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Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis
Open accessAbstract
Background COVID-19 pandemic has the potential to significantly affect the mental health of healthcare workers (HCWs), who stand in the frontline of this crisis. It is, therefore, an immediate priority to monitor rates of mood, sleep and other mental health issues in order to understand mediating factors and inform tailored interventions. The aim of this review is to synthesize and analyze existing evidence on the prevalence of depression, anxiety and insomnia among HCWs during the Covid-19 outbreak.Methods A systematic search of literature databases was conducted up to April 17th, 2020. Two reviewers independently assessed full-text articles according to predefined criteria. Risk of bias for each individual study was assessed and data pooled using random-effects meta-analyses to estimate the prevalence of specific mental health problems. The review protocol is registered in PROSPERO and is available online.Findings Thirteen studies were included in the analysis with a combined total of 33,062 participants. Anxiety was assessed in 12 studies, with a pooled prevalence of 23·2% and depression in 10 studies, with a prevalence rate of 22·8%. A subgroup analysis revealed gender and occupational differences with female HCPs and nurses exhibiting higher rates of affective symptoms compared to male and medical staff respectively. Finally, insomnia prevalence was estimated at 38·9% across 5 studies.Interpretation Early evidence suggests that a considerable proportion of HCWs experience mood and sleep disturbances during this outbreak, stressing the need to establish ways to mitigate mental health risks and adjust interventions under pandemic conditions.
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TL;DR
This systematic review and meta-analysis pooled 13 cross-sectional studies of healthcare workers during the COVID-19 pandemic and found substantial pooled prevalence of anxiety, depression, and insomnia. It reports roughly one in four workers with anxiety or depression and about one in three with insomnia, with higher estimates among women and nursing staff.
Key findings
- Pooled prevalence was 23.21% for anxiety (95% CI 17.77–29.13, I² = 99%; 12 studies), 22.8% for depression (95% CI 15.1–31.51, I² = 99.62%; 10 studies), and 34.32% for insomnia (95% CI 27.45–41.54, I² = 98%; 5 studies).
- Subgroup estimates were higher for women than men for anxiety (29.06% vs 20.92%) and depression (26.87% vs 20.34%), and higher for nurses than doctors for anxiety (25.80% vs 21.73%) and depression (30.30% vs 25.37%).
- Mild symptoms were more common than moderate/severe symptoms: anxiety 17.93% vs 6.88%; depression 24.60% vs 16.18%. Scale-specific pooled estimates varied, e.g., GAD-7 anxiety 36.92% vs SAS anxiety 16.47%, and PHQ-9 depression 36.72 vs SDS depression 32.81.
Methods
- The review followed PRISMA and MOOSE guidance and was registered in PROSPERO (CRD42020180313). Searches covered MEDLINE, PubMed, Google Scholar, MedRxiv, and SSRN through April 17, 2020, with no language restrictions, and included cross-sectional studies of healthcare workers in COVID-19-affected areas that used validated measures for depression, anxiety, or insomnia.
- The meta-analysis included 13 cross-sectional studies with 33,062 participants; 12 were conducted in China (2 in Wuhan) and 1 in Singapore. Median study size was 1,563 (range 134–11,118), median male representation was 18%, and median questionnaire participation was 85.3%.
- Pooled prevalence was estimated with a random-effects model in MetaXL using double arcsine transformation. Subgroup analyses examined gender, rating scales, symptom severity, and professional group; sensitivity analyses excluded each study in turn. Study quality was assessed with a modified Newcastle-Ottawa scale.
Limitations
- Stated in the paper: heterogeneity was high across studies because of different assessment scales and cut-offs; some studies may have sampled overlapping populations from the same region or country; most studies were from China, limiting generalizability; all included studies were cross-sectional, so long-term mental health effects remain unknown; and the number of available studies was relatively small early in the pandemic.
- Evident from the text: the very high I² values (often near 99%) indicate substantial unexplained between-study variability, and the inclusion of preprints means some data may not have been peer-reviewed.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The pooled prevalence was 23·21% (95% CI 17·77-29·13, I2 = 99%) as presented in Fig. 2 .”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Results > Anxiety prevalence
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- The authors state this as an assumption: One true effect size cannot be assumed across studies due to different patient populations, regions, and assessment methods.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“when both were excluded, the recalculated pooled prevalence was 16·94% (95% CI, 10·38-24·67, I2 = 99·56%).”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Results > Depression prevalence
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- The authors state this as an assumption: One true effect size cannot be assumed across studies due to different patient populations, regions, and assessment methods.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“low risk of bias studies (n = 9) revealed a total pooled anxiety prevalence of 24·06% (95% CI 16·84-32·09, I2 = 99%).”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Results > Anxiety prevalence
Strength:plain· not yet calibratedn = 9Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- The authors state this as an assumption: One true effect size cannot be assumed across studies due to different patient populations, regions, and assessment methods.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“four studies (Huang and Zhao, 2020, Lai et al., 2020, Zhang et al., 2020a, Zhu et al., 2020) used the GAD-7 scale with a pooled prevalence of 36·92% (95% CI 26·06-48·23, I2 = 99%).”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Results > Anxiety prevalence
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- The authors state this as an assumption: One true effect size cannot be assumed across studies due to different patient populations, regions, and assessment methods.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The pooled prevalence was calculated as 34·32% (95% CI 27·45–41·54, I2 = 98%).”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Results > Insomnia prevalence
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- The authors state this as an assumption: One true effect size cannot be assumed across studies due to different patient populations, regions, and assessment methods.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Three (Lai et al., 2020, Zhang et al., 2020a, Zhu et al., 2020) studies used the PHQ-9 score for which the pooled prevalence was 36·72 (95% CI 7·69–69·16, Ι2 = 100%)”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Results > Depression prevalence
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- The authors state this as an assumption: One true effect size cannot be assumed across studies due to different patient populations, regions, and assessment methods.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Among low risk of bias studies (n = 8) the pooled prevalence was 22·93% (95% CI 13·16–34·38).”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Results > Depression prevalence
Strength:plain· not yet calibratedn = 8Tests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- The authors state this as an assumption: One true effect size cannot be assumed across studies due to different patient populations, regions, and assessment methods.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“four studies (Guo et al., 2020, Huang et al., 2020b, Liu et al., 2020, Liu et al., 2020)used the Zung Self-Rating Anxiety Scale (SAS) with a pooled prevalence of 16·47% (95% CI 14·66-18·63, I2 = 84%)”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Results > Anxiety prevalence
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- The authors state this as an assumption: One true effect size cannot be assumed across studies due to different patient populations, regions, and assessment methods.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Prevalence of depression by severity could be calculated in four (Du et al., 2020, Liu et al., 2020, Lu et al., 2020, Tan et al., 2020)studies, with respective values for mild and moderate/severe of 24·60% and 16·18%.”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Results > Subgroup analysis
Strength:hedged· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- The authors state this as an assumption: One true effect size cannot be assumed across studies due to different patient populations, regions, and assessment methods.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In sensitivity analysis, no study affected the pooled prevalence by over 2% when excluded.”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Results > Anxiety prevalence
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- It may state two separate claims as one. 17
- Probably not a substantial claim. 16
