInternational Journal of Environmental Research and Public Health
A10(Backman et al., 2021)In the Eye of the Storm: Entrepreneurs and Well-Being During the COVID-19 CrisisEntrepreneurship Theory and Practice
A11(Cheng et al., 2022)Maintaining Quality of Life during the Pandemic: Managing Economic, Social, and HealthWell-Being Amid the COVID-19 Crisis of Agricultural EntrepreneursSustainability
A12(Torrès et al., 2022)Risk of burnout in French entrepreneurs during the COVID-19 crisisSmall Business Economics
A13(Popkova et al., 2022)Changing entrepreneurial attitudes for mitigating the global pandemic’s social dramaHumanities and Social Sciences Communications
A14(Khudaykulov et al., 2022)The fear of COVID-19 and job insecurity impact on depression and anxiety: An empirical study in China in the COVID-19 pandemic aftermathCurrent Psychology
A15(Madeira et al., 2020)The Impact of Pandemic Crisis on the Restaurant BusinessSustainability
A16(Lee & Jung, 2021)The Mediating Role of Entrepreneurial Mindset between Intolerance of Uncertainty and Career AdaptabilitySustainability
A17(Caccia et al., 2022)Work, Depression and Pandemic Stress in Times of COVID-19 in Buenos Aires, ArgentinaInterpersona: An International Journal on Personal Relationships
A18(Borowiec & Drygas, 2022)Work–Life Balance and Mental and Physical Health among Warsaw Specialists, Managers and EntrepreneursInternational Journal of Environmental Research and Public Health

Additionally, in order to meet the research objectives, it was identified which country each of the experiences of mental health problems in entrepreneurs during the COVID-19 pandemic belong to, as exposed in the 18 scientific articles. These results are found in Table 3 and Figure 2.

Table 3. Country each article identified.

CodeCountry
A1Canada
A2Malaysia
A3India
A4Sweden
A5India
A6Pakistan
A7Thailand
A8China
A9South Korea
A10Sweden
A11Netherlands
A12France
A13Russia
A14China
A15Portugal
A16South Korea
A17Argentina
A18Poland
9f17aaa2-113d-4f9b-ac9d-4452516ec420_figure2.gif

Figure 2. Country of origin for each record.

Finally, Table 4 presents the conclusions of each article, accompanied by the lessons learned that can be drawn from such research.

Table 4. Conclusions and lessons for each article identified.

