A multinational, multicentre study on the psychological outcomes and associated physical symptoms amongst healthcare workers during COVID-19 outbreak
Open accessAbstract
Objective Since the declaration of the coronavirus 2019 (COVID-19) outbreak as pandemic, there are reports on the increased prevalence of physical symptoms observed in the general population. We investigated the association between psychological outcomes and physical symptoms among healthcare workers.Methods Healthcare workers from 5 major hospitals, involved in the care for COVID-19 patients, in Singapore and India were invited to participate in a study by performing a self-administered questionnaire within the period of February 19 to April 17, 2020. Healthcare workers included doctors, nurses, allied healthcare workers, administrators, clerical staff and maintenance workers. This questionnaire collected information on demographics, medical history, symptom prevalence in the past month, Depression Anxiety Stress Scales (DASS-21) and the Impact of Events Scale-Revised (IES-R) instrument. The prevalence of physical symptoms displayed by healthcare workers and the associations between physical symptoms and psychological outcomes of depression, anxiety, stress, and post-traumatic stress disorder (PTSD) were evaluated.Results Out of the 906 healthcare workers who participated in the survey, 48 (5.3%) screened positive for moderate to very-severe depression, 79 (8.7%) for moderate to extremely-severe anxiety, 20 (2.2%) for moderate to extremely-severe stress, and 34 (3.8%) for moderate to severe levels of psychological distress. The commonest reported symptom was headache (32.3%), with a large number of participants (33.4%) reporting more than four symptoms. Participants who had experienced symptoms in the preceding month were more likely to be older, have pre-existing comorbidities and a positive screen for depression, anxiety, stress, and PTSD. After adjusting for age, gender and comorbidities, it was found that depression (OR 2.79, 95% CI 1.54-5.07, p = 0.001), anxiety (OR 2.18, 95% CI 1.36-3.48, p = 0.001), stress (OR 3.06, 95% CI 1.27-7.41, p = 0.13), and PTSD (OR 2.20, 95% CI 1.12-4.35, p = 0.023) remained significantly associated with the presence of physical symptoms experienced in the preceding month. Linear regression revealed that the presence of physical symptoms was associated with higher mean scores in the IES-R, DASS Anxiety, Stress and Depression subscales.Conclusions Our study demonstrates a significant association between the prevalence of physical symptoms and psychological outcomes among healthcare workers during the COVID-19 outbreak. We postulate that this association may be bi-directional, and that timely psychological interventions for healthcare workers with physical symptoms should be considered once an infection has been excluded.
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The included studies' findings indicate trauma-related stress in healthcare workers with a prevalence ranging from 7.4% to 35%.
“Overall, the available findings highlight the presence of trauma-related stress, with a prevalence ranging from 7.4 to 35%, particularly among women, nurses, frontline workers, and in workers who experienced physical symptoms.”
From Traumatic Stress in Healthcare Workers during COVID-19 Pandemic: A Review of the Immediate Impact (2020) · cites this paper as Chew et al., 2020
Chew et al. (2020) found that 7.4% of the total sample of healthcare workers exceeded the IES-R cut-off, with 7.5% in Singapore and 7.3% in India.
“The results of the study by Chew et al. (2020) were similar; 7.4% of the total sample of HCWs exceeded the IES-R cut-off (Singapore, 7.5%; India, 7.3).”
From Traumatic Stress in Healthcare Workers during COVID-19 Pandemic: A Review of the Immediate Impact (2020) · cites this paper as Chew et al., 2020
Chew et al. (2020) and Kang et al. (2020) associated having physical symptoms with an increased probability of high scores for trauma-related stress.
“Like to the finding of Chew et al. (2020) and Kang et al. (2020) associated having physical symptoms with an increased probability of high scores for trauma-related stress.”
From Traumatic Stress in Healthcare Workers during COVID-19 Pandemic: A Review of the Immediate Impact (2020) · cites this paper as Chew et al., 2020
The included studies had higher percentages of females (64.3-82.7%) and nurses (up to 82.7%), with average ages ranging from 26 to 40 years.
