Acute Stress Response Patterns and Factors Associated with Impaired Psychological Status in Health Workers Facing SARS-CoV-2: Saving Private Ryan

Abstract

Background: Italy was the second country to be strongly hit by SARS-CoV-2 outbreak; numbers of hospitalized patients, death tolls and limited information on treatment could undermine health workers psychological status during Covid outbreak. The aim of the study was to assess the acute stress response patterns and factors associated with impaired psychological status in health workers facing SARS-CoV-2. Methods: Web-based cross-sectional study conducted between April 15th to 28th 2020 on Italian health workers. Depressive and anxiety symptoms as assessed by the Patient Health Questionnaire and Generalized Anxiety Disorder respectively, sleeping and occupational impairment as assessed by the Insomnia Severity Index , and the Work and Social Adjustment Scale, respectively, and distress as assessed by the Impact of Event Scale–Revised were measured. Outcomes: The study included 858 subjects (78% physicians), with 70% frontline workers 50% from Red zone. Moderate/severe depression was found in 29%, moderate/severe anxiety in 55% and 15% insomnia. Distress was found in 52% and functional work impairment in 51%; 3% subjects reported frequent suicidal thoughts. Female participants show a greater likelihood of having depression (OR=1.71, p=.02), anxiety (OR=1.90; p=.001) and distress (OR=2.39, p 15 hours/week in a Covid-19 unit is associated with higher risk of distress (OR=1.90; p=0.002), insomnia (OR=1.80, p=0.018) depression (OR=1.77, p=0.003), and functional impairment (OR=1.70, p=0.002). Living apart from family increases the risk of depression (OR=1.51, p=0.041), stress (OR=1.88, p=0.008), work inability (OR=1.93, p=0.001) and insomnia (OR=1.85, p=0.012). Interpretation: Acute distress, anxiety, depression and functional work impairment are more common in health workers facing Covid-19 than previously reported. The identification, monitoring and treatment of impaired psychological status may become crucial to face future waves of Covid-19 outbreak. Funding Statement: The authors received no financial support for the research, authorship, and/or publication of this article. Declaration of Interests: The authors declare no conflict of interest. Ethics Approval Statement: The Institutional Review Board (IRB) at the Department of Human and Social Science of the University of Enna “Kore” approved the study protocol and the informed consent forms, with respect to scientific content and compliance with the Italian applicable research and human subjects’ regulations. Online informed consent was provided by all survey participants prior to their enrollment.