Background: COVID-19 pandemic has the potential to significantly affect the mental health of healthcare workers (HCWs), who stand in the frontline of this crisis. It is, therefore, an immediate priority to monitor rates of mood, sleep and other mental health issues in order to understand mediating factors and inform tailored interventions. The aim of this review is to synthesize and analyze existing evidence on the prevalence of depression, anxiety and insomnia among HCWs during the Covid-19 outbreak.
Methods: A systematic search of literature databases was conducted up to April 17th, 2020. Two reviewers independently assessed full-text articles according to predefined criteria. Risk of bias for each individual study was assessed and data pooled using random-effects meta-analyses to estimate the prevalence of specific mental health problems. The review protocol is registered in PROSPERO and is available online. Findings Thirteen studies were included in the analysis with a combined total of 33062 participants. Anxiety was assessed in 12 studies, with a pooled prevalence of 23·2% and depression in 10 studies, with a prevalence rate of 22·8%. A subgroup analysis revealed gender and occupational differences with female HCPs and nurses exhibiting higher rates of affective symptoms compared to male and medical staff respectively. Finally, insomnia prevalence was estimated at 38·9% across 4 studies. Interpretation Early evidence suggests that a considerable proportion of HCWs experience mood and sleep disturbances during this outbreak, stressing the need to establish ways to mitigate mental health risks and adjust interventions under pandemic conditions.
Keywords: COVID-19; anxiety, insomnia; coronavirus; depression; health care workers; mental health.
Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.
Conflict of interest statement
SP and PK report grants and personal fees outside the submitted work
VN, TG, VGG, EP have nothing to disclose
Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019.JAMA Netw Open. 2020 Mar 2;3(3):e203976. doi: 10.1001/jamanetworkopen.2020.3976. JAMA Netw Open. 2020. PMID: 32202646 Free PMC article.
Mitigating the Psychological Impact of COVID-19 on Healthcare Workers: A Digital Learning Package.Int J Environ Res Public Health. 2020 Apr 26;17(9):E2997. doi: 10.3390/ijerph17092997. Int J Environ Res Public Health. 2020. PMID: 32357424
Mental health problems faced by healthcare workers due to the COVID-19 pandemic-A review.Asian J Psychiatr. 2020 Apr 22;51:102119. doi: 10.1016/j.ajp.2020.102119. Online ahead of print. Asian J Psychiatr. 2020. PMID: 32339895 Free PMC article.
Behavioral and Pharmacotherapy Weight Loss Interventions to Prevent Obesity-Related Morbidity and Mortality in Adults: An Updated Systematic Review for the U.S. Preventive Services Task Force [Internet].Rockville (MD): Agency for Healthcare Research and Quality (US); 2018 Sep. Report No.: 18-05239-EF-1. Agency for Healthcare Research and Quality (US). 2018. PMID: 30354042 Free Books & Documents. Review.
Yoga for improving health-related quality of life, mental health and cancer-related symptoms in women diagnosed with breast cancer.Cochrane Database Syst Rev. 2017 Jan 3;1(1):CD010802. doi: 10.1002/14651858.CD010802.pub2. Cochrane Database Syst Rev. 2017. PMID: 28045199 Free PMC article. Review.
- Murdoch D.R., Howie S.R.C. The global burden of lower respiratory infections: making progress, but we need to do better. Lancet Infect. Dis. 2018;18:1162–1163. - PubMed
- Lung F.W., Lu Y.C., Chang Y.Y., Shu B.C. Mental symptoms in different health professionals during the SARS attack: A Follow-up study. Psychiatr Q. 2009;80:107–116. - PubMed
- Wu P, Fang Y, Guan Z, et al. The Psychological Impact of the SARS Epidemic on Hospital Employees in China: Exposure, Risk Perception, and Altruistic Acceptance of Risk.