Abstract
Background: With increasing morbidity and mortality rates throughout the world, COVID-19 has caused a universal psychological impact on the lives of people.
 Aims: To examine psychological wellbeing of frontline healthcare professionals and compare mental health among doctors, paramedical staff and allied health workers.
 Methods: This cross-sectional study included 225 healthcare professionals from 13 different hospitals in Karachi, Pakistan. The symptoms of depression, anxiety and insomnia were assessed using the 9-item Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder (GAD-7) and the 7-item Insomnia Severity Index (ISI) respectively.
 Results: Major findings of the study were that 44.7% participants had no depression, 38% were reported to have mild anxiety and 3.5% had severe insomnia. Insomnia was correlated with anxiety and depression leading to moderate correlation of 0.516 and 0.694 in both with a highly significant p value (p=0.001 and p=0.001). A significant association of depression was seen with healthcare providers and years of experience with (p=0.009) and (p=0.010) respectively. Levels of anxiety were associated with occupation and years of experience that led to the finding that doctors suffered more from mild anxiety (83.5%) whereas years of experience had no significant association. Correlation of insomnia with occupation and years of experience led to the finding that sub threshold insomnia was found in 29% participants, where majority of participants were allied health workers. However, borderline significant association was found between insomnia and the number of years of work experience (p=0.049).
 Conclusion: It is concluded that frontline workers experienced different levels and symptoms of psychological distress in this pandemic.
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