Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2021 Jul:126:252-264.
doi: 10.1016/j.neubiorev.2021.03.024. Epub 2021 Mar 24.

Anxiety, depression, trauma-related, and sleep disorders among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis

Maxime Marvaldi  1 , Jasmina Mallet  2 , Caroline Dubertret  3 , Marie Rose Moro  4 , Sélim Benjamin Guessoum  5
Affiliations
Meta-Analysis

Anxiety, depression, trauma-related, and sleep disorders among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis

Maxime Marvaldi et al. Neurosci Biobehav Rev. 2021 Jul.

Abstract

Healthcare workers have been facing the COVID-19 pandemic, with numerous critical patients and deaths, and high workloads. Quality of care is related to the mental status of healthcare workers. This PRISMA systematic review and meta-analysis, on Pubmed/Psycinfo up to October 8, 2020, estimates the prevalence of mental health problems among healthcare workers during this pandemic. The systematic review included 70 studies (101 017 participants) and only high-quality studies were included in the meta-analysis. The following pooled prevalences were estimated: 300 % of anxiety (95 %CI, 24.2-37.05); 311 % of depression (95 %CI, 25.7-36.8); 565 % of acute stress (95 %CI - 30.6-80.5); 20,2% of post-traumatic stress (95 %CI, 9.9-33.0); 44.0 % of sleep disorders (95 %CI, 24.6-64.5). The following factors were found to be sources of heterogeneity in subgroups and metaregressions analysis: proportion of female, nurses, and location. Targeted prevention and support strategies are needed now, and early in case of future health crises.

Keywords: Anxiety; COVID-19; Depression; Healthcare workers; Meta-analysis; Psychological trauma; Sleep wake disorders; Stress disorders, traumatic, acute; Systematic review.

PubMed Disclaimer

Conflict of interest statement

All authors declare none.

Figures

None
Graphical abstract
Fig. 1
Fig. 1
Flowchart diagram.
Fig. 2
Fig. 2
A. Forest plots of the prevalence of symptoms of anxiety in healthcare workers during the COVID-19 pandemic. The figure shows the results of the meta-analysis of the studies using random-effect models after Freeman-Tukey double arcsine transformation. Error bars represent the 95% confidence intervals. B. Forest plots of the prevalence of symptoms of depression in healthcare workers during the COVID-19 pandemic. The figure shows the results of the meta-analysis of the studies using random-effect models after Freeman-Tukey double arcsine transformation. Error bars represent the 95% confidence intervals C. Forest plots of the prevalence of trauma-related symptoms in healthcare workers during the COVID-19 pandemic. The figure shows the results of the meta-analysis of the studies using random-effect models after Freeman-Tukey double arcsine transformation. Error bars represent the 95% confidence intervals D. Forest plots of the prevalence of symptoms of sleep disorders in healthcare workers during the COVID-19 pandemic. The figure shows the results of the meta-analysis of the studies using random-effect models after Freeman-Tukey double arcsine transformation. Error bars represent the 95% confidence intervals.
Fig. 2
Fig. 2
A. Forest plots of the prevalence of symptoms of anxiety in healthcare workers during the COVID-19 pandemic. The figure shows the results of the meta-analysis of the studies using random-effect models after Freeman-Tukey double arcsine transformation. Error bars represent the 95% confidence intervals. B. Forest plots of the prevalence of symptoms of depression in healthcare workers during the COVID-19 pandemic. The figure shows the results of the meta-analysis of the studies using random-effect models after Freeman-Tukey double arcsine transformation. Error bars represent the 95% confidence intervals C. Forest plots of the prevalence of trauma-related symptoms in healthcare workers during the COVID-19 pandemic. The figure shows the results of the meta-analysis of the studies using random-effect models after Freeman-Tukey double arcsine transformation. Error bars represent the 95% confidence intervals D. Forest plots of the prevalence of symptoms of sleep disorders in healthcare workers during the COVID-19 pandemic. The figure shows the results of the meta-analysis of the studies using random-effect models after Freeman-Tukey double arcsine transformation. Error bars represent the 95% confidence intervals.
Fig. 2
Fig. 2
A. Forest plots of the prevalence of symptoms of anxiety in healthcare workers during the COVID-19 pandemic. The figure shows the results of the meta-analysis of the studies using random-effect models after Freeman-Tukey double arcsine transformation. Error bars represent the 95% confidence intervals. B. Forest plots of the prevalence of symptoms of depression in healthcare workers during the COVID-19 pandemic. The figure shows the results of the meta-analysis of the studies using random-effect models after Freeman-Tukey double arcsine transformation. Error bars represent the 95% confidence intervals C. Forest plots of the prevalence of trauma-related symptoms in healthcare workers during the COVID-19 pandemic. The figure shows the results of the meta-analysis of the studies using random-effect models after Freeman-Tukey double arcsine transformation. Error bars represent the 95% confidence intervals D. Forest plots of the prevalence of symptoms of sleep disorders in healthcare workers during the COVID-19 pandemic. The figure shows the results of the meta-analysis of the studies using random-effect models after Freeman-Tukey double arcsine transformation. Error bars represent the 95% confidence intervals.
Fig. 2
Fig. 2
A. Forest plots of the prevalence of symptoms of anxiety in healthcare workers during the COVID-19 pandemic. The figure shows the results of the meta-analysis of the studies using random-effect models after Freeman-Tukey double arcsine transformation. Error bars represent the 95% confidence intervals. B. Forest plots of the prevalence of symptoms of depression in healthcare workers during the COVID-19 pandemic. The figure shows the results of the meta-analysis of the studies using random-effect models after Freeman-Tukey double arcsine transformation. Error bars represent the 95% confidence intervals C. Forest plots of the prevalence of trauma-related symptoms in healthcare workers during the COVID-19 pandemic. The figure shows the results of the meta-analysis of the studies using random-effect models after Freeman-Tukey double arcsine transformation. Error bars represent the 95% confidence intervals D. Forest plots of the prevalence of symptoms of sleep disorders in healthcare workers during the COVID-19 pandemic. The figure shows the results of the meta-analysis of the studies using random-effect models after Freeman-Tukey double arcsine transformation. Error bars represent the 95% confidence intervals.
See this image and copyright information in PMC

References

    1. Ades A.E., Lu G., Higgins J.P.T. The interpretation of random-effects meta-analysis in decision models. Med. Decis. Mak. 2005 doi: 10.1177/0272989x05282643. - DOI - PubMed
    1. American Psychiatric Association . American Psychiatric Pub.; 2013. Diagnostic and Statistical Manual of Mental Disorders (DSM-5®)
    1. Bao Yanping, Sun Yankun, Meng Shiqiu, Shi Jie, Lu Lin. 2019-nCoV epidemic: address mental health care to empower society. Lancet. 2020;395(10224):e37–38. - PMC - PubMed
    1. Bastien C.H., Vallières A., Morin C.M. Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Med. 2001;2(4):297–307. - PubMed
    1. Blake Holly, Bermingham Fiona, Johnson Graham, Tabner Andrew. Mitigating the psychological impact of COVID-19 on healthcare workers: a digital learning package. Int. J. Environ. Res. Public Health. 2020;17(9) doi: 10.3390/ijerph17092997. - DOI - PMC - PubMed