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“After de-duplication and screening, thirteen studies (Du et al., 2020, Guo et al., 2020, Huang et al., 2020b, Huang and Zhao, 2020, Lai et al., 2020, Liu et al., 2020, Liu et al., 2020, Lu et al., 2020, Qi et al., 2020, Tan et al., 2020, Zhang et al., 2020a, Zhang et al., 2020b, Zhu et al., 2020) with a total of 33,062 participants were included in the analysis.”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Results > Characteristics of included studies
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
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In the paper
“Out of the 13 studies, 12 were undertaken in China, two of which were in Wuhan (Lai et al., 2020, Zhu et al., 2020), while one took place in Singapore (Tan et al., 2020).”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Results > Characteristics of included studies
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
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In the paper
“Regarding the severity of the anxiety, data were available in six studies with a pooled prevalence of 17·93% for mild anxiety and 6·88% for moderate/severe”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Results > Subgroup analysis
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
- The authors state this as an assumption: One true effect size cannot be assumed across studies due to different patient populations, regions, and assessment methods.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“it appears that the majority of the HCWs experienced mild symptoms both for depression and anxiety, while moderate and severe symptoms were less common among the participants.”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Discussion
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Between doctors and nurses, in the five studies with available data on depression, the pooled prevalence was calculated as 30.30% for nurses and 25.37% for doctors”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Results > Subgroup analysis
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
- The authors state this as an assumption: One true effect size cannot be assumed across studies due to different patient populations, regions, and assessment methods.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In doctor and nurse groups, prevalence could be calculated in six studies, with respective values of 21·73%and 25·80%”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Results > Subgroup analysis
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- The authors state this as an assumption: One true effect size cannot be assumed across studies due to different patient populations, regions, and assessment methods.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The prevalence rate of anxiety and depression appeared to be higher in females”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Discussion
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“nursing staff exhibited higher prevalence estimates both for anxiety and depression compared to doctors.”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Discussion
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In the paper
“These results may be partly confounded by the fact that nurses are mostly female but could be also attributed to the fact they may face a greater risk of exposure to COVID-19 patients as they spend more time on wards, provide direct care to patients and are responsible for the collection of sputum for virus detection”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Discussion
What the sources say
- Not checked yetcites Liu et al., 2020
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None of the sources cited for this claim have been checked yet.
In the paper
“a number of other studies published in recent weeks provide emerging evidence that COVID-19 is severely affecting the wellbeing of healthcare professionals.”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Discussion
What the sources say
- Not checked yetcites Cheung et al., 2020
- Not checked yetcites Bohlken et al., 2020
- Not checked yetcites Xu et al., 2020
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“The systematic review was conducted in accordance with the PRISMA statement”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Materials and methods
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In the paper
“physicians are already at an increased risk of suicide compared to the general population (West et al., 2018).”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Discussion
What the sources say
- Not checked yetcites West et al., 2018 source
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“the studies included in our meta-analysis were all cross-sectional, thus the long-term implications of COVID-19 pandemic on HCW’s mental health warrant further research.”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Discussion
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“Two authors independently identified records published until April 17th 2020 that reported on the prevalence of depression, anxiety, and insomnia in HCWs during the coronavirus pandemic through systematically searching MEDLINE, PubMed and Google Scholar databases.”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Materials and methods > Research strategy and selection criteria
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In the paper
“another study performed in the original center of the epidemic, Wuhan, showed that a large proportion of HCW in Wuhan were affected and that mental health support was necessary even for mild psychological reactions (Kang et al., 2020).”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Discussion
What the sources say
- Not checked yetcites Kang et al., 2020 source
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“Another limitation is that several studies might have included the same population as they were broadly conducted in the same region/country.”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Discussion
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“The following data were extracted from each article by two reviews independently”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Materials and methods > Data extraction and quality assessment
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In the paper
“The MOOSE (Meta-analyses Of Observational Studies in Epidemiology) Checklist was followed.”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Materials and methods
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In the paper
“considering the fact that China was severely affected, they provide a reliable indication of the potential of COVID-19 pandemic to affect the mental health of HCWs.”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Discussion
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- Rests on an assumption: China was severely affected by COVID-19.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Potential differences, however, between these outbreaks and the COVID-19 pandemic could be explained on the basis of the extremely high infectious potential and mortality rate of the former but also the experience acquired in the interim in these areas.”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Discussion
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In the paper
“The accuracy of the extracted or calculated data was confirmed by comparing the collection forms of the two investigators.”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Materials and methods > Data extraction and quality assessment
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In the paper
“Different assessment scales were utilized for population screening and different cut offs set even though several studies used the same tests. Thus, threshold criteria for case definition varied”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Discussion
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In the paper
“The review protocol is registered in PROSPERO and is available online (CRD42020180313).”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Materials and methods
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In the paper
“two authors independently evaluated the risk of bias of the included cross-sectional studies using a modified form of the Newcastle-Ottawa scale. Potential disagreements were resolved by a third author.”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Materials and methods > Data extraction and quality assessment
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“our systematic review and meta-analysis provide a timely and comprehensive synthesis of the existing evidence highlighting the high prevalence rates of depression, anxiety and insomnia of healthcare professionals.”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Discussion
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In the paper
“Findings can help to quantify staff support needs and inform tiered and tailored interventions under pandemic conditions that enhance resilience and mitigate vulnerability.”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Discussion
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In the paper
“level of social support was found to positively correlate with self-efficacy and sleep quality and negatively with anxiety and stress (Xiao et al., 2020).”
§ Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis > Discussion
What the sources say
- Not checked yetcites Xiao et al., 2020
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The paper relies on this without support.
The impact of the COVID-19 crisis on the psychological well-being of medical and nursing staff had not yet been established at the time of the review.
“However, to date, the impact of the current unprecedented crisis on the psychological well-being of medical and nursing staff is yet to be established.”
The paper relies on this without support.
This is the first systematic review and meta-analysis to examine the pooled prevalence of depression, anxiety and insomnia in healthcare workers during the COVID-19 outbreak.
“To our knowledge, this is the first systematic review and meta-analysis to examine the pooled prevalence of depression, anxiety and insomnia on HCW during the COVID-19 outbreak.”
The authors state this as an assumption.
One true effect size cannot be assumed across studies due to different patient populations, regions, and assessment methods.
“Due to the different patient populations, regions, and assessment methods across studies, one true effect size cannot be assumed; therefore, a random effects model (DerSimonian & Laird) was used to extract the pooled prevalence.”
The paper relies on this without support.
China was severely affected by COVID-19.
“considering the fact that China was severely affected, they provide a reliable indication of the potential of COVID-19 pandemic to affect the mental health of HCWs.”
The paper relies on this without support.
Healthcare systems vary greatly between countries.
“generalizing this type of results could pose severe flaws as healthcare systems vary greatly between countries.”
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In the citing paper
“A meta-analysis of 13 studies of mental health among healthcare workers found that almost a quarter exhibited elevated COVID-19 related symptoms of anxiety (23.2%) and depression (22.8%), and more than a third (38.9%) experienced problems with insomnia (Pappa et al. 2020).”
From Risk and protective factors for prospective changes in adolescent mental health during the COVID-19 pandemic (2021) · cites this paper as Pappa et al. 2020
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Several factors have been reported to increase the risk for psychological symptoms in healthcare workers, including being a nurse, female gender, and frontline work (Muller et al., 2020; Pappa et al., 2020).”
From Beyond the physical risk: Psychosocial impact and coping in healthcare professionals during the COVID‐19 pandemic. (2025) · cites this paper as Pappa et al., 2020
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Several factors have been reported to increase the risk for psychological symptoms in healthcare workers, including being a nurse, female gender, and frontline work (Muller et al., 2020; Pappa et al., 2020).”
From Beyond the physical risk: Psychosocial impact and coping in healthcare professionals during the COVID‐19 pandemic. (2025) · cites this paper as Pappa et al., 2020
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The COVID-19 pandemic led to increased stress, distress, and burnout across the health and social care workforce,9–12 including palliative care13–16 and exacerbated the need for healthcare staff support internationally.13–17”
From Feasibility of RESTORE: An online Acceptance and Commitment Therapy intervention to improve palliative care staff wellbeing. (2023) · cites this paper as [9]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Several factors have been reported to increase the risk for psychological symptoms in healthcare workers, including being a nurse, female gender, and frontline work (Muller et al., 2020; Pappa et al., 2020).”
From Beyond the physical risk: Psychosocial impact and coping in healthcare professionals during the COVID‐19 pandemic. (2025) · cites this paper as Pappa et al., 2020
In the citing paper
“These findings were supported by a systematic review of 13 studies including more than 33 000 participants.6”
From COVID-19: a heavy toll on health-care workers (2021) · cites this paper as [6]
In the citing paper
“These findings provide new knowledge, since in most of the emergent scientific literature on this topic, these levels have been studied in health workers rather than undergraduates (Pappa et al., 2020).”
From Fear of COVID-19, Stress, and Anxiety in University Undergraduate Students: A Predictive Model for Depression (2020) · cites this paper as Pappa et al., 2020
In the citing paper
“However, most of these studies were carried out in samples of health workers (Pappa et al., 2020), and much less is known about young people.”
From Fear of COVID-19, Stress, and Anxiety in University Undergraduate Students: A Predictive Model for Depression (2020) · cites this paper as Pappa et al., 2020
In the citing paper
“With regard to the risk factor related to psychopathology, consistently with previous epidemiological studies, we have found that females, and patients with positive previous psychiatric diagnoses, suffered more in all psychopathological dimensions (Vindegaard and Eriksen Benros, 2020, Ozamiz-Etxebarria et al., 2020, Pappa et al., 2020).”
From Anxiety and depression in COVID-19 survivors: role of inflammatory and clinical predictors (2020) · cites this paper as Pappa et al., 2020
In the citing paper
“The published literature posits that the distress and anxiety among individuals in this COVID-19 pandemic may increase the incidence of mental disorders [53,54,99]”
From Psychosocial Effects of the COVID-19 Pandemic: Large-scale Quasi-Experimental Study on Social Media (2020) · cites this paper as [99]
In the citing paper
“The stressful situation of healthcare workers, specially the fear to infect relatives, may lead to depressive symptoms (12.2–26.3%), anxiety (13–29%), and PTSS (3–20.7%) as well.”
From Hyperactivation of P2X7 receptors as a culprit of COVID-19 neuropathology (2021) · cites this paper as [184]
In the citing paper
“Meta-analyses have found a high prevalence of anxious and depressive symptoms among HCWs, especially among women and nurses (Pan et al., 2020; Pappa et al., 2020).”
From Traumatic Stress in Healthcare Workers during COVID-19 Pandemic: A Review of the Immediate Impact (2020) · cites this paper as Pappa et al., 2020
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14 of the 62 references couldn’t be matched to a known paper.
Research works printed but not linked: 1
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Cited by
Sorted by citations
Anxiety and depression in COVID-19 survivors: role of inflammatory and clinical predictors
Mazza, M. G., De Lorenzo, R., Conte, C., Poletti, S., Vai, B., Bollettini, I., Melloni, E. M. T., Furlan, R., Ciceri, F., Rovere-Querini, P., et al. (2020) · Brain, Behavior, and Immunity · doi:10.1016/j.bbi.2020.07.037 · Cited by 1,804
“With regard to the risk factor related to psychopathology, consistently with previous epidemiological studies, we have found that females, and patients with positive previous psychiatric diagnoses, suffered more in all psychopathological dimensions (Vindegaard and Eriksen Benros, 2020; Ozamiz-Etxebarria et al., 2020;…”
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“Regarding the current situation, a novel review and meta-analysis of the impact of the pandemic on our mental health, with 13 studies only carried out in Asian countries, indicated that anxiety and depression are often more than 20% prevalent (Pappa et al., 2020), with differences in gender and occupation.”
