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Impact of coronavirus syndromes on physical and mental health of health care workers: Systematic review and meta-analysis
Open accessAbstract
Background Health care workers (HCW) are at high risk of developing physical/mental health outcomes related to coronavirus syndromes. Nature and frequency of these outcomes are undetermined.Methods PRISMA/MOOSE-compliant (PROSPERO-CRD42020180205) systematic review of Web of Science/grey literature until 15th April 2020, to identify studies reporting physical/mental health outcomes in HCW infected/exposed to Severe Acute Respiratory Syndrome -SARS-, Middle East Respiratory Syndrome -MERS-, Novel coronavirus -COVID-19-. Proportion random effect meta-analyses, I 2 statistic, quality assessment and sensitivity analysis.Results 115 articles were included (n=60,458 HCW, age 36.1±7.1, 77.1% female). Physical health outcomes: 75.9% HCW infected by SARS/MERS/COVID-19 reported fever (95%CI=65.9-83.7%, k=12, n=949), 47.9% cough (95%CI=39.2-56.8%, k=14, n=970), 43.6% myalgias (95%CI=31.9-56.0%, k=13, n=898), 42.3% chills (95%CI=20.2-67.9%, k=7, n=716), 41.2% fatigue (95%CI=18.2-68.8%, k=6, n=386), 34.6% headaches (95%CI=23.1-48.2%, k=11, n=893), 31.2% dyspnoea (95%CI=23.2-40.5%, k=12, n=1003), 25.3% sore throat (95%CI=18.8-33.2%, k=8, n=747), 22.2% nausea/vomiting (95%CI=14.9-31.8%, k=6, n=662), 18.8% diarrhoea (95%CI=11.9-28.4%, k=9, n=824). Mental health outcomes: 62.5% HCW exposed to SARS/MERS/COVID-19 reported general health concerns (95%CI=57.0-67,8%, k=2, n=2254), 43.7% fear (95%CI=33.9-54.0%, k=4, n=584), 37.9% insomnia (95%CI=30.9-45.5%, k=6, n=5067), 37.8% psychological distress (95%CI=28.4-48.2%, k=15, n=24,346), 34.4% burnout (95%CI=19.3-53.5%, k=3, n=1337), 29.0% anxiety features (95%CI=14.2-50.3%, k=6, n=9191), 26.3% depressive symptoms (95%CI=12.5-47.1%, k=8, n=9893), 20.7% post-traumatic stress disorder features (95%CI=13.2-31%, k=11, n=3826), 16.1% somatisation (95%CI=0.2-96.0%, k=2, n=2184), 14.0% stigmatisation feelings (95%CI=6.4-28.1%, k=2, n=411).Limitations Limited amount of evidence for some outcomes and suboptimal design in several studies included.Conclusions SARS/MERS/COVID-19 have a substantial impact on the physical and mental health of HCW, which should become a priority for public health strategies.
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“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 [182]
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“During this pandemic, burnout was identified among HW and persistent burnout was found to be able to contribute to higher levels of anxiety, acute stress, and depersonalization symptoms [18,19,20].”
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 [18]
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Emotional distress during the first year of the COVID-19 pandemic-large sample serbian study
Dunjić-Kostić, B., Mitković-Vončina, M., Jović, J., Erić, E., Gostiljac, M., Jerotić, S., Lalović, N., Latas, M. B., & Pantović-Stefanović, M. (2025) · Scientific Reports · doi:10.1038/s41598-025-96452-2 · Cited by 1
“…exposure to the pandemic were health care professionals (HCP), whose mental health functioning during this period was a target of various studies 5,10,29–36 , identifying HCP as a particularly vulnerable group faced with physically and psychologically challenging situation during the pandemic 6,7 .”
Ansiedad en docentes en contexto COVID-19 de dos universidades de la región Ica (Perú)
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“…dentro de los problemas de salud mental que presentan los docentes es la ansiedad con un 31%; existen estudios de revisiones sistemáticas donde se han logrado evidenciar problemas de salud en pandemia en donde el 29% de los participantes han desarrollado ansiedad (Salazar de Pablo et al ., 2020).”
