Impact of SARS-CoV-2 (COVID-19) on the mental health of healthcare professionals: a systematic review
e202007088
Keywords:
SARS-CoV-2, Pandemic, Health personnel, Mental health, Professional burnout, Psychological stress, Anxiety, DepressionAbstract
Background: In times of this global pandemic situation, population’s mental health is compromised, especially in those groups that are at the forefront of defence against the virus such as healthcare professionals. The objective of this study was to analyze the impact of the SARS-CoV-2 outbreak on healthcare professionals’ mental health.
Methods: A systematic review was carried out following the PRISMA format in Pubmed, Scopus, Web of Science, CINAHL, PsycINFO and ScienceDirect electronic databases between January and May 2020. Methodological quality was evaluated using the Joanna Briggs Institute (JBI) critical appraisal tools for non-randomized studies.
Results: A total of 13 studies were included in this review. Professionals’ mental health and mental functions were compromised, being especially affected those professionals on the front line of battle against the virus. However, these stats were below the general population data. Although there is wide variability of results, medium-high levels of anxiety (26,5%-44,6%), depression (8,1%-25%), concern and insomnia are detected (23,6%-38%). Paradoxically, stress levels were below expectations (3,8%-68,3%).
Conclusions: The mental well-being of health professionals working on the front line is compromised in times of pandemic by presenting medium-high levels of anxiety, depression, nervousness and insomnia, and, to a lesser extent, stress.
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References
Organización Mundial de la Salud. Preguntas y respuestas sobre la enfermedad por coronavirus (COVID-19) [Internet]. Ginebra: Organización Mundial de la Salud; [consultado el 24/05/2020]. Disponible en: https://www.who.int/es/emergencies/diseases/novel-coronavirus-2019/advice-for-public/q-a-coronaviruses.
Organización Mundial de la Salud. The world health report 2003-shaping the future. Chapter 5. SARS: lessons from a new disease. 2003. [Internet]. Ginebra: Organización Mundial de la Salud; [consultado el 24/05/2020]. Disponible en: https://www.who.int/whr/2003/en/.
de Wit E, van Doremalen N, Falzarano D, Munster VJ. SARS and MERS: recent insights into emerging coronaviruses. Nat Rev Microbiol. 2016;14(8):523-34.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497-506.
Lu R, Zhao X, Li J, Niu P, Yang B, Wu H et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020;395:565-74.
Zhu N, Zhang D, Wang W, Li X, Yang B, Song J et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-33. doi: 10.1056/NEJMoa2001017.
Del Rio C, Malani PN. 2019 Novel Coronavirus-Important Information for Clinicians. JAMA. 2020;323:1039-40. doi: 10.1001/jama.2020.1490.
Organización Mundial de la Salud. Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV) [Internet]. Ginebra: Organización Mundial de la Salud; [consultado el 24/05/2020]. Disponible en: https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov).
Sohrabi C, Alsafi Z, O’Neill N, Khan M, Kerwan A, Al-Jabir A et al. World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). Int J Surg. 2020:76:71-6. doi: 10.1016/j.ijsu.2020.02.034.
Wilder-Smith A, Freedman, DO. Isolation, quarantine, social distancing and community containment: pivotal role for old-style public health measures in the novel coronavirus (2019-nCoV) outbreak. Journal of Travel Medicine. 2020;27(2):1-4. doi: 10.1093/jtm/taaa020.
Bruinen de Bruin Y, Lequarre AS, McCourt J, Clevestig P, Pigazzani F, Jeddi MZ et al. Initial impacts of global risk mitigation measures taken during the combatting of the COVID-19 pandemic. Saf Sci. 2020;128:104773. 10.1016/j.ssci.2020.104773.
Dong L, Bouey J. Public Mental Health Crisis during COVID-19 Pandemic, China. Emerg Infect Dis. 2020;26(7). doi: 10.3201/eid2607.200407.
Ho CS, Chee CY, Ho RC. Mental Health Strategies to Combat the Psychological Impact of COVID-19 Beyond Paranoia and Panic. Ann Acad Med Singapore. 2020;49(3):155-60.
Torales J, O’Higgins M, Castaldelli-Maia JM, Ventriglio A et al. The outbreak of COVID-19 coronavirus and its impact on global mental health. Int J Soc Psychiatry. 2020;20764020915212. doi: 10.1177/0020764020915212.
Zhao G. Tomar medidas preventivas inmediatamente: evidencia de China sobre el COVID-19. Gac santit. 2020;34(3):217-9. doi: 10.1016/j.gaceta.2020.03.002.