Magson, N. R., Freeman, J. Y. A., Rapee, R. M., Richardson, C. E., Oar, E. L., & Fardouly, J. (2021) · Journal of Youth and Adolescence · doi:10.1007/s10964-020-01332-9 · Cited by 1,498
“%) experienced problems with insomnia (Pappa et al. 2020).”
Epidemiology of mental health problems in COVID-19: a review
Hossain, M. M., Tasnim, S., Sultana, A., Faizah, F., Mazumder, H., Zou, L., McKyer, E. L. J., Ahmed, H. U., & Ma, P. (2020) · F1000Research · doi:10.12688/f1000research.24457.1 · Cited by 1,113
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Cénat, J. M., Blais-Rochette, C., Kokou-Kpolou, C. K., Noorishad, P.-G., Mukunzi, J. N., McIntee, S.-E., Dalexis, R. D., Goulet, M.-A., & Labelle, P. R. (2021) · Psychiatry Research · doi:10.1016/j.psychres.2020.113599 · Cited by 952
Labrague, L. J., & Santos, J. A. A. D. L. (2020) · Journal of Nursing Management · doi:10.1111/jonm.13121 · Cited by 1,046
“Further, due to their direct contact with COVID-19 patients, healthcare workers (HCWs) are more exposed to traumatic events such as patients’ suffering and deaths (Pappa et al., 2020), which could further amplify their fears and anxiety.”
BackgroundSøvold, L. E., Naslund, J. A., Kousoulis, A. A., Saxena, S., Qoronfleh, M. W., Grobler, C., & Münter, L. (2021) · Frontiers in Public Health · doi:10.3389/fpubh.2021.679397 · Cited by 973
Labrague, L. J., & Santos, J. A. A. (2021) · Journal of Nursing Management · doi:10.1111/jonm.13168 · Cited by 882
Muller, A. E., Hafstad, E. V., Himmels, J. P. W., Smedslund, G., Flottorp, S., Stensland, S. Ø., Stroobants, S., Van de Velde, S., & Vist, G. E. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.113441 · Cited by 895
“Pappa et al. 11 identified thirteen studies in a search on 17 April 2020 and pooled prevalence rates; they reported that more than one of every five healthcare workers suffered from anxiety and/or depression; nearly two in five reported insomnia.”
Moreno, L., Talavera‐Velasco, B., García-Albuerne, Y., & Martín‐García, J. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17155514 · Cited by 834
COVID-19 pandemic: A review of the global lockdown and its far-reaching effects
Onyeaka, H. N., Anumudu, C. K., Al-Sharify, Z. T., Egele-Godswill, E., & Mbaegbu, P. (2021) · Science Progress · doi:10.1177/00368504211019854 · Cited by 883
The prevalence of depression, anxiety, and sleep disturbances in COVID-19 patients: a meta-analysis
Deng, J., Zhou, F., Hou, W., Silver, Z., Wong, C. Y., Chang, O., Huang, E., & Zuo, Q. K. (2021) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.14506 · Cited by 771
Nochaiwong, S., Ruengorn, C., Thavorn, K., Hutton, B., Awiphan, R., Phosuya, C., Ruanta, Y., Wongpakaran, N., & Wongpakaran, T. (2021) · Scientific Reports · doi:10.1038/s41598-021-89700-8 · Cited by 743
“%) for psychological distress; from 9.2% (Italy) to 53.9% (Thailand) for sleep problems.”
BackgroundMethodInfluentialContact with blue-green spaces during the COVID-19 pandemic lockdown beneficial for mental health.
Pouso, S., Borja, Á., Fleming, L. E., Gómez-Baggethun, E., White, M. P., & Uyarra, M. C. (2021) · Science of The Total Environment · doi:10.1016/j.scitotenv.2020.143984 · Cited by 604
Serrano-Ripoll, M. J., Meneses-Echavez, J. F., Ricci-Cabello, I., Fraile-Navarro, D., Fiol-deRoque, M. A., Pastor-Moreno, G., Castro, A., Ruiz-Pérez, I., Zamanillo Campos, R., & Gonçalves-Bradley, D. C. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.08.034 · Cited by 592
“We searched databases from inception to 3rd August 2020, and checked the list of included studies of relevant systematic reviews (Shaukat et al., 2020; Pappa et al., 2020; Pan et al., 2020; Luo et al., 2020; Kisely et al., 2020; Garcia-Iglesias et al., 2020; Carmassi et al., 2020; Brooks et al., 2018) to identify pote…”
The psychological impact of the COVID-19 outbreak on health professionals: A cross-sectional study
Giusti, E. M., Pedroli, E., D'Aniello, G. E., Stramba Badiale, C., Pietrabissa, G., Manna, C., Stramba Badiale, M., Riva, G., Castelnuovo, G., & Molinari, E. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.01684 · Cited by 533
Shanafelt, T. D., West, C. P., Dyrbye, L. N., Trockel, M., Tutty, M., Wang, H., Carlasare, L. E., & Sinsky, C. (2022) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2022.09.002 · Cited by 558
Shah, S. M. A., Mohammad, D., Qureshi, M. F. H., Abbas, M. Z., & Aleem, S. (2021) · Community Mental Health Journal · doi:10.1007/s10597-020-00728-y · Cited by 554
Marvaldi, M., Mallet, J., Dubertret, C., Moro, M. R., & Guessoum, S. B. (2021) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2021.03.024 · Cited by 562
“5) (Pappa et al., 2020); 25 % (95 %CI, 19 %–32 %)(Krishnamoorthy et al.”