“All studies found higher percentages of females (64.3–82.7%) and nurses (up to 82.7%), with average ages ranging from 26 to 40 years (Chew et al., 2020; Kang et al., 2020; Lai et al., 2020; Li et al., 2020; Tan et al., 2020; Xiao et al., 2020; Zhang et al., 2020).”
From Traumatic Stress in Healthcare Workers during COVID-19 Pandemic: A Review of the Immediate Impact (2020) · cites this paper as Chew et al., 2020
Risk factors for traumatic symptoms in healthcare workers include being female, younger, a frontline worker, a nurse, having less work experience, exposure to infected people, poor social support, difficult access to psychological material, insomnia, and physical symptoms.
“Overall, the available findings highlight the presence of trauma-related stress, with a prevalence ranging from 7.4 to 35%, particularly among women, nurses, frontline workers, and in workers who experienced physical symptoms.”
From Traumatic Stress in Healthcare Workers during COVID-19 Pandemic: A Review of the Immediate Impact (2020) · cites this paper as Chew et al., 2020
The COVID-19 pandemic has revealed that healthcare workers are at risk of developing psychological and psychiatric disorders due to extreme working conditions, with high rates of anxiety, depression, and insomnia among them.
“The COVID-19 pandemic has revealed that healthcare workers (HW) are at risk of developing psychological and psychiatric disorders due to the extreme working conditions [3], with a high rate of anxiety, depression, and insomnia among them [4,5,6,7].”
From Anxiety, depression and risk of post-traumatic stress disorder in health workers: the relationship with burnout during COVID-19 pandemic in Italy (2021) · cites this paper as [7]
Somatic symptoms were significantly associated with psychological outcomes.
“which were significantly associated with psychological outcomes (Chew et al., 2020).”
From The psychological impact of COVID-19 and other viral epidemics on frontline healthcare workers and ways to address it: A rapid systematic review (2020) · cites this paper as Chew et al., 2020
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“Personal factors Demographic characteristics Age Older [39, 90, 94, 98, 99] Younger [32, 43, 66, 69, 73–75, 87, 101, 103] Gender Male [8, 43, 69, 74] Female [21, 31, 32, 34, 35, 39, 51, 57, 58, 65–67, 75, 76, 83, 86, 88, 90, 94, 97, 99, 100, 103, 104, 107] Low annual income [38, 69] Occupation Business units [90, 93]…”
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Shahrour, G., & Dardas, L. A. (2020) · Journal of Nursing Management · doi:10.1111/jonm.13124 · Cited by 276 · see citing works
Stress and coping during COVID-19 pandemic: Result of an online survey
Kar, N., Kar, B., & Kar, S. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.113598 · Cited by 294 · see citing works
PTSD symptoms among health workers and public service providers during the COVID-19 outbreak
Johnson, S. U., Ebrahimi, O. V., & Hoffart, A. (2020) · PLoS ONE · doi:10.1371/journal.pone.0241032 · Cited by 278 · see citing works
“3% experiencing PTSD-symptoms, were lower than in the current study [45].”
ResultKunzler, A. M., Röthke, N., Günthner, L., Stoffers-Winterling, J., Tüscher, O., Coenen, M., Rehfuess, E., Schwarzer, G., Binder, H., Schmucker, C., et al. (2021) · Globalization and Health · doi:10.1186/s12992-021-00670-y · Cited by 262 · see citing works
“Finally, given the pandemic timeline, the evidence is substantially based Table 4 Results of subgroup analyses for those populations and outcomes with at least k = 4 studies in main analysis (Continued) Subgroup analysis (subgroups) Outcome Test for subgroup differencesa Population Subgroup difference: elevated effect…”
InfluentialShahnazi, H., Ahmadi-Livani, M., Pahlavanzadeh, B., Rajabi, A., Hamrah, M. S., & Charkazi, A. (2020) · Infectious Diseases of Poverty · doi:10.1186/s40249-020-00776-2 · Cited by 272 · see citing works
Ozamiz-Etxebarria, N., Idoiaga Mondragon, N., Dosil Santamaría, M., & Picaza Gorrotxategi, M. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.01491 · Cited by 246 · see citing works
“Healthcare workers experienced high levels of anxiety due to concerns about spreading COVID-19 to their family members (Chew et al., 2020).”