Assari S, Habibzadeh P. The COVID-19 Emergency Response Should Include a Mental Health Component. Arch Iran Med. 2020;23(4):281-2. doi: 10.34172/aim.2020.12.
Ferrán MB, Trigo SB. Caring for the caregiver: the emotional impact of the coronavirus epidemic on nurses and other health professionals. Enferm Clin. 2020;10. doi: 10.1016/j.enfcli.2020.05.006.
Dichter MN, Sander M, Seismann-Petersen S, Köpke S et al. COVID-19: It is time to balance infection management and person-centered care to maintain mental health of people living in German nursing homes. Int Psychogeriatr. 2020;1-11. doi: 10.1017/S1041610220000897.
Kang L, Li Y, Hu S, Chen M, Yang C, Xiang-Yang B et al. The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus. Lancet Psychiatry. 2020;7(3):e14. doi: 10.1016/S2215-0366(20)30047-X.
Shigemura J, Ursano RJ, Morganstein JC, Kurosawa M, Benedek DM. Public responses to the novel 2019 coronavirus (2019-nCoV) in Japan: mental health consequences and target populations. Psychiatry Clin Neurosci. 2020; 74(4):281-2. doi: 10.1111/pcn.12988.
Zumla A, Hui DS, Azhar EI, Memish ZA, Maeurer M et al. Reducing mortality from 2019-nCoV: host-directed therapies should be an option. Lancet. 2020;395(10224):e35–6. doi: 10.1016/S0140-6736(20)30305-6.
Xiang YT, Yang Y, Li W, Zhang L, zhang Q, Cheung T et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. The Lancet Psychiatry. 2020;7(3):228–9. doi: 10.1016/S2215-0366(20)30046-8.
Rubin GJ, Wessely S. The psychological effects of quarantining a city. BMJ. 2020;368:m313. doi: 10.1136/bmj.m313.
Junquera LM, Baladron J, Albertos JM, Olay S. Medicina basada en la evidencia (MBE): Ventajas. Rev Esp Cirug Oral Maxilofac. 2003;25(5):265-72.
Urrutia G, BonFill X. Declaración PRISMA: propuesta para mejorarla publicación de revisiones sistemáticas y metaanálisis. Med Clin (Barc). 2010;135(11):507-11. doi: 10.1016/j.medcli.2010.01.015.
Jordan Z, Lockwood C, Munn Z, Aromataris E. The updated JBI model for evidence-based healthcare. Int J Evid Based Healthc. 2019;17(1):58-71. doi: 10.1097/XEB.0000000000000155.
Moola S, Munn Z, Tufanaru C, Sears K, Sfetcu R, Currie M et al. Chapter 7: Systematic reviews of etiology and risk. In: Aromataris E, Munn Z (Editors). Joanna Briggs Institute Reviewer’s Manual. Adelaida: The Joanna Briggs Institute; 2017.
Lockwood C, Munn Z, Porritt K. Qualitative research synthesis: methodological guidance for systematic reviewers utilizing meta-aggregation. Int J Evid Based Healthc. 2015;13(3):179-87. doi: 10.1097/XEB.0000000000000062.
Mo Y, Deng L, Zhang L, Lang Q, Liao C, Wang N et al. Work stress among Chinese nurses to support Wuhan in fighting against COVID-19 epidemic. J Nurs Manag. 2020. doi: 10.1111/jonm.13014.
Zhang C, Yang L, Liu S, Ma S, Wang Y, Cai Z et al. Survey of insomnia and related social psychological factors among medical staff involved in the 2019 novel coronavirus disease outbreak. Front Psychiatry. 2020;11:306. doi: 10.3389/fpsyt.2020.00306.
Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open. 2020;3(3):e203976. doi: 10.1001/jamanetworkopen.2020.3976.
Chew NWS, Lee GKH, Tan BYQ, Jing M, Goh Y, Ngiam NJH et al. A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak. Brain Behav Immun. 2020;S0889-1591(20):30523-7. doi: 10.1016/j.bbi.2020.04.049.
Huang Y, Zhao N. Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey. Psychiatry Res. 2020;288:112954. doi: 10.1016/j.psychres.2020.112954.
Kang L, Ma S, Chen M, Yang J, Wang Y, Li R et al. Impact on mental health and perceptions of psychological care among medical and nursing staff in Wuhan during the 2019 novel coronavirus disease outbreak: A cross-sectional study. Brain Behav Immun. 2020. doi: 10.1016/j.bbi.2020.03.028.