BackgroundInfluentialMa, L., Mazidi, M., Ke, L., Li, Y., Chen, S., Kirwan, R., Zhou, H., Yan, N., Rahman, A., Wang, W.-D., et al. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.06.021 · Cited by 527
The effect of smoking on COVID‐19 severity: A systematic review and meta‐analysis
Reddy, R. K., Charles, W. N., Sklavounos, A., Dutt, A., Seed, P. T., & Khajuria, A. (2020) · Journal of Medical Virology · doi:10.1002/jmv.26389 · Cited by 478
“which is unsurprising given the stress, isolation, and other adverse psychosocial repercussions of life during a global pandemic.(91,92) Con-”
BackgroundDeng, J., Zhou, F., Hou, W., Silver, Z. A., Wong, C. Y., Chang, O., Drakos, A., Zuo, Q., & Huang, E. (2021) · Psychiatry Research · doi:10.1016/j.psychres.2021.113863 · Cited by 532
Scott, A. J., Tan, B. Y., Huak, C. Y., Sia, C.-H., Chua, Y. X., Goh, E. T., Zbikowska, G., Dykowska, G., Martin, G., Kinross, J. K., et al. (2021) · PLoS ONE · doi:10.1371/journal.pone.0238666 · Cited by 500
Alnazly, E. K., Khraisat, O. M. A., Al-Bashaireh, A. M., & Bryant, C. L. (2021) · PLoS ONE · doi:10.1371/journal.pone.0247679 · Cited by 452
“[39] support the results of the current study, as they indicate that health-care workers experience anxiety and depression during COVID-19; however, Pappa et al.”
BackgroundResultShanafelt, T. D., West, C. P., Sinsky, C. A., Trockel, M., Tutty, M., Wang, H., Carlasare, L. E., & Dyrbye, L. N. (2022) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2021.11.021 · Cited by 456
Prevalence of Depression, Anxiety, and Stress during COVID-19 Pandemic
Lakhan, R., Agrawal, A., & Sharma, M. (2020) · Journal of Neurosciences in Rural Practice · doi:10.1055/s-0040-1716442 · Cited by 421
Buselli, R., Corsi, M., Baldanzi, S., Chiumiento, M., Lupo, E. D., Dell’Oste, V., Bertelloni, C. A., Massimetti, G., Dell’Osso, L., Cristaudo, A., et al. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17176180 · Cited by 465
Saragih, I. D., Tonapa, S. I., Saragih, I. S., Advani, S., Batubara, S. O., Suarilah, I., & Lin, C. (2021) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2021.104002 · Cited by 427
Rodríguez-Hidalgo, A. J., Pantaleón, Y., Dios, I., & Falla, D. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.591797 · Cited by 408
Wang, Y., Kala, M. P., & Jafar, T. H. (2020) · PLOS ONE · doi:10.1371/journal.pone.0244630 · Cited by 382
COVID-19: a heavy toll on health-care workers
Mehta, S., Machado, F., Kwizera, A., Papazian, L., Moss, M., Azoulay, É., & Herridge, M. (2021) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(21)00068-0 · Cited by 381
Symptoms of burnout in intensive care unit specialists facing the COVID-19 outbreak
Azoulay, É., Waele, J. J. D., Ferrer, R., Staudinger, T., Borkowska, M., Póvoa, P. M. S. R., Iliopoulou, K., Artigas, A., Schaller, S. J., Shankar‐Hari, M., et al. (2020) · Annals of Intensive Care · doi:10.1186/s13613-020-00722-3 · Cited by 408
Paredes, M. R., Apaolaza, V., Fernandez-Robin, C., Hartmann, P., & Yañez-Martinez, D. (2021) · Personality and Individual Differences · doi:10.1016/j.paid.2020.110455 · Cited by 383
Murat, M., Köse, S., & Şavaşer, S. (2020) · International Journal of Mental Health Nursing · doi:10.1111/inm.12818 · Cited by 369
The Mental Health Impact of the COVID-19 Pandemic Across Different Cohorts
Khan, K. S., Mamun, M. A., Griffiths, M. D., & Ullah, I. (2020) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-020-00367-0 · Cited by 356
“…and have reported the highest level of depression and anxiety compared to low-risk healthcare workers working in chest and pulmonology departments (Pappa et al. 2020), alongside the anxiety and fear of getting infected with COVID-19 because of their increased risk of exposure (Ho et al. 2020).”
BackgroundInvestigating the psychological impact of COVID-19 among healthcare workers: a meta-analysis
Batra, K., Singh, T. P., Sharma, M., Batra, R., & Schvaneveldt, N. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17239096 · Cited by 342
“Discussion This pooled analysis included a large data sample of studies (n = 65) with 79,437 participants, compared to previous meta-analyses that included 13–19 studies [14,15].”
BackgroundResultInfluentialŞahin, M. K., Aker, S., Şahin, G., & Karabekiroğlu, A. (2020) · Journal of Community Health · doi:10.1007/s10900-020-00921-w · Cited by 351
Jahrami, H., Alhaj, O. A., Humood, A. M., Alenezi, A. F., Fekih‐Romdhane, F., Al-Rasheed, M. M., Saif, Z., Bragazzi, N. L., Pandi-Perumal, S. R., BaHammam, A. S., et al. (2022) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2022.101591 · Cited by 359
“Ten previous systematic reviews and meta-analyses were performed and published before our review [2 e 11]; and were critically appraised as a preparatory step.”
COVID-19 Pandemic: Age-Related Differences in Measures of Stress, Anxiety and Depression in Canada
Nwachukwu, I., Nkire, N., Shalaby, R., Hrabok, M., Vuong, W., Gusnowski, A., Surood, S., Urichuk, L., Greenshaw, A. J., & Agyapong, V. I. O. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17176366 · Cited by 336
“A recent meta-analysis reported rates of depression and anxiety that exceed 20% with differences in certain demographic variables such as gender and occupation [10].”
BackgroundGalehdar, N., Kamran, A., Toulabi, T., & Heydari, H. (2020) · BMC Psychiatry · doi:10.1186/s12888-020-02898-1 · Cited by 329
“Also, a systematic review and meta-analysis has shown a high prevalence of mental disturbances such as anxiety and depression among healthcare workers during the COVID-19 pandemic [13].”
