Impact of the COVID-19 pandemic on the mental health of hospital staff: An umbrella review of 44 meta-analyses

Abstract

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: Systematic searches were conducted in PubMed/Medline, CINAHL, EMBASE, and PsycINFO from December 1st, 2019, until August 13th 2021. The random effects model was used for the meta-analysis, and the I² 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.

Keywords: COVID-19; Doctors; Health care; Hospital staff; Mental health; Meta-analysis; Nurses; Prevalence; Systematic review.