CodeConclusionsLessons
A1The article briefly touches upon the challenges faced by restaurants during the COVID-19 pandemic and the need to adapt quickly to survive. It is likely that the pandemic has caused significant stress for restaurant owners and workers, as they had to navigate through uncertainties related to the pandemic, changing regulations, and economic difficulties. Furthermore, the article highlights the importance of effective communication with customers during the crisis. The need to keep customers informed about safety measures and changes in operating procedures can add to the workload and stress levels of restaurant workers.The pandemic has taken a toll on the mental health and well-being of restaurant workers. Supporting employee well-being through mental health resources, work-life balance, and a positive work culture can improve productivity and performance.
A2The article examines the impact of the MCO on the economy and the susceptibility of microentrepreneurs to its effects. It also investigates the measures adopted by microentrepreneurs to counter the impact of the MCO such as obtaining financial aid, adjusting business models, and modifying product offerings. The study's outcomes can guide policymakers and other interested parties in developing more effective approaches to assist microentrepreneurs during times of crisis.Economic stressors can be a significant source of stress for microentrepreneurs during a pandemic such as COVID-19, especially when their business is affected by movement restrictions and supply chain disruptions. Microentrepreneurs in Malaysia experienced multiple stressors during the pandemic, including financial strain, reduced social support, and uncertainty about the future. Coping strategies, such as seeking social support, engaging in problem-solving, and maintaining a positive outlook, can help reduce stress levels among microentrepreneurs during times of crisis.
A3The study specifically focuses on the impact of the pandemic on the psychological distress, anxiety, depression, and stress levels of business owners in India, as well as the coping mechanisms they have used to deal with these mental health concerns. The results of the study provide insights into the mental health challenges faced by business owners in India during the pandemic, and suggest that there is a need for targeted mental health interventions to support this population.The mental health of business owners in India has been greatly affected by the COVID-19 pandemic, resulting in many experiencing elevated levels of psychological distress, anxiety, depression, and stress. To manage their mental health concerns during the pandemic, business owners have resorted to various coping strategies such as seeking social support, engaging in physical exercise, and practicing mindfulness.
A4The article posits that the COVID-19 pandemic has adversely impacted many entrepreneurs; however, it has also presented opportunities for entrepreneurial endeavors, which can positively impact eudaimonic well-being. Eudaimonic well-being refers to a type of well-being that emphasizes personal growth and fulfillment rather than mere satisfaction or happiness. The authors' research indicates that entrepreneurs who took action in response to the crisis had higher levels of eudaimonic well-being than those who did not. Additionally, the authors identified various factors that contribute to the positive relationship between entrepreneurial action and eudaimonic well-being, including a sense of purpose, social support, and personal development.Engaging in entrepreneurial activities during a crisis can positively impact eudaimonic well-being, which refers to a sense of personal growth and fulfillment. Also, the article highlights the importance of having a sense of purpose, social support, and personal development in promoting eudaimonic well-being. Finally, the article suggests that entrepreneurship can provide opportunities for personal growth and development, even in the face of challenging circumstances.
A5The study aimed to investigate the relationship between perceived stress, health locus of control (HLC), and the COVID-19 pandemic, as well as differences in these factors between entrepreneurs and corporate employees. HLC refers to an individual's beliefs about their ability to control their health outcomes. The study found that both entrepreneurs and corporate employees experienced high levels of perceived stress during the pandemic, with entrepreneurs reporting significantly higher levels of stress.The article highlights that the COVID-19 pandemic has caused an increase in perceived stress among entrepreneurs and corporate employees. The study stresses the importance of an individual's Health Locus of Control (HLC) in moderating their stress levels, as those with a higher internal HLC tend to experience lower levels of stress.
A6The study examines the challenges that these entrepreneurs faced due to the pandemic, including financial difficulties, supply chain disruptions, and decreased demand for their products or services. The article also highlights the coping strategies that women entrepreneurs used to overcome these challenges, including innovative business models and the use of digital technology.While the article does not provide specific lessons about stress management, it does demonstrate the importance of resilience and adaptability in the face of challenges, which can be helpful in managing stress.
