Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyoku, Tokyo, 113-0033, Japan.
Department of Public Health, Kitasato University School of Medicine, Sagamihara, Japan.
BMC Med. 2024 Sep 12;22(1):386. doi: 10.1186/s12916-024-03585-8.
Long-term deterioration in the mental health of healthcare workers (HCWs) has been reported during and after the COVID-19 pandemic. Determining the impact of COVID-19 incidence and mortality rates on the mental health of HCWs is essential to prepare for potential new pandemics. This study aimed to investigate the association of COVID-19 incidence and mortality rates with depressive symptoms over 2 years among HCWs in 20 countries during and after the COVID-19 pandemic.
This was a multi-country serial cross-sectional study using data from the first and second survey waves of the COVID-19 HEalth caRe wOrkErS (HEROES) global study. The HEROES study prospectively collected data from HCWs at various health facilities. The target population included HCWs with both clinical and non-clinical roles. In most countries, healthcare centers were recruited based on convenience sampling. As an independent variable, daily COVID-19 incidence and mortality rates were calculated using confirmed cases and deaths reported by Johns Hopkins University. These rates represent the average for the 7 days preceding the participants' response date. The primary outcome was depressive symptoms, assessed by the Patient Health Questionnaire-9. A multilevel linear mixed model (LMM) was conducted to investigate the association of depressive symptoms with the average incidence and mortality rates.
A total of 32,223 responses from the participants who responded to all measures used in this study on either the first or second survey, and on both the first and second surveys in 20 countries were included in the analysis. The mean age was 40.1 (SD = 11.1), and 23,619 responses (73.3%) were from females. The 9323 responses (28.9%) were nurses and 9119 (28.3%) were physicians. LMM showed that the incidence rate was significantly and positively associated with depressive symptoms (coefficient = 0.008, standard error 0.003, p = 0.003). The mortality rate was significantly and positively associated with depressive symptoms (coefficient = 0.049, se = 0.020, p = 0.017).
This is the first study to show an association between COVID-19 incidence and mortality rates with depressive symptoms among HCWs during the first 2 years of the outbreak in multiple countries. This study's findings indicate that additional mental health support for HCWs was needed when the COVID-19 incidence and mortality rates increase during and after the early phase of the pandemic, and these findings may apply to future pandemics.
Clinicaltrials.gov, NCT04352634.
在 COVID-19 大流行期间和之后，有报道称医护人员（HCWs）的心理健康状况长期恶化。确定 COVID-19 发病率和死亡率对 HCWs 心理健康的影响对于为潜在的新大流行做好准备至关重要。本研究旨在调查 COVID-19 大流行期间和之后 20 个国家的 COVID-19 发病率和死亡率与 HCWs 抑郁症状之间的 2 年关联。
这是一项多国系列横断面研究，使用了 COVID-19 健康护理工作者（HEROES）全球研究第一和第二调查波的数据。HEROES 研究前瞻性地从各种医疗设施的 HCWs 中收集数据。目标人群包括具有临床和非临床角色的 HCWs。在大多数国家，医疗中心是根据便利抽样招募的。作为一个独立变量，使用约翰霍普金斯大学报告的确诊病例和死亡人数计算了每日 COVID-19 发病率和死亡率。这些比率代表参与者回答日期前 7 天的平均值。主要结果是使用患者健康问卷-9 评估的抑郁症状。使用多层线性混合模型（LMM）调查了抑郁症状与平均发病率和死亡率之间的关联。
共纳入 32223 名参与者的回复，这些参与者在 20 个国家的第一或第二调查中，以及在第一和第二调查中都回复了所有措施，进行了分析。平均年龄为 40.1（SD=11.1），23619 名（73.3%）为女性。9323 名（28.9%）为护士，9119 名（28.3%）为医生。LMM 显示，发病率与抑郁症状呈显著正相关（系数=0.008，标准误差 0.003，p=0.003）。死亡率与抑郁症状呈显著正相关（系数=0.049，se=0.020，p=0.017）。
这是第一项表明 COVID-19 发病率和死亡率与大流行早期多国 HCWs 抑郁症状之间存在关联的研究。本研究结果表明，在 COVID-19 发病率和死亡率增加期间和之后，需要为 HCWs 提供更多的心理健康支持，这些发现可能适用于未来的大流行。
Clinicaltrials.gov，NCT04352634。