BackgroundSagherian, K., Steege, L. M. B., Cobb, S. J., & Cho, H. (2020) · Journal of Clinical Nursing · doi:10.1111/jocn.15566 · Cited by 254 · see citing works
“From Singapore and India, Chew et al. (2020) found that the prevalence of tiredness or lethargy was 26.6% in healthcare workers.”
BackgroundInfluentialWomen's Mental Health in the Time of Covid-19 Pandemic
Thibaut, F., & van Wijngaarden-Cremers, P. J. M. (2020) · Frontiers in Global Women s Health · doi:10.3389/fgwh.2020.588372 · Cited by 254 · see citing works
“(27) reported that in 906 healthcare workers (64.”
BackgroundTraumatic Stress in Healthcare Workers during COVID-19 Pandemic: A Review of the Immediate Impact
Benfante, A., Di Tella, M., Romeo, A., & Castelli, L. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.569935 · Cited by 237 · see citing works
Psychological impact of COVID-19 on medical care workers in China
Si, M.-Y., Su, X.-Y., Jiang, Y., Wang, W.-J., Gu, X.-F., Ma, L., Li, J., Zhang, S.-K., Ren, Z.-F., Ren, R., et al. (2020) · Infectious Diseases of Poverty · doi:10.1186/s40249-020-00724-0 · Cited by 243 · see citing works
“Compared to the results of a multinational study on psychological impact of COVID-19 outbreak among health care professionals using the similar measurements, the proportion of PTSD symptoms, depression, anxiety, and stress were relatively higher in this study than in Singapore and in India, especially the prevalence o…”
Kumar, P., Kumar, N., Aggarwal, P., & Yeap, J. A. L. (2021) · Current Psychology · doi:10.1007/s12144-021-01567-0 · Cited by 252 · see citing works
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“Public Health 2021, 18, 8172 2 of 17 have been found in Mexico [9], Singapore [10] and China [11–13].”
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Symptoms in Health Care Workers during the COVID-19 Epidemic. A Cross-Sectional Survey
Magnavita, N., Tripepi, G. L., & Prinzio, R. R. D. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17145218 · Cited by 234 · see citing works
“A questionnaire survey in Singapore and India postulated that various symptoms of throat pain, cough and myalgia in HCWs may be over-represented as a result of the psychological stress [65].”
BackgroundSchnell, T., & Krampe, H. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.582352 · Cited by 245 · see citing works
Dhiman, S., Sahu, P., Reed, W. R., Ganesh, G., Goyal, R. K., & Jain, S. (2020) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2020.103790 · Cited by 31 · see citing works
Qualitative study of the psychological experience of COVID-19 patients during hospitalization
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Anxiety and Depression Among People Under the Nationwide Partial Lockdown in Vietnam
Le, H. T., Lai, A. J. X., Sun, J., Hoang, M. T., Vu, L. G., Pham, H. Q., Nguyen, T. H., Tran, B. X., Latkin, C. A., Le, X. T. T., et al. (2020) · Frontiers in Public Health · doi:10.3389/fpubh.2020.589359 · Cited by 203 · see citing works
“The inclusion criteria were: (1) Giving online informed consent for the survey, (2) Having the ability to access the questionnaire online, and (3) Having the ability to understand and respond to the questionnaire.”
BackgroundSelf-citationMariani, R., Renzi, A., Di Trani, M., Trabucchi, G., Danskin, K., & Tambelli, R. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.587724 · Cited by 199 · see citing works
“Extant literature regarding the combined psychological responses and coping methods used by the general population in past outbreaks has shown that coping strategies have included problem-focused coping (seeking alternatives, self- and other-preservation) and seeking social support to mitigate anxiety and depression (…”
BackgroundSirois, F. M., & Owens, J. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.589545 · Cited by 194 · see citing works
“HCW who reported elevated levels of psychological distress during the COVID-19 outbreak also experienced sleep disturbances (10), poorer physical health (11), and a greater number of physical symptoms, including headaches (12).”