A7The article investigates the effects of COVID-19-related restrictions on the mental health of Thai restaurant entrepreneurs. The study highlights the adverse outcomes of the pandemic on the restaurant sector in Thailand, where many entrepreneurs are facing economic hardship, low consumer demand, and heightened levels of stress. The research outcomes demonstrate that variables like age, education level, marital status, and financial status are significantly linked to anxiety and depression among restaurant entrepreneurs during the COVID-19 outbreak. The research underlines the necessity for specialized psychological support and interventions tailored to the needs of restaurant entrepreneurs in times of crisis.The article highlights the need for targeted mental health support and interventions for entrepreneurs in the restaurant industry during times of crisis. This is particularly important given the significant impact of the pandemic on the restaurant industry in Thailand and the high levels of stress experienced by entrepreneurs in this sector.
A8The study examines how threat perception, or the perception of the pandemic as a threat to one's business, and performance pressure, or the pressure to maintain or improve business performance during the pandemic, contribute to increased anxiety levels among entrepreneurs. The article discusses the findings of a survey-based study conducted with a sample of entrepreneurs in China, and provides implications for managing entrepreneur anxiety during the pandemic.The article suggests that providing support to entrepreneurs during the pandemic could help to mitigate the negative impact on their mental health. This could include providing resources for stress management or offering financial support. Seeking support from friends, family, or mental health professionals can also be beneficial for individuals experiencing anxiety or other mental health concerns.
A9The study suggest that failed entrepreneurs who display defensive pessimism and use coping humor are more likely to cope with failure positively and successfully re-enter entrepreneurship. However, excessive optimism can hinder their ability to learn from failure and negatively impact their chances of success.Defensive pessimism involves anticipating failure and imagining worst-case scenarios, which can help individuals prepare for setbacks and reduce anxiety. Coping humor refers to using humor to cope with stress and difficult situations, which can help individuals maintain a positive outlook and reduce negative emotions.
A10The article examines the unique challenges faced by entrepreneurs during the pandemic, including financial difficulties, social isolation, and uncertainty about the future. The article also discusses strategies that entrepreneurs can use to cope with the stress and anxiety caused by the pandemic, such as seeking social support, practicing mindfulness, and maintaining a healthy work-life balance.The article suggests that entrepreneurs prioritize their mental health by seeking social support, practicing mindfulness, and maintaining a healthy work-life balance. It also suggests that organizations and policymakers play a role in supporting the mental health needs of entrepreneurs by providing resources and support for mental health and well-being.
A11The article investigates the effect of the COVID-19 pandemic on the economic, social, and health well-being of agricultural entrepreneurs, and identifies the obstacles encountered by such individuals as a result of the pandemic. The research also delineates the approaches used by agricultural entrepreneurs to preserve their quality of life, including the adoption of innovative and diversified business practices, collaboration with peers, and obtaining support from their social networks. The results demonstrate that agricultural entrepreneurs were faced with a range of issues stemming from the pandemic, such as decreased demand for their products, disruptions in supply chains, and heightened levels of stress and anxiety.The study found that agricultural entrepreneurs who sought support from their social networks experienced better mental health outcomes compared to those who did not seek support. The study also found that the ability to adapt to changing circumstances and maintain resilience was critical for agricultural entrepreneurs to maintain their mental health during the pandemic.
A12According to the study, the COVID-19 pandemic has had a notable impact on the likelihood of burnout among entrepreneurs in France, with over half of the participants experiencing high levels of burnout. The researchers also identified various contributing factors to the increased risk of burnout, such as reduced turnover, augmented workload, and social isolation. These findings offer valuable insights into the psychological repercussions of the pandemic on entrepreneurs and emphasize the significance of providing supportive measures and resources to assist them in coping with the stress and difficulties of the crisis. The study's conclusions have broader implications for entrepreneurs worldwide facing comparable challenges during the pandemic.Providing support and resources to entrepreneurs can help them cope with the stress and challenges of the crisis and reduce the risk of burnout. Policymakers, support organizations, and investors need to be aware of the psychological impacts of the pandemic on entrepreneurs and consider measures to address these concerns.