Medical technologists’ experiences handling medical specimens during the COVID-19 pandemic
Mafolo, M. C., Mutava, E., Sunnasy, A., & du Plessis-Faurie, A. S. (2025) · Health SA Gesondheid · doi:10.4102/hsag.v30i0.2929 · Cited by 1
“…that has explored and discussed the effects of COVID-19-related workload increases, with a primary focus on the psychosocial and mental well-being of HCWs and other workers (De Matteis 2021; Nyashanu, Pfende & Ekpenyong 2020; Salazar et al. 2020; Shreffler, Petrey & Huecker 2020; Sim 2020).”
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CE: Providing Care for Caregivers During COVID-19
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“The current COVID-19 pandemic, SARS in 2003 and MERS-CoV in 2014, have caused serious psychological problems in people (De Pablo et al., 2020).”
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“Serrano J V and other scholars tried to classify college students with different mental health characteristics and conducted long-term tracking experiments to record the changes of students with different mental characteristics in their mental status in the face of the same pressure to realize the characteristic analy…”
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The psychological impact of the COVID-19 pandemic among the medical-sanitary staff, a new challenge
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Prevalence of post-traumatic stress disorder (PTSD) in nurses during COVID-19 epidemic
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“[3] The study found that the top three most frequently reported mental health concerns included general health concerns (62.”
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Riscos da profissão: percepções dos jornalistas da capital brasileira sobre seu trabalho na pandemia
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“A recent meta-analysis showed that health care workers also had more issues with sleep and somatization than the general population during past pandemics [12].”
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Impacto de la pandemia de COVID-19 en la salud mental del personal de salud
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Orakpoghenor, O., Markus, T. P., Atata, A. J., Erin, J. P., Samuel, O. O., Udechukwu, C. C., Ogbuagu, N. E., Jolayemi, K. O., Okoronkwo, M. O., & Ningi, U. B. (2020) · Annals of Cytology and Pathology · doi:10.17352/acp.000021 · Cited by 1
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“Moreover, working hours of health professionals has been significantly increased with detrimental impact on their quality of life, and the need to protect the mental and physical health of workers and specially to reduce their stress to become priority (20, 21).”
BackgroundComo melhorar a qualidade da saúde da equipe de enfermagem mediante ao COVID-19
Botelho, J. L. D. S., Santos, S. M., Aquino, C. F., de Melo, J. M. O., & de Freitas, I. G. C. (2021) · Saúde Coletiva (Barueri) · doi:10.36489/saudecoletiva.2021v11i64p5680-5689 · Cited by 1
Metadata
- Authors
- Salazar de Pablo, G., Vaquerizo-Serrano, J., Catalan, A., Arango, C., Moreno, C., Ferre, F., Shin, J. I., Sullivan, S., Brondino, N., Solmi, M., & Fusar-Poli, P.
- Affiliations
- Hospital General Universitario Gregorio Marañón (ES)
- Universidad Complutense de Madrid (ES)
- Yonsei University (KR)
- University of Bristol (GB)
- University of Pavia (IT)
- University of Padua (IT)
- ORCID
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2020-10
- Volume
- 275
- Pages
- 48-57
- ISSN
- 0165-0327 (ISSN-L)
- PMC
- PMC7314697
- OpenAlex
- W3037551969
- Cited by
- 631
- References
- 121
- Citations by year
- 2026: 9 · 2025: 37 · 2024: 72 · 2023: 99 · 2022: 152 · 2021: 224 · 2020: 37
- FWCI
- 10.01
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Bristol Research (University of Bristol) (publishedVersion, cc-by-nc-nd)
- Padua Research Archive (University of Padova) (submittedVersion)
- Funders
- Seventh Framework Programme
- Oficina Regional de Coordinación de Salud Mental, Comunidad de Madrid
- Fundación Mutua Madrileña
- H2020 Euratom
- Fundación Alicia Koplowitz
- Instituto de Salud Carlos III
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Medicine › Clinical Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Keywords
- healthcare workers, COVID-19 pandemic, SARS, MERS, physical health outcomes, mental health outcomes, post-traumatic stress disorder, depression, anxiety, occupational exposure, fever, fatigue, psychological distress
- MeSH terms
- COVID-19, Anxiety, Burnout, Professional, Fatigue, Female, Health Personnel, Humans, Male, Mental Health, Middle Aged, Pneumonia, Viral, Stress Disorders, Post-Traumatic, Coronavirus Infections, Severe Acute Respiratory Syndrome, Pandemics
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