To the Editor,

We welcome the publication of the article "Perceived Stress by Students of the Medical Sciences in Cuba Toward the COVID-19 Pandemic: Results of an Online Survey" in Rev Colomb Psiquiatr, in which reference is made to the adaptation of the Cohen Perceived Stress Scale for the context of Cuban Medical Sci ences students in the midst of the epidemiological situation established by COVID.¹

In these times of pandemic, students of Medical Sciences have the distinction that, in addition to suffering isolation and other problems associated with the general population, it was highlighted by the Ministry of Public Health of Cuba (MINSAP) for a National need in the actions for the fight and control of the disease through a prolonged process of investigations that lasts more than a year and voluntary intervention in isolation centers as members of the health personnel, all of which has been obtained on several occasions a strictly periodic charac ter, without days of rest, and has been complemented with distance education.¹

All these stressors are coupled with the fact that these stu dents are young people, some just finishing their adolescence period while others have been stuck in the terminal years of their university career in the midst of the pandemic, for all of which it is possible suspect that this is one of the most psychologically affected sectors.^1,3

In the results of this work, a very poor level of stress is revealed in the population under study despite all the above. This draws our attention and the existence of studies that indi cate the opposite is very interesting,^3,4 while others confirm these findings,⁵ all from this perspective, a fact that is accen tuated if we take into account that other studies carried out in different communities have even led to the establishment of measures to reduce the psychological effects derived from the pandemic situation.^6,7

However, thanks to the creation and the application of the adapted Perceived Stress Scale, we can interpret an apparent personal growth in the surveyed students, who have taken advantage of the complexity of the situation to improve themselves.

We are struck by the choice of August for the application of the surveys, above all because what is measured is the perceived stress in the students and precisely that month was the only one that the students were on vacation. It would have been more curious, instead, to carry out the study in a time where the students were linked to epidemiological control tasks.

Likewise, it would have been good to classify and work with students according to the University to which they belong since, in the Cuban panorama of Higher Medical Education, each University of Medical Sciences corresponds to a province and each province has its own level of affectation by the pan demic which translates into a greater/lesser amount of actions aimed at its control, falling on the students.

It would also have been better to include a greater num ber of respondents for the conformation of the work, trying to achieve a number that is as representative as possible in each career, for example, complementing the online survey with a direct one and the support of the student mass organizations as the University Student Federation (FEU) of each province for a greater dissemination of the first.

As a major merit, we emphasize that the work is one of the few inquiries about the psychological exhaustion of Cuban medical students and the only one to cover almost the entire country, thus constituting the largest reference on this topic to date