A13The article posits that the COVID-19 pandemic has presented an opening for entrepreneurs to utilize their expertise and resources to tackle societal hurdles, such as developing remedies for remote work, healthcare, and education. The authors recommend a change in entrepreneurial mindset that values social impact and sustainability over profit maximization. The article also presents multiple case studies of companies that have altered their focus to address pandemic-related difficulties, including the production of personal protective equipment, development of COVID-19 tests, and provision of essential goods and services. The authors argue that these examples underscore the potential of entrepreneurship to foster constructive change in times of crisis.The article stresses the significance of providing mental health resources and support to entrepreneurs during the COVID-19 pandemic to help them cope with the stress and anxiety resulting from the crisis. The article also emphasizes the value of social support networks for entrepreneurs, as engaging with others in comparable situations could mitigate feelings of loneliness and isolation.
A14The study focuses on exploring the association between the COVID-19 related fear and job insecurity with psychological indications of depression and anxiety. The findings suggest that there is a positive association between fear of COVID-19 and job insecurity with symptoms of depression and anxiety. Additionally, the investigation discloses that individuals with increased levels of social support exhibit decreased levels of depression and anxiety.It is crucial to address mental health issues during and after a pandemic. The findings of the study suggest that there is a need to pay attention to mental health issues during and after a pandemic, as fear of COVID-19 and job insecurity can contribute to symptoms of depression and anxiety.
A15In this article, the authors investigate the effects of the COVID-19 pandemic on restaurant entrepreneurship and sustainability. They evaluate the difficulties encountered by restaurant proprietors amid the pandemic and the measures taken to adapt to the situation, including the incorporation of online ordering systems and delivery services. Additionally, the article assesses the environmental and social sustainability outcomes of these strategies, while also considering the possibility of enduring alterations to the restaurant industry.The article underscores the significance of cultivating traits such as resilience, adaptability, and innovation when confronted with unforeseen challenges. These characteristics may serve as coping mechanisms for restaurant entrepreneurs and workers in coping with stress and anxiety during a crisis. Furthermore, the article recognizes the necessity for cooperation and community backing among restaurant stakeholders, as this may offer a sense of connectedness and social support to individuals experiencing isolation or emotional distress.
A16This article explores the relationship between entrepreneurial mindset, career adaptability, and intolerance of uncertainty. The authors propose a conceptual model and use survey data to test the model's hypotheses. The results suggest that entrepreneurial mindset has a positive effect on career adaptability, and that this relationship is mediated by intolerance of uncertainty. In other words, individuals with an entrepreneurial mindset may be better equipped to adapt to changes in their career, and this adaptability may be linked to a higher tolerance for uncertainty.The article suggests that developing an entrepreneurial mindset promotes career adaptability and could have positive effects on mental health. The mindset includes risk-taking, proactive problem-solving, and focusing on opportunity. The article also highlights the role of tolerance of uncertainty in mediating the relationship between the mindset and adaptability. Increasing tolerance could reduce stress and anxiety, and have positive implications for mental health.
A17The study focuses on the impact of COVID-19 pandemic on work-related stress, depression, and anxiety among workers in Buenos Aires, Argentina. The authors explore the subjective experiences of workers during the pandemic, including alterations to work routines, financial distress, and social isolation, and how these experiences influence mental health outcomes. The article aims to contribute to the development of interventions and policies to support mental well-being during crises by providing insights into the pandemic's effect on workers' mental health.Social support and a sense of belonging are important protective factors against the negative mental health impacts of the pandemic. Therefore, it is essential to promote social connections and provide resources to support workers' mental health. The article also suggests that interventions and policies aimed at promoting mental well-being among workers during the pandemic should focus on addressing the specific stressors and challenges faced by workers, such as financial difficulties and social isolation. Finally, the authors highlight the importance of adopting a holistic approach to mental health, which includes addressing not only the individual but also the organizational and societal factors that contribute to mental health outcomes.
A18The study investigates the association between work-life balance and mental and physical health outcomes, such as stress, depression, and chronic diseases, among a sample of specialists, managers, and entrepreneurs in Warsaw, Poland. Moreover, the authors explore the possible predictors of work-life balance, such as age, gender, and occupational status. The study aims to offer valuable insights for policymakers and interventions to enhance work-life balance and foster the overall health and well-being of workers in Warsaw.The article found that work-life balance was significantly related to both mental and physical health outcomes, with better work-life balance associated with lower levels of stress, depression, and chronic diseases.