BackgroundPsychological effects of the COVID 19 pandemic on healthcare workers globally: A systematic review
Sheraton, M., Deo, N., Dutt, T., Surani, S., Hall‐Flavin, D. K., & Kashyap, R. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.113360 · Cited by 195 · see citing works
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“Healthcare workers experienced increased psychological distress, especially MMPD, consistent with previous studies reporting a higher risk to healthcare workers [10,44].”
ResultDe los Santos, J. A. A., & Labrague, L. J. (2021) · Traumatology · doi:10.1037/trm0000294 · Cited by 188 · see citing works
Hao, F., Tam, W., Hu, X., Tan, W., Jiang, L., Jiang, X., Zhang, L., Zhao, X., Zou, Y., Hu, Y., et al. (2020) · Translational Psychiatry · doi:10.1038/s41398-020-01039-2 · Cited by 190 · see citing works
Self-citationThe psychological impact of COVID-19 and restrictive measures in the world
Passavanti, M., Argentieri, A., Barbieri, D. M., Lou, B., Wijayaratna, K. P., Mirhosseini, A. F., Wang, F., Naseri, S., Qamhia, I. I. A., Tangerås, M., et al. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.01.020 · Cited by 190 · see citing works
Self-citationYörük, S., & Güler, D. S. (2020) · Perspectives In Psychiatric Care · doi:10.1111/ppc.12659 · Cited by 192 · see citing works
Studies of Novel Coronavirus Disease 19 (COVID-19) Pandemic: A Global Analysis of Literature
Tran, B., Ha, G. H., Nguyen, L., Vu, G., Hoang, M. T., Le, H., Latkin, C., Ho, C. S. H., & Ho, R. C. M. (2020) · medRxiv · doi:10.3390/ijerph17114095 · Cited by 172 · see citing works
“Moreover, continued medical training for healthcare workers [47] and preventive measures for the workforce [48], along with frequent transparent communication and educational interventions for the public, is essential to strengthen the preventive capacity of each individual and thus, contribute to the global fight aga…”
BackgroundSelf-citationChigwedere, O. C., Sadath, A., Kabir, Z., & Arensman, E. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18136695 · Cited by 181 · see citing works
“Amerio et al. (2020) 8 Y Y Y Y Y Y Y Y Cai et al. (2020) 5 Y Y Y Y N N N Y Chew et al. (2020) 8 Y Y Y Y Y Y Y Y Du et al. (2020) 5 N Y Y Y N N Y Y Hacimusalar et al. (2020) 8 Y Y Y Y Y Y Y Y Hu et al. (2020) 6 Y Y Y Y N N Y Y Kang et al. (2020) 7 N Y Y Y Y Y Y Y Lai et al. (2020) 8 Y Y Y Y Y Y Y…”
BackgroundInfluentialBareeqa, S. B., Ahmed, S. I., Samar, S. S., Yasin, W., Zehra, S., Monese, G. M., & Gouthro, R. V. (2020) · The International Journal of Psychiatry in Medicine · doi:10.1177/0091217420978005 · Cited by 186 · see citing works
“5% are stressed due to COVID-19 contagion.(38) Considering the mental health issues due to COVID-19, when compared to these other countries, the levels seen in China were significantly higher.”
BackgroundDinçer, B., & İnangil, D. (2020) · EXPLORE · doi:10.1016/j.explore.2020.11.012 · Cited by 195 · see citing works
“Numerous studies have recently appeared which suggest that special interventions should be applied to promote the mental wellbeing of healthcare professionals exposed to COVID-19 and to prevent burnout.(3,4,7-10) Failure to take these steps may not only create”
BackgroundImpacto psicológico de la COVID-19 en una muestra de profesionales sanitarios españoles
Santamaría, M. D., Ozamiz-Etxebarria, N., Rodríguez, I. R., Jaureguizar, J., & Gorrotxategi, M. P. (2020) · Revista de Psiquiatría y Salud Mental · doi:10.1016/j.rpsm.2020.05.004 · Cited by 183 · see citing works
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Industry 4.0 Disruption and Its Neologisms in Major Industrial Sectors: A State of the Art
Bongomin, O., Yemane, A., Kembabazi, B., Malanda, C., Mwape, M. C., Mpofu, N. S., & Tigalana, D. (2020) · Journal of Engineering · doi:10.1155/2020/8090521 · Cited by 177 · see citing works
“0 adoption have been witnessed in the fight of the novel coronavirus 2019 (COVID-19) pandemic [426].”