Li Z, Ge J, Yang M, Feng J, Qiao M, Jiang R et al. Vicarious traumatization in the general public, members, and non-members of medical teams aiding in COVID-19 control. Brain Behav Immun. 2020; S0889-1591(20)30309-3. doi: 10.1016/j.bbi.2020.03.007.
Wu Y, Wang J, Luo C, Hu S, Anderson AE, Bruera E et al. A comparison of burnout frequency among oncology physicians and nurses working on the frontline and usual wards during the COVID-19 epidemic in Wuhan, China. J Pain Symptom Manage. 2020; S0885-3924(20)30205-0. doi: 10.1016/j.jpainsymman.2020.04.008.
Tan BYQ, Chew NWS, Lee GKH, Jing M, Goh Y, Yeo LLL et al. Psychological Impact of the COVID-19 Pandemic on Health Care Workers in Singapore. Ann Intern Med. 2020;M20-1083. doi: 10.7326/M20-1083.
Lu W, Wang H, Lin Y, Li L. Psychological status of medical workforce during the COVID-19 pandemic: A cross-sectional study. Psychiatry Res. 2020;288:112936. doi: 10.1016/j.psychres.2020.11293.
Wang S, Xie L, Xu Y, Yu S, Yao B, Xiang D. Sleep disturbances among medical workers during the outbreak of COVID-2019. Occup Med (Lond). 2020;kqaa074. doi: 10.1093/occmed/kqaa074.
Yin X, Zeng L. A study on the psychological needs of nurses caring for patients with coronavirus disease 2019 from the perspective of the existence, relatedness, and growth theory. Int J Nurs Sci. 2020;7(2):157-60. doi: 10.1016/j.ijnss.2020.04.002.
He K, Stolarski A, Whang E, Kristo G. Addressing General Surgery Residents’ Concerns in the Early Phase of the COVID-19 Pandemic. J Surg Educ. 2020;1–4. doi: 10.1016/j.jsurg.2020.04.003.
Centro Cochrane Iberoamericano, traductores. Manual Cochrane de Revisiones Sistemáticas de Intervenciones, versión 5.1.0 [actualizada en marzo de 2011] [Internet]. Barcelona: Centro Cochrane Iberoamericano; 2012 [consultado el 24/05/2020]. Disponible en http://www.cochrane.es/?q=es/node/269.
Cheung T, Yip PS. Depression, Anxiety and Symptoms of Stress among Hong Kong Nurses: A Cross-sectional Study. Int J Environ Res Public Health. 2015;12(9):11072-100. doi: 10.3390/ijerph120911072.
Gu B, Tan Q, Zhao S. The association between occupational stress and psychosomatic wellbeing among Chinese nurses: A cross-sectional survey. Medicine (Baltimore). 2019;98(22):e15836. doi: 10.1097/MD.0000000000015836.
Ding Y, Qu J, Yu X, Wang S. The mediating effects of burnout on the relationship between anxiety symptoms and occupational stress among community healthcare workers in China: a cross-sectional study. PLoS ONE. 2014;9(9):e107130.
Bromet E, Andrade LH, Hwang I, Sampson NA, Alonso J, de Girolamo G et al. Cross-national epidemiology of DSM-IV major depressive episode. BMC Med. 2011;9:90. doi: 10.1186/1741-7015-9-90.
Yang X, Hu S. The association between social support as well as coping style and anxiety and depressive symptoms among nurses. Chin. J. Health Psychol. 2011;19:300–1.
Wei Y, Fu Shen X. Research concentrated on the depressive symptoms status among nurses. Health Occupational Education. 2007;25:95–6.
Peng K. The prevalence of anxiety and depressive symptoms among nurses in oncology department. Chinese Community Doctors. 2012;14:370–1.
Gong Y, Han T, Yin X, Yang G, Zhuang R, Chen Y et al. Prevalence of depressive symptoms and work-related risk factors among nurses in public hospitals in southern China: A cross-sectional study. Sci Rep. 2015;4:7109. doi: 10.1038/srep07109.
Letvak S, Ruhm CJ, McCoy T. Depression in hospital-employed nurses. Clin Nurse Spec. 2012;26(3):177-82. doi: 10.1097/NUR.0b013e3182503ef0.
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Copyright (c) 2020 Juan Jesús García-Iglesias, Juan Gómez-Salgado, Jorge Martín-Pereira, Javier Fagundo-Rivera, Diego Ayuso-Murillo, José Ramón Martínez-Riera, Carlos Ruiz-Frutos
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