Prevalence of burnout among health care workers during coronavirus disease (COVID-19) pandemic: A systematic review and meta-analysis

The aim of this systematic review and meta-analysis study was to estimate the pooled prevalence of burnout among health care workers (HCWs), who worked in health centers during the coronavirus disease (COVID-19) outbreak, based on the Maslach Burnout Inventory (MBI) Questionnaire. A comprehensive search based on specific terms was performed through the online studies of Pubmed, Scopus, Web of Science, and ProQuest, until January 2022. The methodological quality of included studies was assessed using the National Institutes of Health (NIH) tool. Data analysis was carried out through the random-effects model, and the heterogeneity was investigated by I2 statistic using the software STATA Version 16. In total, seven articles with 5,022 participants were included in the final analysis. Four studies with 4,419 participants reported the prevalence of burnout as percent in moderate and severe types for all three components of burnout syndrome. Our results showed that the 45% of pooled moderate and 37% of severe levels of emotional exhaustion, 49% of pooled moderate and 18% of severe levels of depersonalization, 38% of pooled moderate and 51% of pooled severe levels of reduced personal accomplishment. Whereas six studies with 4,838 sample size reported the mean prevalence of MBI-based burnout syndrome and the mean pooled prevalence of emotional exhaustion, depersonalization, and accomplishment was 21.57, 7.47, and 33.48, respectively. Based on our findings, HCWs who worked in health centers during COVID-19 outbreak, experienced significant burnout. Therefore, it is necessary to design and implement programs to deal with burnout among this populations. (PsycInfo Database Record (c) 2022 APA, all rights reserved) Impact Statement What is the public health significance of this article? This study suggests that health care workers (HCWs) who worked in health centers during the outbreak of COVID-19 and were in direct and/or indirect contact with COVID-19 patients experienced significant burnout. Burnout among HCWs is an important issue because it not only has an impact on their quality of life, but it can potentially affect the quality of care provided, increase medical errors, reduce patient safety, and even the influence on the mental health of their families and society. Therefore, it is necessary to design and implement programs to deal with burnout among this populations. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Prevalence of burnout among health care workers during coronavirus disease (COVID-19) pandemic: A systematic review and meta-analysis

The aim of this systematic review and meta-analysis study was to estimate the pooled prevalence of burnout among health care workers (HCWs), who worked in health centers during the coronavirus disease (COVID-19) outbreak, based on the Maslach Burnout Inventory (MBI) Questionnaire. A comprehensive search based on specific terms was performed through the online studies of Pubmed, Scopus, Web of Science, and ProQuest, until January 2022. The methodological quality of included studies was assessed using the National Institutes of Health (NIH) tool. Data analysis was carried out through the random-effects model, and the heterogeneity was investigated by I-2 statistic using the software STATA Version 16. In total, seven articles with 5,022 participants were included in the final analysis. Four studies with 4,419 participants reported the prevalence of burnout as percent in moderate and severe types for all three components of burnout syndrome. Our results showed that the 45% of pooled moderate and 37% of severe levels of emotional exhaustion, 49% of pooled moderate and 18% of severe levels of depersonalization, 38% of pooled moderate and 51% of pooled severe levels of reduced personal accomplishment. Whereas six studies with 4,838 sample size reported the mean prevalence of MBI-based burnout syndrome and the mean pooled prevalence of emotional exhaustion, depersonalization, and accomplishment was 21.57, 7.47, and 33.48, respectively. Based on our findings, HCWs who worked in health centers during COVID-19 outbreak, experienced significant burnout. Therefore, it is necessary to design and implement programs to deal with burnout among this populations. Public Significance Statement What is the public health significance of this article? This study suggests that health care workers (HCWs) who worked in health centers during the outbreak of COVID-19 and were in direct and/or indirect contact with COVID-19 patients experienced significant burnout. Burnout among HCWs is an important issue because it not only has an impact on their quality of life, but it can potentially affect the quality of care provided, increase medical errors, reduce patient safety, and even the influence on the mental health of their families and society. Therefore, it is necessary to design and implement programs to deal with burnout among this populations.

A cluster analysis of epidemiological and clinical factors associated with the accumulation process of the burden of COVID-19 in European countries.