Discussion and conclusion

As a global pandemic, COVID-19 has affected millions of people worldwide, causing a range of symptoms from mild to severe. The virus primarily spreads through respiratory droplets, leading many countries to implement social distancing and quarantine measures. The pandemic has had a significant impact on the global economy, employment, and education, leading to widespread school and university closures, as well as business shutdowns.

Entrepreneurs have faced the difficult decision of whether to continue, pause, or carry on with their operations throughout the pandemic. These conditions, combined with the uncertain and challenging circumstances, could result in mental health problems, such as fear, anxiety, or stress. Fear is a universal emotion that arises instinctively and serves a fundamental role in human survival. Anxiety and stress are also natural emotional responses of the body to a situation perceived as a threat or challenge.

The primary objective of the research is to identify studies that delineate the mental health issues that entrepreneurs faced during the COVID-19 era. The specific objectives were to determine the countries from which these investigations originated, to elaborate on their conclusions, and extract the lessons learned in each case.

The results of the systematic review allowed for the identification of 18 scientific articles that detailed the mental health issues faced by entrepreneurs during the COVID-19 pandemic, as well as how they demonstrated resilience in the face of this situation.

An interesting finding was that the scientific journal where the most articles related to this topic were published was Sustainability, with 3 records. On the other hand, the rest of the publications were found in various journals, with topics related to business, psychology, and public health.

Based on the 18 results provided, the main themes related to entrepreneurship during the COVID-19 pandemic are:

  • • The pandemic has presented significant challenges for entrepreneurs, including financial difficulties, reduced demand for products and services, supply chain disruptions, and social isolation. These challenges have made it difficult for many entrepreneurs to maintain their businesses and achieve their goals.

  • • The pandemic has also had a significant impact on the mental health of entrepreneurs, with many experiencing increased levels of stress, anxiety, and burnout. The pressures of running a business during a pandemic have been particularly challenging, and it is important for entrepreneurs to prioritize their mental health and seek support when needed.

  • • Despite these challenges, many entrepreneurs have found ways to cope with the pandemic, such as seeking social support, using digital technology, and adopting innovative business models. These coping strategies and mechanisms have helped entrepreneurs to adapt and overcome the challenges presented by the pandemic.

  • • The pandemic has highlighted the potential for entrepreneurship to positively impact eudaimonic well-being, emphasizing personal growth and fulfillment. Entrepreneurship allows individuals to pursue their passions and create meaningful work that aligns with their values, which can lead to a greater sense of purpose and well-being.

  • • Effective communication with customers has been crucial during the pandemic, particularly regarding safety measures and changes in operating procedures. Entrepreneurs who have been able to effectively communicate with their customers have been better able to maintain their businesses and build customer loyalty.

  • • The pandemic has highlighted the need for specialized psychological support and interventions tailored to the needs of entrepreneurs in times of crisis. Entrepreneurs face unique challenges and stresses, and it is important for them to have access to resources that can help them manage their mental health and well-being.

  • • Finally, the pandemic has highlighted the potential for entrepreneurship to address societal challenges, with a focus on social impact and sustainability over profit maximization. Entrepreneurs who are able to adapt their businesses to address the challenges presented by the pandemic can make a positive impact on their communities and contribute to a more sustainable future.

According to the given data, it is clear that the mental health and overall well-being of entrepreneurs have been significantly affected by the COVID-19 pandemic. Table 5 provides a concise overview as a general interpretation of the results in the context of other evidence.

Table 5. Key points from the information.

Key pointsImplications for entrepreneurs
COVID-19 impact on mental healthProfound impact on entrepreneurs, leading to stress & distress
Stressors during the pandemicEconomic uncertainties, financial strain, reduced social support
Coping strategiesProvide mental health resources & social support
Offer stress management & financial assistance
Resilience & adaptabilityEssential for coping with challenges and maintaining a positive outlook
Importance of work-life balanceBetter balance leads to improved mental & physical health
Role of organizations & policymakersSupport employee well-being through policies and work-life balance
Social support & sense of belongingProtective factors for mental health during the pandemic
Holistic approach to mental well-beingPromote social connections & mental health resources

These themes highlight the multifaceted nature of the challenges faced by entrepreneurs during the COVID-19 pandemic and the need for tailored support measures to address them effectively.

In conclusion, the COVID-19 pandemic has posed considerable difficulties for entrepreneurs, leading to increased stress and exhaustion. Nevertheless, numerous entrepreneurs have managed to overcome these challenges by seeking assistance, utilizing digital technology, and adopting creative business approaches. Entrepreneurship can have a positive effect on individuals’ well-being, as it allows them to pursue fulfilling work that aligns with their values. Maintaining effective communication with customers is crucial for ensuring business sustainability and building loyalty. The pandemic has emphasized the necessity for specialized psychological support tailored to address the distinctive challenges that entrepreneurs face. Furthermore, entrepreneurship has the potential to tackle societal issues with a strong emphasis on social impact and sustainability.