BackgroundRodriguez, R. M., Medak, A. J., Baumann, B. M., Lim, S. C., Chinnock, B. F., Frazier, R., & Cooper, R. J. (2020) · Academic Emergency Medicine · doi:10.1111/acem.14065 · Cited by 169 · see citing works
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“…on the COVID19 pandemic indicates high rates of mental disorders among HSCWs in many countries, including China, USA, India, and Italy (Braquehais et al., 2020; Carmassi et al., 2020; Chew et al., 2020; Krishnamoorthy, Nagarajan, Saya, & Menon, 2020; Pappa et al., 2020; Shechter et al., 2020).”
BackgroundThe effect of the COVID-19 pandemic on healthcare workers' mental health
Hall, H. (2020) · JAAPA · doi:10.1097/01.jaa.0000669772.78848.8c · Cited by 162 · see citing works
Chen, X., Zhang, S. X., Jahanshahi, A. A., Álvarez-Risco, A., Dai, H., Li, J., & Ibarra, V. J. G. (2020) · JMIR Public Health and Surveillance · doi:10.2196/20737 · Cited by 162 · see citing works
“In particular, we focus on the mental health and well-being of health care workers, which is a prevalent and emergent issue during the COVID-19 pandemic [9].”
BackgroundThe Mental Health Impact of the COVID-19 Pandemic: Implications for Sub-Saharan Africa
Semo, B., & Frissa, S. (2020) · Psychology Research and Behavior Management · doi:10.2147/prbm.s264286 · Cited by 182 · see citing works
Civantos, A. M., Byrnes, Y. M., Chang, C., Prasad, A., Chorath, K. T., Poonia, S. K., Jenks, C. M., Bur, A. M., Thakkar, P., Graboyes, E. M., et al. (2020) · Head & Neck · doi:10.1002/hed.26292 · Cited by 162 · see citing works
Nurses’ Mental Health During the Covid-19 Outbreak
Sampaio, F., Sequeira, C., & Teixeira, L. (2020) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000001987 · Cited by 160 · see citing works
“5).(29) The findings of our study indicate tendentially higher levels of anxiety, stress and depression, which can be explained by the fact that our sample is composed only by nurses, that is, by personnel who had contact with patients with Covid-19.”
BackgroundCOVID-19: anxiety among hospital staff and associated factors
Mattila, E., Peltokoski, J., Neva, M. H., Kaunonen, M., Helminen, M., & Parkkila, A. (2020) · Annals of Medicine · doi:10.1080/07853890.2020.1862905 · Cited by 160 · see citing works
“This association is most probably bi-directional, which may result in the exacerbation of insignificant symptoms [16].”
BackgroundChew, N. W. S., Ngiam, J. N., Tan, B. Y.-Q., Tham, S.-M., Tan, C. Y.-S., Jing, M., Sagayanathan, R., Chen, J. T., Wong, L. Y. H., Ahmad, A., et al. (2020) · BJPsych Open · doi:10.1192/bjo.2020.98 · Cited by 159 · see citing works
Self-citationRosyanti, L., & Hadi, I. (2020) · Health Information Jurnal Penelitian · doi:10.36990/hijp.vi.191 · Cited by 174 · see citing works
Social Stigma: The Hidden Threat of COVID-19
Abdelhafiz, A., & Alorabi, M. (2020) · Frontiers in Public Health · doi:10.3389/fpubh.2020.00429 · Cited by 129 · see citing works
“Healthcare workers also suffered from burnout and faced tremendous stress (8, 9) and potential stigma.”