Background and aim of the work European COVID-19 statistics showed differentiation between mortality and new cases. Some studies suggested several factors including migration, cancer incidence, life expectancy and health system capacity maybe associated with differentiations. Up to now, impact of those factors in different European societies is not discussed and compared. Aim of the present study was to perform the cluster analysis in European countries in attention to clinical and epidemiological factors due to covid-19. Methods We collected some appropriate extreme data of COVID-19 to access the situations by ANOVA post-hoc test in 3 scenarios, as well as to estimate regression coefficients in simple linear regression, and a cluster analysis using average linkage. Covid-19 Statistics were considered in all analyses until April 24, 2020. Results Among 39 European countries, several countries reported highest rate of confirmed cases included of Italy (current statues=2270.52) and Spain (current status=2616.24). The highest rate of mortality was seen in France (current status=242.16), Italy (current status=305.52). Life expectancy (female) (P=0.01, 95%Cl=1521.27,15264.58), migration (P<0.001, 95%Cl=41.42,96.72) had significant association with confirmed cases and death. Overall cancer death (P<0.001, 95%Cl=0.36,0.68; P<0.001, 95%Cl=0.01,0.07) and lung cancer death (P<0.001, 95%Cl=1.97,3.56; P<0.001, 95%Cl=0.09,0.37) associated with confirmed cases and mortality, too. We were also determined 5 clusters which more than 30 countries were categorized in the first cluster. Conclusions Demographic factors, including population, life expectancy and migration, underlying disorders, such as several types of cancers, especially lung cancers lead to various distribution of COVID-19 in terms of prevalence and mortality, across European counties.

Identification, Monitoring, and Prediction of Disease Severity in Patients with COVID-19 Pneumonia Based on Chest Computed Tomography Scans: A Retrospective Study.

Background and Aims Non-contrast chest computed tomography (CT) scans can accurately evaluate the type and extent of lung lesions. The aim of this study was to investigate the chest CT features associated with critical and non-critical patients with coronavirus disease 2019 (COVID-19). Methods A total of 1078 patients with COVID-19 pneumonia who underwent chest CT scans, including 169 critical cases and 909 non-critical cases, were enrolled in this retrospective study. The scans of all participants were reviewed and compared in two groups of study. In addition, the risk factors associated with disease in critical and non-critical patients were analyzed. Results Chest CT scans showed bilateral and multifocal involvement in most (86.4%) of the participants, with 97.6 and 84.3% reported in critical and non-critical patients, respectively. The incidences of pure consolidation (p = 0.019), mixed ground-glass opacities (GGOs) and consolidation (p < 0.001), pleural effusion (p < 0.001), and intralesional traction bronchiectasis (p = 0.007) were significantly higher in critical compared to non-critical patients. However, non-critical patients showed higher incidence of pure GGOs than the critical patients (p < 0.001). Finally, the total opacity scores of the critical patients were significantly higher than those of non-critical patients (13.71 ± 6.26 versus 4.86 ± 3.52, p < 0.001), with an area under the curve of 0.91 (0.88-0.94) for COVID-19 detection. Conclusions Our results revealed that the chest CT examination was an effective means of detecting pulmonary parenchymal abnormalities in the natural course of COVID-19. It can distinguish the critical patients from the non-critical patients (AUC = 0.91), which is helpful for the judgment of clinical condition and has important clinical value for the diagnosis and follow-up of COVID-19 pneumonia.

The Primary Outcomes and Epidemiological and Clinical Features of Coronavirus Disease 2019 (COVID-19) in Iran.

AIM: We aimed to describe the epidemiological and clinical characteristics of Iranian patients with COVID-19. METHODS: In this single-center and retrospective study, patients with confirmed COVID-19 infections were enrolled. Univariate and multivariate logistic regression methods were used to explore the risk factors associated with outcomes. RESULTS: Of 179 patients with confirmed COVID-19 infection, 12 remained hospitalized at the end of the study and 167 were included in the final analysis. Of these, 153 (91.6%) were discharged and 14 (8.38%) died in hospital. Approximately half (50.9%) of patients suffered from a comorbidity, with diabetes or coronary heart disease being the most common in 20 patients. The most common symptoms on admission were fever, dyspnea, and cough. The mean durations from first symptoms to hospital admission was 8.64 ± 4.14 days, whereas the mean hospitalization time to discharge or death was 5.19 ± 2.42 and 4.35 ± 2.70 days, respectively. There was a significantly higher age in non-survivor patients compared with survivor patients. Multivariate regression showed increasing odds ratio (OR) of in-hospital death associated with respiratory rates >20 breaths/min (OR: 5.14, 95% CI: 1.19-22.15, p = 0.028) and blood urea nitrogen (BUN) >19 mg/dL (OR: 4.54, 95% CI: 1.30-15.85, p = 0.017) on admission. In addition, higher respiratory rate was associated with continuous fever (OR: 4.08, 95% CI: 1.18-14.08, p = 0.026) and other clinical symptoms (OR: 3.52, 95% CI: 1.05-11.87, p = 0.04). CONCLUSION: The potential risk factors including high respiratory rate and BUN levels could help to identify COVID-19 patients with poor prognosis at an early stage in the Iranian population.

