ABSTRACT
BackgroundWomen are overrepresented amongst individuals suffering from post-acute sequelae of SARS-CoV-2 infection (PASC). Biological (sex) as well as sociocultural (gender) differences between women and men might account for this imbalance, yet their impact on PASC is unknown. Methods and FindingsBy using Bayesian models comprising >200 co-variates, we assessed the impact of social context in addition to biological data on PASC in a multi-centre prospective cohort study of 2927 (46% women) individuals in Switzerland. Women more often reported at least one persistent symptom than men (43.5% vs 32.0% of men, p<0.001) six (IQR 5-9) months after SARS-CoV-2 infection. Adjusted models showed that women with personality traits stereotypically attributed to women were most often affected by PASC (OR 2.50[1.25-4.98], p<0.001), in particular when they were living alone (OR 1.84[1.25-2.74]), had an increased stress level (OR 1.06[1.03-1.09]), had undergone higher education (OR 1.30[1.08-1.54]), preferred pre-pandemic physical greeting over verbal greeting (OR 1.71[1.44-2.03]), and had experienced an increased number of symptoms during index infection (OR 1.27[1.22-1.33]). ConclusionBesides gender- and sex-sensitive biological parameters, sociocultural variables play an important role in producing sex differences in PASC. Our results indicate that predictor variables of PASC can be easily identified without extensive diagnostic testing and are targets of interventions aiming at stress coping and social support.
ABSTRACT
BackgroundThe current SARS-CoV-2 pandemic poses various challenges for health care workers (HCWs), which may impair their mental health. First evidence from China suggests that HCWs are at risk for anxiety and depression. However, generalizability to western countries is limited. The current study aimed at exploring HCWs mental health during the SARS-CoV-2 pandemic in Switzerland. In addition, we conducted a network analysis to investigate the independent effect of risk and protective factors on HCWs mental health and their interplay. MethodsIn an exploratory, cross-sectional, nation-wide online survey, we assessed demographics, work characteristics, COVID-19 exposure, and anxiety, depression, and burnout in 857 physicians and 553 nurses during the pandemic in Switzerland. At the time of data collection, Switzerland had among the highest per capita rate of COVID-19 cases in the world. ResultsOverall symptom levels of anxiety, depression, and burnout were elevated. Women, nurses, frontline staff and HCWs exposed to COVID-19 patients reported more symptoms than their peers. However, these effects were all small and, in the network analysis, most of them did not remain significant after controlling for the other factors. Whereas COVID-19 exposure was only partially associated with mental health, perceived support by the employer independently predicted anxiety and burnout. ConclusionsOur finding that HCWs had elevated levels of anxiety, depression, and burnout underscores the importance to systematically monitor HCWs mental health during this ongoing pandemic. Because perceived support and mental health impairments were negatively related, we encourage the implementation of supportive measures for HCWs well-being during this crisis.
