Mental Health Outcomes Among Healthcare Workers Dealing with COVID-19/ SARS-CoV-2 Pandemic: A Systematic Review and Meta-Analysis

Abstract

Introduction: The psychological impact of COVID-19 on healthcare workers has received attention from researchers seeking to understand the extent of the effects of the ongoing pandemic on this population. The aim to this systematic review and meta-analysis was to synthesise the currently available literature on the topic to determine the prevalence of mental health problems in healthcare workers. Methods: We conducted a systematic review and meta-analysis, searching PubMed, PsycINFO, Scopus and Cochrane register of clinical trials (CENTRAL) databases for articles published from December 2019 to May 31, 2020. We identified cross-sectional, case-control and cohort studies reporting prevalence of any International Classification of Diseases (ICD) or Diagnostic and Statistical Manual of Mental Disorders (DSM) mental health disorders in healthcare workers involved directly or indirectly in providing services during the COVID-19 pandemic. Studies reporting or having extractable prevalence data were also included. The prevalence proportion for individual outcome was extracted as an estimate of interest. We performed random-effects meta-analyses evaluated using Q statistic, I2 statistic, subgroup analyses, sensitivity analyses and assessed study quality. This review was done in adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. The study protocol was registered prospectively at PROSPERO, CRD42020182005. Results: We identified 988 studies of which 928 studies were excluded during screening for duplicates and did not meet the inclusion criteria. We further assessed 56 full-texts and finally included 17 studies for analysis with 34021 participants. The overall prevalence estimated were: depression 25.9% (95%CI 18.4-34.1, I2=99.5%), anxiety 24.5% (95% CI 17.9-31.9, I2=99.1%), insomnia or poor sleep quality or sleep disturbance 35.8% (95% CI 28.3-48.1, I2=99.2%), and stress 30.7% (95% CI 13-51.6, I2=99.9%). Conclusion: Healthcare workers who are dealing with the COVID-19 pandemic have a significant prevalence of depression, anxiety, insomnia and poor sleep quality, and stress. The healthcare workforce needs to practice self-care now more than ever, while healthcare managers and policy makers need to factor in the mental health consequences of COVID-19 on their workforce.Funding Statement: None.Declaration of Interests: None.