BackgroundMedical education challenges and innovations during COVID-19 pandemic
Papapanou, M., Routsi, E., Tsamakis, K., Fotis, L., Marinos, G., Lidoriki, I., Karamanou, M., Papaioannou, T. G., Tsiptsios, D., Smyrnis, N., et al. (2021) · Postgraduate Medical Journal · doi:10.1136/postgradmedj-2021-140032 · Cited by 325
Rahman, M. A., Hoque, N., Alif, S. M., Salehin, M., Islam, S. M. S., Banik, B., Sharif, A., Nazim, N. B., Sultana, F., & Cross, W. (2020) · Globalization and Health · doi:10.1186/s12992-020-00624-w · Cited by 327
“Findings related to self-identification as a frontline or essential service worker exhibiting a lower level of stress in the present study was somewhat incongruous with other initial studies, which showed a significant mental health burden on frontline healthcare workers during pandemics [30].”
ResultLasalvia, A., Amaddeo, F., Porru, S., Carta, A., Tardivo, S., Bovo, C., Ruggeri, M., & Bonetto, C. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-045127 · Cited by 324
Insomnia, anxiety, and depression during the COVID-19 pandemic: An international collaborative study
Morin, C. M., Bjorvatn, B., Chung, F., Holzinger, B., Partinen, M., Penzel, T., Ivers, H., Wing, Y. K., Chan, N. Y., Merikanto, I., et al. (2021) · Sleep Medicine · doi:10.1016/j.sleep.2021.07.035 · Cited by 312
“Another meta-analysis of studies conducted with health-care workers [9] found pooled prevalence of 38.”
BackgroundResultKulkarni, A. P., Khasne, R. W., Dhakulkar, B. S., & Mahajan, H. C. (2020) · Indian Journal of Critical Care Medicine · doi:10.5005/jp-journals-10071-23518 · Cited by 325
Sahebi, A., Nejati-Zarnaqi, B., Moayedi, S., Yousefi, K., Torres, M., & Golitaleb, M. (2021) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2021.110247 · Cited by 311
Exploring COVID-19 stress and its factors in Bangladesh: A perception-based study
Islam, S. M. D.-U., Bodrud-Doza, M., Khan, R. M., Haque, M. A., & Mamun, M. A. (2020) · Heliyon · doi:10.1016/j.heliyon.2020.e04399 · Cited by 304
Dragioti, E., Li, H. J., Tsitsas, G. D., Lee, K. H., Choi, J., Kim, J., Choi, Y. J., Tsamakis, K., Estradé, A., Agorastos, A., et al. (2021) · Journal of Medical Virology · doi:10.1002/jmv.27549 · Cited by 316
The gendered pandemic: The implications of COVID‐19 for work and family
Yavorsky, J. E., Qian, Y., & Sargent, A. C. (2021) · Sociology Compass · doi:10.1111/soc4.12881 · Cited by 286
“In view of the fact that women make up the majority of the healthcare workforce and rates of depression and anxiety were higher for women healthcare workers relative to comparable men during the pandemic (Pappa et al., 2020), women appear to bear a disproportionate mental health toll associated with this work.”
BackgroundPoortinga, W., Bird, N., Hallingberg, B., Phillips, R., & Williams, D. (2021) · Landscape and Urban Planning · doi:10.1016/j.landurbplan.2021.104092 · Cited by 295
Analysis of the Delta Variant B.1.617.2 COVID-19
Shiehzadegan, S., Alaghemand, N., Fox, M., & Venketaraman, V. (2021) · Clinics and Practice · doi:10.3390/clinpract11040093 · Cited by 275
“Healthcare workers are not the only group that have undergone excessive stress due to this pandemic; the general population has illustrated psychiatric symptoms as well [3].”
BackgroundDeng, J., Zhou, F., Hou, W., Heybati, K., Lohit, S., Abbas, U., Silver, Z., Wong, C. Y., Chang, O., Huang, E., et al. (2023) · Annals of the New York Academy of Sciences · doi:10.1111/nyas.14947 · Cited by 283
Sanghera, J., Pattani, N., Hashmi, Y., Varley, K. F., Cheruvu, M. S., Bradley, A., & Burke, J. R. (2020) · Journal of Occupational Health · doi:10.1002/1348-9585.12175 · Cited by 274
Yan, H., Ding, Y., & Guo, W. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.617001 · Cited by 283
“A modified form of the Newcastle–Ottawa scale was applied for quality assessment (Pappa et al., 2020).”
MethodChang, J.-J., Ji, Y., Li, Y.-H., Pan, H.-F., & Su, P.-Y. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.05.109 · Cited by 275
Necho, M., Tsehay, M., Birkie, M., Biset, G., & Amsalu, E. T. (2021) · International Journal of Social Psychiatry · doi:10.1177/00207640211003121 · Cited by 297
“The present prevalence of anxiety and depression was also higher than the result of a systematic review and meta-analysis on health care professionals during the COVID-19 period (23.2% for anxiety and 22.8% for depression) (Pappa et al., 2020).”
BackgroundResultInfluentialWang, C., Wen, W., Zhang, H., Ni, J., Jiang, J., Cheng, Y., Zhou, M., Ye, L., Feng, Z., Ge, Z., et al. (2023) · Journal of American College Health · doi:10.1080/07448481.2021.1960849 · Cited by 267
Finstad, G. L., Giorgi, G., Lulli, L. G., Pandolfi, C., Foti, G., León-Perez, J. M., Cantero-Sánchez, F. J., & Mucci, N. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18189453 · Cited by 273
“Likewise, there is growing evidence that COVID-19 is associated with post-traumatic symptoms and psychological disorders, especially for frontline health workers [8,9].”
BackgroundAzoulay, E., Cariou, A., Bruneel, F., Demoule, A., Kouatchet, A., Reuter, D., Souppart, V., Combes, A., Klouche, K., Argaud, L., et al. (2020) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.202006-2568oc · Cited by 272
“Furthermore, in a systematic review and meta-analysis (4), anxiety was assessed in 12 studies, with a pooled prevalence of 23.”
BackgroundRacine, N., Hetherington, E., McArthur, B. A., McDonald, S., Edwards, S., Tough, S., & Madigan, S. (2021) · The Lancet Psychiatry · doi:10.1016/s2215-0366(21)00074-2 · Cited by 263
Mental health of nursing in coping with COVID-19 at a regional university hospital
Dal’Bosco, E. B., Floriano, L. S. M., Skupien, S. V., Arcaro, G., Martins, A. R., & Anselmo, A. C. C. (2020) · Revista Brasileira de Enfermagem · doi:10.1590/0034-7167-2020-0434 · Cited by 275
“The prevalence of depression observed in this research was in line with an international study(16).”
