Symptoms of burnout in intensive care unit specialists facing the COVID-19 outbreak

Elie Azoulay,Antonio Artigas,Pedro Povoa,Marta Borkowska,Mariangela Pellegrini,Ricard Ferrer,Jozef Kesecioglu,Esicm ,Katerina Iliopoulou,Jan De Waele,Michael Darmon,Maurizio Cecconi,Manu Shankar Hari,Stefan J Schaller,Thomas Staudinger

doi:10.1186/s13613-020-00722-3

Abstract

BackgroundThe COVID-19 pandemic has resulted in an unprecedented healthcare crisis with a high prevalence of psychological distress in healthcare providers. We sought to document the prevalence of burnout syndrome amongst intensivists facing the COVID-19 outbreak.MethodsCross-sectional survey among intensivists part of the European Society of Intensive Care Medicine. Symptoms of severe burnout, anxiety and depression were collected. Factors independently associated with severe burnout were assessed using Cox model.ResultsResponse rate was 20% (1001 completed questionnaires were returned, 45 years [39–53], 34% women, from 85 countries, 12 regions, 50% university-affiliated hospitals). The prevalence of symptoms of anxiety and depression or severe burnout was 46.5%, 30.2%, and 51%, respectively, and varied significantly across regions. Rating of the relationship between intensivists and other ICU stakeholders differed significantly according to the presence of anxiety, depression, or burnout. Similar figures were reported for their rating of the ethical climate or the quality of the decision-making. Factors independently associated with anxiety were female gender (HR 1.85 [1.33–2.55]), working in a university-affiliated hospital (HR 0.58 [0.42–0.80]), living in a city of > 1 million inhabitants (HR 1.40 [1.01–1.94]), and clinician’s rating of the ethical climate (HR 0.83 [0.77–0.90]). Independent determinants of depression included female gender (HR 1.63 [1.15–2.31]) and clinician’s rating of the ethical climate (HR 0.84 [0.78–0.92]). Factors independently associated with symptoms of severe burnout included age (HR 0.98/year [0.97–0.99]) and clinician’s rating of the ethical climate (HR 0.76 [0.69–0.82]).ConclusionsThe COVID-19 pandemic has had an overwhelming psychological impact on intensivists. Follow-up, and management are warranted to assess long-term psychological outcomes and alleviate the psychological burden of the pandemic on frontline personnel.

Highlights

With more than six million confirmed cases worldwide and more than 350,000 deaths between February and May 2020, the COVID-19 pandemic has emerged as an unprecedented healthcare crisis [1,2,3]
Preliminary reports from countries affected early on in the pandemic highlight the high prevalence of psychological burden in healthcare providers outside the critical care setting [7, 8]
They were significantly associated with depression, anxiety, and stress symptoms [4, 9]. This psychological burden appears to be higher in healthcare providers, especially in those who are younger, less experienced, and amongst those working in frontline [10]

Summary

Introduction

With more than six million confirmed cases worldwide and more than 350,000 deaths between February and May 2020, the COVID-19 pandemic has emerged as an unprecedented healthcare crisis [1,2,3]. Preliminary reports from countries affected early on in the pandemic highlight the high prevalence of psychological burden in healthcare providers outside the critical care setting [7, 8]. In the general population exposed to the health crisis and state of emergency, high levels of loneliness, worry, fatigue, and low distress tolerance were reported during the early weeks of the COVID-19 pandemic. They were significantly associated with depression, anxiety, and stress symptoms [4, 9]. We sought to document the prevalence of burnout syndrome amongst intensivists facing the COVID-19 outbreak

Methods

Results

Conclusion