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Meta-Analysis
. 2020 Oct 1:275:48-57.
doi: 10.1016/j.jad.2020.06.022. Epub 2020 Jun 25.

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

Gonzalo Salazar de Pablo  1 , Julio Vaquerizo-Serrano  2 , Ana Catalan  3 , Celso Arango  4 , Carmen Moreno  4 , Francisco Ferre  5 , Jae Il Shin  6 , Sarah Sullivan  7 , Natascia Brondino  8 , Marco Solmi  9 , Paolo Fusar-Poli  10
Affiliations
Meta-Analysis

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

Gonzalo Salazar de Pablo et al. J Affect Disord. .

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.

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Conflict of interest statement

Declaration of Competing Interest Dr Catalan has received personal fees from Janssen. Dr Fusar-Poli has received grants from Lundbeck and personal fees from Lundbeck, Menarini and Angelini. Dr Arango has been a consultant to or has received honoraria or grants from Acadia, Angelini, Gedeon Richter, Janssen Cilag, Lundbeck, Otsuka, Roche, Sage, Servier, Shire, Schering Plough, Sumitomo Dainippon Pharma, Sunovion and Takeda. Dr Moreno has acted as consultant or participated in DMC for Janssen, Servier, Lundbeck, Nuvelution, Angelini and Otsuka.

Figures

Fig 1
Fig. 1
PRISMA 2009 Flow Diagram.
Fig 2
Fig. 2
Top 10 Most frequently reported physical health outcomes in HCW with SARS/MERS/COVID-19 infection.
Fig 3
Fig. 3
Top 10 Most frequently reported mental health outcomes in HCW exposed to SARS/MERS/COVID-19.
See this image and copyright information in PMC

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