BackgroundXiong, H., Yi, S., & Lin, Y. (2020) · INQUIRY The Journal of Health Care Organization Provision and Financing · doi:10.1177/0046958020957114 · Cited by 173 · see citing works
Rieckert, A., Schuit, E., Bleijenberg, N., ten Cate, D., de Lange, W., Ginkel, J. M. D. M., Mathijssen, E. G. E., Smit, L. C., Stalpers, D., Schoonhoven, L., et al. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-043718 · Cited by 159 · see citing works
Anxiety and Resilience of Healthcare Workers During COVID-19 Pandemic in Indonesia
Setiawati, Y., Wahyuhadi, J., Joestandari, F., Maramis, M. M., & Atika, A. (2021) · Journal of Multidisciplinary Healthcare · doi:10.2147/jmdh.s276655 · Cited by 174 · see citing works
Ken, C. S., Francis, B., Ng, Y. H., Naim, N., Beh, H. C., Ariffin, M. A. A., Yusuf, M. H. M., Lee, J. W., & Sulaiman, A. H. (2021) · Healthcare · doi:10.3390/healthcare9010079 · Cited by 162 · see citing works
“Chan, A.O.; Huak, C.Y. Psychological impact of the 2003 severe acute respiratory syndrome outbreak on health care workers in a medium size regional general hospital in Singapore.”
ResultLenzo, V., Quattropani, M. C. A., Sardella, A., Martino, G., & Bonanno, G. A. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.623033 · Cited by 158 · see citing works
“One study involving a large sample of healthcare workers reported prevalence rates of moderate to very severe symptoms of 5 percent for depression, 9 percent for anxiety, and 2 percent for stress (Chew et al., 2020).”
BackgroundPsychological well-being of Australian hospital clinical staff during the COVID-19 pandemic
Holton, S., Wynter, K. H., Trueman, M., Bruce, S., Sweeney, S., Crowe, S., Dabscheck, A., Eleftheriou, P., Booth, S., Hitch, D., et al. (2020) · Australian Health Review · doi:10.1071/ah20203 · Cited by 152 · see citing works
Danet, A. (2021) · Medicina Clínica · doi:10.1016/j.medcli.2020.11.009 · Cited by 163 · see citing works
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Santabárbara, J., Bueno‐Notivol, J., Lipnicki, D. M., Olaya, B., Pérez-Moreno, M. A., Gracia‐García, P., Mondragón, N. I., & Ozamiz-Etxebarria, N. (2021) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2021.110244 · Cited by 147 · see citing works
Predictors of UK healthcare worker burnout during the COVID-19 pandemic
Ferry, A. V., Wereski, R., Strachan, F. E., & Mills, N. L. (2020) · QJM · doi:10.1093/qjmed/hcab065 · Cited by 147 · see citing works
Mental Health Challenges of United States Healthcare Professionals During COVID-19
Pearman, A. M., Hughes, M., Smith, E. L., & Neupert, S. D. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.02065 · Cited by 140 · see citing works
“Those who have higher levels of proactive coping compared to those with lower levels of proactive coping have more meaning in life (Miao et al., 2017), fewer symptoms of PTSD (Vernon et al., 2009), and higher levels of quality of life (Cruz et al., 2018).”
BackgroundSriharan, A., Ratnapalan, S., Tricco, A. C., Lupea, D., Ayala, A. P., Pang, H. Y. M., & Lee, D. D. (2020) · Frontiers in Global Women s Health · doi:10.3389/fgwh.2020.596690 · Cited by 149 · see citing works
Dai, L., Wang, X., Jiang, T., Li, P., Wang, Y., Wu, S., Jia, L., Liu, M., An, L., & Cheng, Z. (2020) · PLoS ONE · doi:10.1371/journal.pone.0238416 · Cited by 139 · see citing works
Weiner, L., Berna, F. S., Nourry, N., Séverac, F., Vidailhet, P., & Mengin, A. C. (2020) · Trials · doi:10.1186/s13063-020-04772-7 · Cited by 143 · see citing works
Health care workers' mental health in the face of COVID-19: a systematic review and meta-analysis
Ghahramani, S., Kasraei, H., Hayati, R., Tabrizi, R., & Marzaleh, M. A. (2022) · International Journal of Psychiatry in Clinical Practice · doi:10.1080/13651501.2022.2101927 · Cited by 155 · see citing works
“Finally for stress, studies in which used DASS (Alnazly et al., 2021; Chew et al., 2020; Sandesh et al., 2020; Tan et al., 2020; Zakeri et al., 2021) questionnaire were meta-analysed.”
