Impact of coronavirus syndromes on physical and mental health of health care workers: Systematic review and meta-analysis

Gonzalo Salazar de Pablo; Julio Vaquerizo-Serrano; Ana Catalan; Celso Arango; Carmen Moreno; Francisco Ferre; Jae Il Shin; Sarah Sullivan; Natascia Brondino; Marco Solmi; Paolo Fusar-Poli

doi:10.1016/j.jad.2020.06.022

Impact of coronavirus syndromes on physical and mental health of health care workers: Systematic review and meta-analysis

J Affect Disord. 2020 Oct 1:275:48-57. doi: 10.1016/j.jad.2020.06.022. Epub 2020 Jun 25.

Authors

Affiliations

¹ Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain. Electronic address: [email protected].
² Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain.
³ Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Mental Health Department, Biocruces Bizkaia Health Research Institute, Basurto University Hospital. Facultad de Medicina y Odontología, Campus de Leioa, University of the Basque Country, UPV/EHU, Bizkaia, Spain.
⁴ Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain.
⁵ Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Madrid, Spain.
⁶ Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea.
⁷ Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK.
⁸ Section of Psychiatry, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
⁹ Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; Neurosciences Department, University of Padua, Padua, Italy; Padua Neuroscience Center, University of Padua, Padua, Italy.
¹⁰ Early Psychosis: Interventions and Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Section of Psychiatry, Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; OASIS service, South London and Maudsley NHS Foundation Trust, London, UK; National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, UK.

Abstract

Background: Health care workers (HCW) are at high risk of developing physical/mental health outcomes related to coronavirus syndromes. Nature and frequency of these outcomes are undetermined.

Methods: PRISMA/MOOSE-compliant (PROSPERO-CRD42020180205) systematic review of Web of Science/grey literature until 15th April 2020, to identify studies reporting physical/mental health outcomes in HCW infected/exposed to Severe Acute Respiratory Syndrome -SARS-, Middle East Respiratory Syndrome -MERS-, Novel coronavirus -COVID-19-. Proportion random effect meta-analyses, I² statistic, quality assessment and sensitivity analysis.

Results: 115 articles were included (n=60,458 HCW, age 36.1±7.1, 77.1% female). Physical health outcomes: 75.9% HCW infected by SARS/MERS/COVID-19 reported fever (95%CI=65.9-83.7%, k=12, n=949), 47.9% cough (95%CI=39.2-56.8%, k=14, n=970), 43.6% myalgias (95%CI=31.9-56.0%, k=13, n=898), 42.3% chills (95%CI=20.2-67.9%, k=7, n=716), 41.2% fatigue (95%CI=18.2-68.8%, k=6, n=386), 34.6% headaches (95%CI=23.1-48.2%, k=11, n=893), 31.2% dyspnoea (95%CI=23.2-40.5%, k=12, n=1003), 25.3% sore throat (95%CI=18.8-33.2%, k=8, n=747), 22.2% nausea/vomiting (95%CI=14.9-31.8%, k=6, n=662), 18.8% diarrhoea (95%CI=11.9-28.4%, k=9, n=824). Mental health outcomes: 62.5% HCW exposed to SARS/MERS/COVID-19 reported general health concerns (95%CI=57.0-67,8%, k=2, n=2254), 43.7% fear (95%CI=33.9-54.0%, k=4, n=584), 37.9% insomnia (95%CI=30.9-45.5%, k=6, n=5067), 37.8% psychological distress (95%CI=28.4-48.2%, k=15, n=24,346), 34.4% burnout (95%CI=19.3-53.5%, k=3, n=1337), 29.0% anxiety features (95%CI=14.2-50.3%, k=6, n=9191), 26.3% depressive symptoms (95%CI=12.5-47.1%, k=8, n=9893), 20.7% post-traumatic stress disorder features (95%CI=13.2-31%, k=11, n=3826), 16.1% somatisation (95%CI=0.2-96.0%, k=2, n=2184), 14.0% stigmatisation feelings (95%CI=6.4-28.1%, k=2, n=411).

Limitations: Limited amount of evidence for some outcomes and suboptimal design in several studies included.

Conclusions: SARS/MERS/COVID-19 have a substantial impact on the physical and mental health of HCW, which should become a priority for public health strategies.

Keywords: COVID-19; Coronavirus; Health care workers; MERS; Meta-analysis; SARS.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Anxiety
Burnout, Professional
COVID-19
Coronavirus Infections / psychology*
Fatigue
Female
Health Personnel / psychology*
Humans
Male
Mental Health*
Middle Aged
Pandemics
Pneumonia, Viral / psychology*
Severe Acute Respiratory Syndrome / psychology*
Stress Disorders, Post-Traumatic