BackgroundResultHow the COVID-19 pandemic will change the future of critical care
Arabi, Y. M., Azoulay, É., Al‐Dorzi, H. M., Phua, J., Salluh, J. I., Binnie, A., Hodgson, C. L., Angus, D. C., Cecconi, M., Du, B., et al. (2021) · Intensive Care Medicine · doi:10.1007/s00134-021-06352-y · Cited by 252
Mamun, M. A., Sakib, N., Gozal, D., Bhuiyan, A. K. M. I., Hossain, S., Bodrud-Doza, M., Al‐Mamun, F., Hosen, I., Safiq, M. B., Abdullah, A. H., et al. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.10.036 · Cited by 252
“9% insomnia were reported among healthcare professionals (Pappa et al., 2020).”
Traumatic 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
Health care workers’ experiences during the COVID-19 pandemic: a scoping review
Chemali, S., Sáez, A. M., Bcheraoui, C. E., & Weishaar, H. B. (2022) · Human Resources for Health · doi:10.1186/s12960-022-00724-1 · Cited by 252
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
“Existing studies refer either to the disease induced by Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) in HCWs [13] or to psychological effects of previous viral epidemics [14] or current one [15,16], but there are no field studies describing the psychophysical state of HCWs during the acute phase of the…”
BackgroundLasalvia, A., Bonetto, C., Porru, S., Carta, A., Tardivo, S., Bovo, C., Ruggeri, M., & Amaddeo, F. (2020) · Epidemiology and Psychiatric Sciences · doi:10.1017/s2045796020001158 · Cited by 241
The psychiatric sequelae of the COVID‐19 pandemic in adolescents, adults, and health care workers
Murata, S., Rezeppa, T. L., Thoma, B. C., Marengo, L., Krancevich, K., Chiyka, E. A., Hayes, B., Goodfriend, E., Deal, M., Zhong, Y., et al. (2020) · Depression and Anxiety · doi:10.1002/da.23120 · Cited by 242
COVID-19 pandemic effects on health worker's mental health: systematic review and meta-analysis
Aymerich, C., Pedruzo, B., Pérez, J. L., Laborda, M., Herrero, J., Blanco, J., Mancebo, G., Andrés, L., Estévez, O., Fernandez, M., et al. (2022) · European Psychiatry · doi:10.1192/j.eurpsy.2022.1 · Cited by 234
Secondary Traumatic Stress and Burnout in Healthcare Workers during COVID-19 Outbreak
Marzetti, F., Vagheggini, G., Conversano, C., Miccoli, M., Gemignani, A., Ciacchini, R., Panait, E., & Orrù, G. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18010337 · Cited by 252
“Two recent systematic reviews and meta-analysis underlined the higher prevalence of depression, anxiety, and insomnia among HCWs during the COVID-19 outbreak [20,21].”
BackgroundSchnell, T., & Krampe, H. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.582352 · Cited by 262
Influence of caring for COVID‐19 patients on nurse's turnover, work satisfaction and quality of care
Lavoie‐Tremblay, M., Gélinas, C., Aubé, T., Tchouaket, E., Tremblay, D., Gagnon, M., & Côté, J. (2022) · Journal of Nursing Management · doi:10.1111/jonm.13462 · Cited by 224
“In March of 2020, the World Health Organization (WHO) declared a global pandemic, given its international transmission affecting substantial amounts of people, resulting in considerable deaths and causing immense social and economic disruptions (Pappa et al., 2021).”
BackgroundInfluentialImpact of COVID-19 outbreak on nurses’ mental health: A prospective cohort study
Sampaio, F., Sequeira, C., & Teixeira, L. (2020) · Environmental Research · doi:10.1016/j.envres.2020.110620 · Cited by 220
Salari, N., Khazaie, H., Far, A. H., Ghasemi, H., Mohammadi, M., Shohaimi, S., Daneshkhah, A., Khaledi‐Paveh, B., & Hosseinian-Far, M. (2020) · Globalization and Health · doi:10.1186/s12992-020-00620-0 · Cited by 228
“Pappa et al. (2020) conducted a meta-analysis to examine the prevalence of sleep disturbances among healthcare staff facing the COVID19 patients; the study reported the prevalence of sleep disturbances among the studied population as 38.8% [36].”
MethodInfluentialPoor Sleep Quality and Its Consequences on Mental Health During the COVID-19 Lockdown in Italy
Franceschini, C., Musetti, A., Zenesini, C., Palagini, L., Scarpelli, S., Quattropani, M. C. A., Lenzo, V., Freda, M. F., Lemmo, D., Vegni, E. A. M., et al. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.574475 · Cited by 229
Dobson, H., Malpas, C. B., Burrell, A. J. C., Gurvich, C., Chen, L., Kulkarni, J., & Winton‐Brown, T. (2020) · Australasian Psychiatry · doi:10.1177/1039856220965045 · Cited by 204
Mahmud, S. A. S., Hossain, S., Muyeed, A., Islam, M. M., & Mohsin, M. (2021) · Heliyon · doi:10.1016/j.heliyon.2021.e07393 · Cited by 222
Danet, A. (2021) · Medicina Clínica (English Edition) · doi:10.1016/j.medcle.2020.11.003 · Cited by 225
Pakenham, K. I., Landi, G., Boccolini, G., Furlani, A., Grandi, S., & Tossani, E. (2020) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2020.07.003 · Cited by 210
Yuan, K., Zheng, Y., Wang, Y., Sun, Y., Gong, Y.-M., Huang, Y., Chen, X., Liu, X., Zhong, Y., Su, S., et al. (2022) · Molecular Psychiatry · doi:10.1038/s41380-022-01638-z · Cited by 227
“Recent published metaanalyses also pointed the existence of high prevalence of mental symptoms during COVID-19 among populations including general public and health workers [12, 13].”
BackgroundEttman, C. K., Cohen, G. H., Abdalla, S. M., Sampson, L., Trinquart, L., Castrucci, B. C., Bork, R. H., Clark, M. A., Wilson, I. B., Vivier, P. M., et al. (2021) · The Lancet Regional Health - Americas · doi:10.1016/j.lana.2021.100091 · Cited by 212
“[2,3] and globally, including among healthcare workers, [4,5] children, [6] and the general public.”