A probable limitation of this systematic review could be the regional confinement of the results, rendering them incapable of generalization to other regions. For instance, certain studies concentrate on entrepreneurs from India, France, China, and Thailand, implying that the conclusions may not be transferable to entrepreneurs from different parts of the world. Additionally, a possibility of publication bias exists, whereby studies exhibiting noteworthy or affirmative outcomes may be more prone to publication. Hence, the reader should consider this factor while evaluating the overall robustness of the evidence.

As for future work, some ideas include:

  • • Further research can be conducted to explore the specific challenges faced by entrepreneurs during the pandemic and how they have adapted to overcome them. This can help to inform policies and interventions that support entrepreneurship during times of crisis.

  • • More research is needed to understand the impact of the pandemic on the mental health of entrepreneurs and the most effective ways to support their well-being. This may involve developing tailored psychological support and interventions that meet the unique needs of entrepreneurs.

  • • Future studies could investigate the potential for entrepreneurship to promote eudaimonic well-being and personal growth, particularly in times of crisis. This can help to identify the conditions under which entrepreneurship can contribute to a more fulfilling and purposeful life.

  • • More research is needed to understand how effective communication with customers can help entrepreneurs maintain their businesses during a crisis. This may involve exploring different communication strategies and their effectiveness in different contexts.

Further work is needed to explore the potential for entrepreneurship to address societal challenges and promote sustainability. This can involve developing innovative business models and strategies that prioritize social impact and environmental sustainability over profit maximization.

Data availability

Underlying data

Zenodo: Data for “Mental health problems of entrepreneurs during the COVID-19 health crisis: Fear, anxiety, and stress”, https://doi.org/10.5281/zenodo.8127850 (Fernández-Bedoya et al., 2023a).

This project contains the following underlying data:

  • - Data for “Mental health problems of entrepreneurs during the COVID-19 health crisis: Fear, anxiety, and stress” (Data for “Mental health problems of entrepreneurs during the COVID-19 health crisis: Fear, anxiety, and stress”).

Reporting guidelines

Zenodo: PRISMA 2020 checklist for “Mental health problems of entrepreneurs during the COVID-19 health crisis: Fear, anxiety, and stress”, https://doi.org/10.5281/zenodo.8127809 (Fernández-Bedoya et al., 2023d).

Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0).

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Fernández-Bedoya VH, Meneses-La-Riva ME, Suyo-Vega JA and Stephanie Gago-Chávez JdJ. Mental health problems of entrepreneurs during the COVID-19 health crisis: Fear, anxiety, and stress. A systematic review [version 1; peer review: 1 not approved]. F1000Research 2023, 12:1062 (https://doi.org/10.12688/f1000research.139581.1)
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GENERAL COMMENTS: This article describes Mental health problems of entrepreneurs during the COVID- 19 health crisis: Fear, anxiety, and stress. A systematic review. However, the study design used is not clear and there are major methodological flaws in the review ... Continue reading
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Conduah AK. Reviewer Report For: Mental health problems of entrepreneurs during the COVID-19 health crisis: Fear, anxiety, and stress. A systematic review [version 1; peer review: 1 not approved]. F1000Research 2023, 12:1062 (https://doi.org/10.5256/f1000research.152864.r205345)
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https://f1000research.com/articles/12-1062/v1#referee-response-205345
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Version 1
VERSION 1 PUBLISHED 31 Aug 2023
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Reviewer Status

Alongside their report, reviewers assign a status to the article:

Approved
The paper is scientifically sound in its current form and only minor, if any, improvements are suggested
Approved with reservations
A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.
Not approved
Fundamental flaws in the paper seriously undermine the findings and conclusions

Reviewer Reports

Invited Reviewers
1
Version 1
31 Aug 23 		read
  1. Andrew Kweku Conduah, University of Professional Studies, Ghana, Ghana

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    keyboard_arrow_left Back to all reports
    Alongside their report, reviewers assign a status to the article:
    Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested
    Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit.
    Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions
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