High COVID-related depression, anxiety and PTSD among health workers — Meta-analysis

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A new systematic review of 65 studies from around the world involves a total of 97,333 health care workers and finds that 1 in 5 have experienced depression, anxiety, and/or post-traumatic stress disorder (PTSD) during the ongoing COVID-19 pandemic.

The pandemic has posed significant challenges for health care workers, with many fearing for their own safety while facing a high workload and limited psychological support. Previous analyses of data from multiple studies have revealed high rates of depression, anxiety, and PTSD among health care workers during the pandemic. However, those reviews did not adequately address the many relevant studies conducted in China, where the first COVID-19 outbreak occurred.

To address that gap, Yufei Li, Nathaniel Scherer, and colleagues at the London School of Hygiene & Tropical Medicine, carried out a systematic search of studies in both English and Chinese that were conducted from December 2019 to August 2020 and addressed prevalence of mental disorders in health care workers. They identified 65 suitable studies from 21 countries, involving a total of 97,333 health care workers.

By pooling and statistically analysing data from all 65 studies, the researchers estimated that 21.7% of the health care workers involved in the studies have experienced depression during the pandemic, 22.1% anxiety, and 21.5% PTSD. Studies conducted in the Middle East showed the highest pooled rates of depression (34.6%) and anxiety (28.9%).

These findings suggest that the COVID-19 pandemic has significantly impacted the mental health of health care workers. For comparison, the World Health Organisation estimates that 4.4% of the entire world population experience depression, and 3.6% experience anxiety disorders, including PTSD. However, those estimates were determined through different methods and prior to the pandemic.

Nonetheless, the authors note, the new findings could help inform policy and initiatives to provide urgently needed psychological support to health care workers.

The authors add: "This systematic review and meta-analysis provides, to date, the most comprehensive synthesis of depression, anxiety and PTSD prevalence amongst health care workers during the COVID-19 pandemic, with the unique inclusion of publications in both English and Chinese."


Study details
Prevalence of depression, anxiety and post-traumatic stress disorder in health care workers during the COVID-19 pandemic: A systematic review and meta-analysis

Yufei Li, Nathaniel Scherer, Lambert Felix, Hannah Kuper.

Published in PLOS One on 10 March 2021

The COVID-19 pandemic has placed health care workers under psychological stress. Previous reviews show a high prevalence of mental disorders among health care workers, but these need updating and inclusion of studies written in Chinese. The aim of this systematic review and meta-analysis was to provide updated prevalence estimates for depression, anxiety and post-traumatic stress disorder (PTSD) among health care workers during the COVID-19 pandemic, benefitting from the inclusion of studies published in Chinese.
Systematic search of EMBASE, MEDLINE, PsycINFO, Global Health, Web of Science, CINAHL, Google Scholar and the Chinese databases SinoMed, WanfangMed, CNKI and CQVIP, for studies conducted between December 2019 and August 2020 on the prevalence of depression, anxiety and PTSD in health care workers during the COVID-19 pandemic. Studies published in both English and Chinese were included.
Data on the prevalence of moderate depression, anxiety and PTSD was pooled across 65 studies involving 97,333 health care workers across 21 countries. The pooled prevalence of depression was 21.7% (95% CI, 18.3%-25.2%), of anxiety 22.1% (95% CI, 18.2%-26.3%), and of PTSD 21.5% (95% CI, 10.5%-34.9%). Prevalence estimates are also provided for a mild classification of each disorder. Pooled prevalence estimates of depression and anxiety were highest in studies conducted in the Middle-East (34.6%; 28.9%). Subgroup and meta-regression analyses were conducted across covariates, including sampling method and outcome measure.
This systematic review and meta-analysis has identified a high prevalence of moderate depression, anxiety and PTSD among health care workers during the COVID-19 pandemic. Appropriate support is urgently needed. The response would benefit from additional research on which interventions are effective at mitigating these risks.


PLOS One study (Open access)

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