The Psychological Impact of COVID-19 Pandemic on Mental Health of Iranian Population

Introduction: As the coronavirus disease 2019 (COVID-19) pandemic rapidly sweeps across the world, it is inducing a considerable degree of psychological problems, which can affect everyone in the community. This study aimed to compare the severity of the psychological distress in the general population and patients during the COVID-19 epidemic in an Iranian population.// Methods: In this cross-sectional study, the mental health status of 221 COVID-19 infected patients and 241 participants from general population were investigated by the self-report questionnaire of Depression, Anxiety, and Stress Scale (DASS). The DASS-21 questionnaire and sociodemographic data sheet were filled out by the participants. All statistical analyses were performed using SPSS software version 21. Results: The results indicated higher scores of DASS in patients than the population simultaneously (Wilks Lambda = 0.934, F (3,440) = 10.44, P < 0.001) and individually (Mean difference [MD] = 2.55, 95% CI = 1.48 to 3.62 for depression, MD = 1.48, 95% CI = 0.39 to 2.57 for anxiety, and MD = 1.41, 95% CI = 0.32 to 2.49 for depression score). Conclusion: The present study revealed a high prevalence of mental health problems among patients with COVID-19 and gaps in providing them with mental health services. We call for systematic screening of mental health status for all patients and developing specific psychological interventions for this vulnerable population. Psychosocial assessment and monitoring should be developed in the community to support aspects of COVID-19.

Manifestations of COVID-19 in pregnant women with focus on gastrointestinal symptoms: a systematic review.

AIM: This review study was conducted to evaluate the symptoms of COVID-19 in pregnant women with a focus on gastrointestinal symptoms. BACKGROUND: COVID-19 is a fatal respiratory disease caused by a novel coronavirus that quickly became a pandemic. Although the main symptoms of this disease include respiratory symptoms, gastrointestinal manifestations have also been observed in some patients suffering from COVID-19. Pregnant women are among the most vulnerable groups in the community to infectious diseases. METHODS: Scientific databases were searched for articles published up to May 8, 2020. Any type of study investigating the manifestations of COVID-19 in pregnant women was included. Symptoms of the disease in pregnant women with an emphasis on gastrointestinal symptoms were assessed. RESULTS: The search resulted in 852 titles and abstracts, which were narrowed down to 43 studies involving 374 women. The most common symptoms of patients were fever (59.1%) and cough (48.4%), respectively. Gastrointestinal symptoms included diarrhea (4.5%), abdominal pain (1.6%), nausea (0.8%), and loss of appetite (0.3%), respectively. In studies on pregnant women with gastrointestinal symptoms, 13 fetal abortions occurred, most of which were induced abortions due to the risks posed by COVID-19.In thirty cases, and infected pregnant women reported a history of chronic pregnancy-related diseases. CONCLUSION: COVID-19 in pregnant women, similar to the general population, can present with gastrointestinal manifestations. The gastrointestinal tract can be a potential route for infection with the novel coronavirus.

Comparison of the severity of psychological distress among four groups of an Iranian population regarding COVID-19 pandemic.

BACKGROUND: Coronavirus disease 2019 (COVID-19) pandemic has caused serious psychological problems, including panic attack, anxiety, stress, and depression. The main objective of this study was to measure the prevalence and compare the severity of this psychological distress among four groups of an Iranian population. METHOD: In a cross-sectional survey, the mental health status of four groups of an Iranian society including community population, patients with COVID-19, medical staff, and medical students were investigated by the self-report questionnaire of Depression, Anxiety, and Stress Scale (DASS). DASS-21 questionnaire and the demographic data sheet were filled out by the participants. All statistical analyses were done using R version 3.6.1 software. P-values less than 0.05 were considered as statistically significant. ANOVA test was used to compare the severity of stress, anxiety, and depression between the four study groups. RESULTS: Of the 886 participants in this survey, 554 (62.5%) were men and 332 (37.5%) were women, and the mean ± standard division of age was 40.91 ± 10.7 years. Among these participants, 241 (27.2%) were selected from community population, 221 (24.9%) were patients with COVID-19, 217 (24.5%) were medical staff, and 207 (23.4%) were medical students. The mean score of stress, anxiety, and depression in medical students and patients with COVID-19 was significantly higher than in medical staff and community population (P < 0.05). Overall, the anxiety score in men was higher than that in women (27.4 ± 4.6 vs. 26.48 ± 4.8, P = 0.006), and unmarried participants had a significantly higher depression score compared with the married group (27.5 ± 4.8 vs. 26.7 ± 4.6, P = 0.023). In addition, the score of depression was higher in female medical staff (27.08 ± 4.6 vs. 25.33 ± 4.3, P = 0.011) and community population (26.6 ± 4.3 vs. 25.3 ± 4.3, P = 0.02) than in male. CONCLUSION: COVID-19 patients and medical students in contact with these patients were at a high risk for mental illness due to lower experience compared with professional medical staff and community population. Continuous surveillance and monitoring of psychological distress for outbreaks should become a routine part of preparedness efforts worldwide.