Research Centre, Montreal Heart Institute, 5000 Bélanger Street, Montréal, H1T 1C8 Québec, Canada; Department of Psychiatry and Addiction, Université de Montréal, Roger-Gaudry Pavilion, Faculty of Medicine, P.O. Box 6128, Downtown Branch, Montréal, H3C 3J7 Québec, Canada.
Research Centre, Montreal Heart Institute, 5000 Bélanger Street, Montréal, H1T 1C8 Québec, Canada; Faculty of Pharmacy, Université de Montréal, P.O. Box 6128, Downtown Branch, Montréal, H3C 3J7 Québec, Canada.
Psychoneuroendocrinology. 2022 Apr;138:105645. doi: 10.1016/j.psyneuen.2021.105645. Epub 2021 Dec 23.
The COVID-19 pandemic has put chronic pressure on worldwide healthcare systems. While the literature regarding the prevalence of psychological distress and associated risk factors among healthcare workers facing COVID-19 has exploded, biological variables have been mostly overlooked.
467 healthcare workers from Quebec, Canada, answered an electronic survey covering various risk factors and mental health outcomes three months after the onset of the COVID-19 pandemic. Of them, 372 (80%) provided a hair sample, providing a history of cortisol secretion for the three months preceding and following the pandemic's start. We used multivariable regression models and a receiver operating characteristic curve to study hair cortisol as a predictor of burnout and psychological health, together with individual, occupational, social, and organizational factors.
As expected, hair cortisol levels increased after the start of the pandemic, with a median relative change of 29% (IQR = 3-59%, p < 0.0001). There was a significant association between burnout status and change in cortisol, with participants in the second quarter of change having lower odds of burnout. No association was found between cortisol change and post-traumatic stress disorder, anxiety, and depression symptoms. Adding cortisol to individual-occupational-socio-organizational factors noticeably enhanced our burnout logistic regression model's predictability.
Change in hair cortisol levels predicted burnout at three months in health personnel at the onset of the COVID-19 pandemic. This non-invasive biological marker of the stress response could be used in further clinical or research initiatives to screen high-risk individuals to prevent and control burnout in health personnel facing an important stressor.
COVID-19 大流行给全球医疗保健系统带来了长期压力。尽管有关应对 COVID-19 的医护人员心理困扰和相关风险因素的文献大量涌现，但生物学变量大多被忽视。
467 名来自加拿大魁北克的医护人员在 COVID-19 大流行开始三个月后，通过电子调查回答了各种风险因素和心理健康结果的问题。其中 372 人（80%）提供了头发样本，提供了大流行开始前三个月和后三个月皮质醇分泌的历史。我们使用多变量回归模型和受试者工作特征曲线来研究头发皮质醇作为倦怠和心理健康的预测因子，同时考虑个体、职业、社会和组织因素。
正如预期的那样，大流行开始后头发皮质醇水平升高，中位数相对变化为 29%（IQR=3-59%，p<0.0001）。皮质醇变化与倦怠状态之间存在显著关联，处于变化第二季度的参与者倦怠的可能性较低。皮质醇变化与创伤后应激障碍、焦虑和抑郁症状之间没有关联。将皮质醇添加到个体-职业-社会-组织因素中，明显提高了我们的倦怠逻辑回归模型的预测能力。
COVID-19 大流行开始时，卫生保健人员头发皮质醇水平的变化可预测三个月后的倦怠。这种应激反应的非侵入性生物标志物可用于进一步的临床或研究计划，以筛查高风险个体，预防和控制面临重要应激源的卫生保健人员的倦怠。
