Prevalence and Risk Factors of Mental Health Problems Among Healthcare Workers During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

Abstract

Objective: The purpose of this meta-analysis was to summarize the prevalence and risk factors of mental health problems among healthcare workers during the COVID-19 pandemic. Methods: We applied an optimized search strategy across the PubMed, EMBASE, Scopus, PsycINFO, and four Chinese databases, with hand searching supplemented to identify relevant surveys. Studies were eligible for inclusion if they were published in peer-reviewed literature and used a validated method to assess the prevalence and risk factors of mental health problems among healthcare workers during the COVID-19 pandemic. Heterogeneity was quantified using Q statistics and the I ² statistics. The potential causes of heterogeneity were investigated using subgroup analysis and meta-regression analysis. Sensitivity analysis was performed to examine the robustness of the results. Results: We pooled and analyzed data from 20 studies comprising 10,886 healthcare workers. The prevalence of depression, anxiety, insomnia, post-traumatic stress symptoms, phobia, obsessive-compulsive symptoms, and somatization symptoms was 24.1, 28.6, 44.1, 25.6, 35.0, 16.2, and 10.7%, respectively. Female and nurses had a high prevalence of depression and anxiety. Frontline healthcare workers had a higher prevalence of anxiety and a lower prevalence of depression than the those in the second-line. Furthermore, the proportion of moderate-severe depression and anxiety is higher in the frontline. Additionally, four studies reported on risk factors of mental health problems. Conclusions: In this systematic review, healthcare workers have a relatively high prevalence of depression, anxiety, insomnia, post-traumatic stress symptoms, phobia, obsessive-compulsive symptoms, and somatization symptoms during the COVID-19 pandemic, and focus should be on the healthcare workers at high risk of mental problems. Mental health problems in healthcare workers should be taken seriously, and timely screening and appropriate intervention for the high-risk group are highly recommended. Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020179189.

Keywords: coronavirus disease; healthcare workers; mental health; meta-analysis; prevalence; risk factors.

Figure 1

Preferred reporting items for systematic reviews and meta-analyses flow diagram of included studies (20).

Figure 2

Forest plot for the meta-analysis of the prevalence of depression and anxiety among healthcare workers. (A) Forest plot of the prevalence of depression. (B) Forest plot of the prevalence of anxiety.

Figure 3

Subgroup analysis of the prevalence of depression among healthcare workers. (A) Subgroup analysis stratification by sample size. (B) Subgroup analysis stratification by staff type. (C) Subgroup analysis stratification by position. (D) Subgroup analysis stratification by gender.

Figure 4

Forest plot for the meta-analysis of the prevalence of moderate to severe depression and subgroup analysis among healthcare workers. (A) Forest plot of the prevalence of moderate to severe depression. (B) Forest plot of moderate to severe depression stratification by position.

Figure 5

Subgroup analysis of the prevalence of anxiety among healthcare workers. (A) Subgroup analysis stratification by sample size. (B) Subgroup analysis stratification by staff type. (C) Subgroup analysis stratification by position. (D) Subgroup analysis stratification by gender.

Figure 6

Forest plot for the meta-analysis of the prevalence of moderate to severe anxiety and subgroup analysis among healthcare workers. (A) Forest plot of the prevalence of moderate to severe anxiety. (B) Forest plot of moderate to severe anxiety stratification by position.

Figure 7

Forest plot for the meta-analysis of the prevalence of other mental health problems among healthcare workers. (A) Forest plot of the prevalence of insomnia. (B) Forest plot of the moderate to severe insomnia. (C) Forest plot of the prevalence of distress. (D) Forest plot of the prevalence of obsessive–compulsive symptoms. (E) Forest plot of the prevalence of somatization symptoms. (F) Forest plot of the prevalence of phobia.