Prevalence and Factors Associated with Post-Traumatic Stress Disorder in Healthcare Workers Exposed to COVID-19 in Wuhan, China: A Cross-Sectional Survey (preprint)

Background: The COVID-19 pandemic has posed significant threats to both physical and psychological health of healthcare workers working in the front-line combating COVID-19. However, evidence regarding the long-term impact of COVID-19 is limited. Therefore, we conducted this cross-sectional survey to investigate the prevalence, factors and impact of post-traumatic stress disorder (PTSD) in healthcare workers exposed to COVID-19 eight months after end of outbreak in Wuhan, China. Methods: A web-based questionnaire was delivered as a link via the communication application WeChat to those healthcare workers who worked at several COVID-19 units in Wuhan during the outbreak (from November 2019 to April 2020). The questionnaire included questions on social-demographic data, the post-traumatic stress disorder checklist-5, the family care index questionnaire, and the quality of life scale. The prevalence, risk and protective factors, and impact of post-traumatic stress disorder healthcare workers were then analyzed with logistic regression.Results: Among the 659 participants, 90 healthcare workers were still suffering from PTSD eight months after the end of outbreak of COVID-19 in Wuhan, in which avoidance and negative impact were the most affected dimensions. Suffering from chronic disease, experiencing social isolation, and job dissatisfaction came up as independent risk factors of PTSD, while obtaining COVID-19 related information at an appropriate frequency, good family function, and working in well-prepared mobile cabin hospitals surfaced as protective factors. The impact of PTSD on COVID-19-exposed healthcare workers was apparent by shortened sleeping time, feeling of loneliness, poorer quality of life and intention to resign.Conclusions: Eight months after the end of the COVID-19 outbreak in Wuhan, the level of PTSD in healthcare workers exposed to COVID-19 was still high. Apart from the common recognized risk factors, comorbid of chronic disease was identified as the new independent risk factors of developing PTSD. For countries where the pandemic is still ongoing or in the case of future outbreaks of new communicable diseases, this research may contribute to preventing cases of PTSD in healthcare workers exposed to infectious diseases under such circumstances.

Coronavirus disease 2019 in pregnancy.

OBJECTIVES: This study aimed to compare clinical courses and outcomes between pregnant and reproductive-aged non-pregnant women with COVID-19, and to assess the vertical transmission potential of COVID-19 in pregnancy. METHODS: Medical records of pregnant and reproductive-aged non-pregnant women hospitalized with COVID-19 from January 15 to March 15, 2020 were retrospectively reviewed. The severity of disease, virus clearance time, and length of hospital stay were measured as the primary objective, while the vertical transmission potential of COVID-19 was also assessed. RESULTS: Eighty-two patients (28 pregnant women, 54 reproductive-aged non-pregnant women) with laboratory-confirmed COVID-19 were enrolled in this study. Univariate regression indicated no association between pregnancy and severity of disease (OR 0.73, 95% CI 0.08-5.15; p=0.76), virus clearance time (HR 1.16, 95% CI 0.65-2.01; p=0.62), and length of hospital stay (HR 1.10, 95% CI 0.66-1.84; p=0.71). Of the pregnant women, 22 delivered 23 live births, either by cesarean section (17, 60.7%) or vaginal delivery (5, 17.9%), and no neonate was infected with SARS-CoV-2. CONCLUSIONS: Pregnant women have comparable clinical courses and outcomes with reproductive-aged non-pregnant women when infected with SARS-CoV-2. No evidence supported vertical transmission of COVID-19 in the late stage of pregnancy, including vaginal delivery.