MethodInfluentialHassannia, L., Taghizadeh, F., Moosazadeh, M., Zarghami, M., Taghizadeh, H., Dooki, A. F., Fathi, M., Alizadeh‐Navaei, R., Hedayatizadeh‐Omran, A., & Dehghan, N. (2020) · Neuropsychopharmacology Reports · doi:10.1002/npr2.12153 · Cited by 133 · see citing works
Depression and Anxiety During the COVID-19 Pandemic: Epidemiology, Mechanism, and Treatment
Zhu, C., Zhang, T., Li, Q., Chen, X., & Wang, K. (2022) · Neuroscience Bulletin · doi:10.1007/s12264-022-00970-2 · Cited by 152 · see citing works
“reported that healthcare workers with comorbid chronic diseases, such as hypertension, hyperlipidemia, and diabetes mellitus, had greater susceptibility to psychological problems than those without comorbidities [41].”
BackgroundClinical update on COVID ‐19 in pregnancy: A review article
Ryan, G. A., Purandare, N. C., McAuliffe, F. M., Hod, M., & Purandare, C. N. (2020) · Journal of obstetrics and gynaecology research · doi:10.1111/jog.14321 · Cited by 131 · see citing works
- Authors
- Chew, N. W. S., Lee, G. K. H., Tan, B. Y. Q., Jing, M., Goh, Y., Ngiam, N. J. H., Yeo, L. L. L., Ahmad, A., Ahmed Khan, F., Napolean Shanmugam, G., Sharma, A. K., Komalkumar, R. N., Meenakshi, P. V., Shah, K., Patel, B., Chan, B. P. L., Sunny, S., Chandra, B., Ong, J. J. Y., Paliwal, P. R., Wong, L. Y. H., Sagayanathan, R., Chen, J. T., Ying Ng, A. Y., Teoh, H. L., Tsivgoulis, G., Ho, C. S., Ho, R. C., & Sharma, V. K.
- Affiliations
- National University Health System (SG)
- National University of Singapore (SG)
- Ng Teng Fong General Hospital (SG)
- Zydus Lifesciences Limited (India) (IN)
- University of Tennessee Health Science Center (US)
- Corresponding author
- Sharma, Vijay K.
- ORCID
- Venue
- Brain, Behavior, and Immunity
- Publisher
- Elsevier BV
- Published
- 2020-08
- Volume
- 88
- Pages
- 559-565
- ISSN
- 0889-1591 (ISSN-L)
- PMC
- PMC7172854
- OpenAlex
- W3016592702
- Cited by
- 1,650
- References
- 29
- Citations by year
- 2026: 24 · 2025: 60 · 2024: 140 · 2023: 250 · 2022: 364 · 2021: 532 · 2020: 277 · 2018: 1 · 2015: 2
- FWCI
- 142.14
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Brain Behavior and Immunity (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- National University of Singapore (submittedVersion)
- Rare & Special e-Zone (The Hong Kong University of Science and Technology) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Keywords
- COVID-19 pandemic, healthcare workers, psychological distress, depression, anxiety, stress, post-traumatic stress disorder, somatic symptoms, headache, workplace mental health, Singapore, India, comorbidities, DASS-21, Impact of Event Scale-Revised, doctors and nurses
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Adult, Allied Health Personnel, Anxiety, Depression, Female, Headache, Health Personnel, Humans, India, Sleep Initiation and Maintenance Disorders, Male, Nurses, Pharyngitis, Physicians, Pneumonia, Viral, Surveys and Questionnaires, Singapore, Stress Disorders, Post-Traumatic, Stress, Psychological, Prevalence, Coronavirus Infections, Internationality, Lethargy, Pandemics
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