López-Moreno, M., López, M. T. I., Miguel, M., & Garcés-Rimón, M. (2020) · Nutrients · doi:10.3390/nu12113445 · Cited by 210
“9% across five studies) during this outbreak [48].”
BackgroundSun, P., Wang, M., Song, T., Wu, Y., Luo, J., Chen, L., & Yan, L. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.626547 · Cited by 214
Xiang, M.-Q., Tan, X.-M., Sun, J., Yang, H.-Y., Zhao, X.-P., Liu, L., Hou, X., & Hu, M. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.582436 · Cited by 213
Arora, T., Grey, I. M., Östlundh, L., Lam, H. K. B., Omar, O. M., & Arnone, D. (2020) · Journal of Health Psychology · doi:10.1177/1359105320966639 · Cited by 206
“The first specifically focused on the psychological impact of COVID-19 among HCWs (Pappa et al., 2020).”
BackgroundHertz‐Palmor, N., Moore, T. M., Gothelf, D., DiDomenico, G. E., Dekel, I., Greenberg, D. M., Brown, L. A., Matalon, N., Visoki, E., White, L. K., et al. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.04.054 · Cited by 226
“While data on mental health during the current pandemic is mounting, most studies to date were either cross-sectional (Pappa et al., 2020; Salari et al., 2020) or compared current reaction with pre-pandemic situation, capturing one specific moment in the course of the pandemic.”
BackgroundAssessing the Psychological Impact of COVID-19 among College Students: An Evidence of 15 Countries
Batra, K., Sharma, M., Batra, R., Singh, T. P., & Schvaneveldt, N. (2021) · Healthcare · doi:10.3390/healthcare9020222 · Cited by 212
Cénat, J. M., Farahi, S. M. M. M., Dalexis, R. D., Darius, W. P., Bekarkhanechi, F. M., Poisson, H., Broussard, C., Ukwu, G., Auguste, E., Nguyen, D. D., et al. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.07.011 · Cited by 194
Chutiyami, M., Cheong, A. M. Y., Salihu, D., Bello, U. M., Ndwiga, D. W., Maharaj, R., Naidoo, K., Kolo, M. A., Jacob, P., Chhina, N., et al. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.804525 · Cited by 206
Sirois, F. M., & Owens, J. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.589545 · Cited by 202
“Implications and Conclusions Whereas, other reviews have documented the extent of distress experienced by HCW during an outbreak (2), the current Review highlights the profiles of HCW most at risk for psychological distress and psychiatric morbidity during an outbreak.”
BackgroundMethodInfluentialFiorenzato, E., Zabberoni, S., da Costa, A. L. C., & Cona, G. (2021) · PLoS ONE · doi:10.1371/journal.pone.0246204 · Cited by 214
“Differently from previous evidence, we did not find workers employed during lockdown, which includes healthcare professionals, to be at a higher risk for mental illness [7, 13, 15, 48], particularly with a high level of burnout [48].”
BackgroundMethodResultInfluentialArafa, A., Mohammed, Z., Mahmoud, O. E., Elshazley, M., & Ewis, A. A. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.09.080 · Cited by 192
Alonso, J., Vilagut, G., Mortier, P., Ferrer, M., Alayo, I., Peña, A. A., Aragonès, E., Campos, M., del Cura-González, I., Emparanza, J. I., et al. (2020) · Revista de Psiquiatría y Salud Mental (English Edition) · doi:10.1016/j.rpsm.2020.12.001 · Cited by 226
Yörük, S., & Güler, D. S. (2020) · Perspectives In Psychiatric Care · doi:10.1111/ppc.12659 · Cited by 192
Spilg, E. G., Rushton, C. H., Phillips, J. L., Kendzerska, T., Saad, M., Gifford, W., Gautam, M., Bhatla, R., Edwards, J. D., Quilty, L. C., et al. (2021) · BMC Psychiatry · doi:10.1186/s12888-021-03637-w · Cited by 202
Brier, N. D., Stroobants, S., Vandekerckhove, P. G., & Buck, E. D. J. D. (2020) · PLoS ONE · doi:10.1371/journal.pone.0244052 · Cited by 211
Public mental health problems during COVID-19 pandemic: a large-scale meta-analysis of the evidence
Liu, X., Zhu, M., Zhang, R., Zhang, J., Zhang, C., Liu, P., Feng, Z., & Chen, Z. (2021) · Translational Psychiatry · doi:10.1038/s41398-021-01501-9 · Cited by 195
“One concern in previous studies is that the conclusions regarding the prevalence of these mental health problems are highly heterogeneous, irrespective of whether they are derived from original investigations or meta-analyses [13, 14].”
BackgroundDe los Santos, J. A. A., & Labrague, L. J. (2021) · Traumatology · doi:10.1037/trm0000294 · Cited by 188
Metadata
- Authors
- Pappa, S., Ntella, V., Giannakas, T., Giannakoulis, V. G., Papoutsi, E., & Katsaounou, P.
- Affiliations
- West London Mental Health NHS Trust (GB)
- National and Kapodistrian University of Athens (GR)
- Corresponding author
- Pappa, Sofia
- ORCID
- Venue
- Brain Behavior and Immunity
- Publisher
- Elsevier BV
- Published
- 2020-08
- Volume
- 88
- Pages
- 901-907
- ISSN
- 0889-1591 (ISSN-L)
- PMC
- PMC7206431
- OpenAlex
- W3021065879
- Cited by
- 3,617
- References
- 62
- Citations by year
- 2026: 161 · 2025: 231 · 2024: 357 · 2023: 568 · 2022: 885 · 2021: 1070 · 2020: 342
- FWCI
- 56.00
- Type
- journal article
- Language
- en
- Update notices
- erratum (2021-02-01)
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Brain Behavior and Immunity (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- 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 › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- COVID-19 pandemic, healthcare workers, depression, anxiety, insomnia, mental health, prevalence, nurses, gender differences, occupational differences, mood disorders, sleep disorders
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Anxiety, Depression, Health Personnel, Humans, Sleep Initiation and Maintenance Disorders, Nurses, Physicians, Pneumonia, Viral, Prevalence, Sex Distribution, Coronavirus Infections, Pandemics
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