IMPACT OF CORONAVIRUS SYNDROMES ON PHYSICAL AND MENTAL HEALTH OF HEALTH CARE WORKERS: SYSTEMATIC REVIEW AND META-ANALYSIS

ABSTRACT 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, I2 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.