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Impact of the COVID-19 pandemic on the mental health of hospital staff: An umbrella review of 44 meta-analyses
Open accessAbstract
BACKGROUND: Hospital staff is at high risk of developing mental health issues during the coronavirus (COVID-19) pandemic. However, the literature lacks an overall and inclusive picture of mental health problems with comprehensive analysis among hospital staff during the COVID-19 pandemic. OBJECTIVES: To ascertain the prevalence of anxiety, depression and other mental health outcomes as reported in original articles among hospital staff during the COVID-19 pandemic. DESIGN: A PRISMA 2020 and MOOSE 2000 compliant umbrella review of published meta-analyses of observational studies evaluating the prevalence of mental health problems in hospital staff during the pandemic. REVIEW METHODS: index was employed to assess between-study heterogeneity. Publication bias using Egger test and LFK index was examined. Data was analyzed using STATA 17.0 software. AMSTAR-2 was applied for the quality assessment of systematic reviews, while we used GRADE to rate the quality of evidence. RESULTS: Forty-four meta-analyses from 1298 individual studies were included in the final analysis, encompassing the prevalence of 16 mental health symptoms. One-third of hospital workers reported anxiety (Prevalence: 29.9%, 95% CI:27.1% to 32.7%) and depression (Prevalence: 28.4%, 95% CI:25.5% to 31.3%) symptomatology, while about 40% (95% CI: 36.9% to 42.0%) suffered from sleeping disorders. Fear-related symptoms, reduced well-being, poor quality of life, and acute stress symptoms had the highest prevalence among hospital staff. However, the quality of evidence in these areas varied from low to very low. Nurses suffered more often from sleep problems and symptoms of anxiety and depression than doctors, whereas doctors reported a higher prevalence of acute stress and post-traumatic disorders. The burden of anxiety, depression, and sleep disorders was higher among female employees than their male counterparts. Remarkably, acute stress and insomnia affected more than half of first-line medical staff. CONCLUSIONS: The prevalence of mental health problems among hospital staff during the COVID-19 pandemic is generally high, with anxiety, depression and insomnia symptoms representing the most robust evidence based on a large dataset of prevalence meta-analyses. However, there is no strong confidence in the body of evidence for each outcome assessed. REGISTRATION: Not registered. TWEETABLE ABSTRACT: The COVID-19 pandemic is having a major impact on the mental health of hospital staff. The need for support must be different for nurses and doctors @eldi12345.
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“Especially during the COVID-19 pandemic, nurses were faced with a variety of challenges, including a dramatic increase in workload and shift frequency, physical strain, high risk of infection, and a shortage of health care workers, all of which contributed to more severe anxiety and depression symptoms [2].”
From Effects and Mechanisms of a Web- and Mobile-Based Acceptance and Commitment Therapy Intervention for Anxiety and Depression Symptoms in Nurses: Fully Decentralized Randomized Controlled Trial. (2023) · cites this paper as [2]
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“A meta-analysis showed that the prevalence of anxiety and depression symptoms among nurses during the COVID-19 pandemic was 31.93% and 32.59%, respectively [2]”
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“A meta-analysis showed that the prevalence of anxiety and depression symptoms among nurses during the COVID-19 pandemic was 31.93% and 32.59%, respectively [2]”
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Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., et al. (2021) · PLoS Medicine · doi:10.1371/journal.pmed.1003583 · Cited by 5,148
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- Cénat, 2021, Prevalence of symptoms of depression, anxiety, insomnia, posttraumatic stress disorder, and psychological distress among populations affected by the COVID-19 pandemic: a systematic review and meta-analysis, Psychiatry Res., 295, 10.1016/j.psychres.2020.113599 · DOI · Paper page
- Munn, 2020, Chapter 5: systematic reviews of prevalence and incidence
Cited by
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A hidden pandemic? An umbrella review of global evidence on mental health in the time of COVID-19
Bower, M., Smout, S., Donohoe‐Bales, A., O’Dean, S., Teesson, L., Boyle, J., Lim, D., Nguyen, A., Calear, A. L., Batterham, P. J., et al. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1107560 · Cited by 121
Lara‐Cabrera, M. L., Betancort, M., Muñoz-Rubilar, C. A., Novo, N. R., Bjerkeset, O. A., & Cuevas, C. D. L. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191610106 · Cited by 71
“In addition to a potential reduction in work performance, these factors can be associated with anxiety and depression symptoms [12,13] with deterioration of psychological well-being [11,14].”
BackgroundEfstathiou, M., Kakaidi, V., Tsitsas, G. D., Mantzoukas, S., Gouva, M., & Dragioti, E. (2025) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2025.104993 · Cited by 72
Self-citationTang, L., Yu, X., Wu, Y., Zhao, N., Liang, R.-L., Gao, X., Jiang, W., Chen, Y.-F., & Yang, W. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2022.1019635 · Cited by 46
“A meta-analysis about the impact of the COVID-19 on mental health of medical staff found the depression, anxiety and insomnia symptoms representing the most robust evidence based on a large dataset of prevalence meta-analyses (20).”
BackgroundChong, Y. Y., Frey, E., Chien, W. T., Cheng, H. Y., & Gloster, A. T. (2023) · Journal of Nursing Scholarship · doi:10.1111/jnu.12874 · Cited by 42
Metadata
- Authors
- Dragioti, E., Tsartsalis, D., Mentis, M., Mantzoukas, S., & Gouva, M.
- Affiliations
- Linköping University (SE)
- Hippocration General Hospital (GR)
- University of Patras (GR)
- University of Ioannina (GR)
- Corresponding author
- Dragioti, Elena
- Venue
- International Journal of Nursing Studies
- Publisher
- Elsevier BV
- Published
- 2022-07
- Volume
- 131
- Pages
- 104272
- ISSN
- 0020-7489 (ISSN-L)
- PMC
- PMC9045868
- OpenAlex
- W4224988184
- Cited by
- 176
- References
- 103
- Citations by year
- 2026: 16 · 2025: 41 · 2024: 52 · 2023: 51 · 2022: 16
- FWCI
- 36.53
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- International Journal of Nursing Studies (publishedVersion, cc-by)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- KTH Publication Database DiVA (KTH Royal Institute of Technology) (submittedVersion, other-oa)
- 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 › Occupational Health and Burnout
- Keywords
- COVID-19 pandemic, hospital staff mental health, anxiety, depression, insomnia, sleep disorders, acute stress, post-traumatic stress disorder, nurses, physicians, gender differences, occupational stress, quality of life, well-being, umbrella review of meta-analyses, evidence quality assessment, publication bias, heterogeneity of results, AMSTAR
- MeSH terms
- COVID-19, Anxiety, Depression, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Mental Health, Personnel, Hospital, Quality of Life, Meta-Analysis as Topic, Prevalence, Pandemics
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