Association of depressive symptoms with incidence and mortality rates of COVID-19 over 2 years among healthcare workers in 20 countries: multi-country serial cross-sectional study.
Journal: BMC medicine
Volume: 22
Issue: 1
Year of Publication: 2024
Affiliated Institutions:
Department of Mental Health, Graduate School of Medicine, The University of Tokyo, -- Hongo, Bunkyoku, Tokyo, -, Japan.
Department of Public Health, Kitasato University School of Medicine, Sagamihara, Japan.
Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
National School of Public Health Universidad de Antioquia, Medellín, Colombia.
Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Department of Epidemiology, Columbia University Mailman School of Public Health, New York, USA.
Department of Population Health, King Abdullah International Medical Research Center (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of National Guard, Riyadh, Saudi Arabia.
Department of Psychiatry, University of Ibadan, Ibadan, Nigeria.
Question Driven Design and Analysis Group (QD-DAG), New York, USA.
Salud Global Bolivia, La Paz, Bolivia.
Instituto Nacional de Psiquiatría Ramón de La Fuente Muñiz, Mexico City, Mexico.
Department of Psychology, Koc University, Istanbul, Turkey.
Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain.
Universidad del Chubut, Escuela de Salud Social y Comunitaria, Chubut, Argentina.
Health Psychology Institute, Faculty of Psychology, University of the Republic, Montevideo, Uruguay.
Escuela de Salud Social y Comunitaria, Universidad del Chubut, Chubut, Argentina.
Faculty of Health and Social Work, University of Applied Sciences Emden / Leer, Emden, Germany.
Dirección de Salud Mental, Ministerio de Salud, Lima, Peru.
Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, USA.
Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain.
Department of Child and Adolescent Psychiatry, NYU Langone Health, New York, USA.
Department of Public Health, School of Medicine, Universidad Nacional de Colombia, Bogotá, Colombia.
Department Psychiatry A, Razi Hospital La Manouba, Manouba, Tunisia.
School of Medicine, University of San Carlos of Guatemala, Guatemala City, Guatemala.
Escuela de Salud Pública CL, Faculty of Medicine, University of Chile, Santiago, Chile.
Instituto Altos Estudios Dr Arnoldo Gabaldon, Maracay, Venezuela.
Department of Epidemiology, Second Faculty of Medicine, Charles University, Prague, Czech Republic.
Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA.
Faculty of Medicine, Federal University of Pelotas, Pelotas, Brazil.
Università Degli Studi Di Cagliari, Cagliari, Italy.
National Institute of Health Named After Academician S. Avdalbekyan, Yerevan, Armenia.
Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
Research, Science and Technology Direction, Universidad San Francisco Xavier de Chuquisaca, Sucre, Bolivia.
Interdisciplinary Centre for Health Studies (CIESAL), Department of Public Health, School of Medicine, Faculty of Medicine, Universidad de Valparaíso, Valparaíso, Chile.
Columbia University Mailman School of Public Health, New York, NY, USA.
Department of Mental Health, Graduate School of Medicine, The University of Tokyo, -- Hongo, Bunkyoku, Tokyo, -, Japan. d-nishi@m.u-tokyo.ac.jp.
Abstract summary
Long-term deterioration in the mental health of healthcare workers (HCWs) has been reported during and after the COVID-19 pandemic. Determining the impact of COVID-19 incidence and mortality rates on the mental health of HCWs is essential to prepare for potential new pandemics. This study aimed to investigate the association of COVID-19 incidence and mortality rates with depressive symptoms over 2 years among HCWs in 20 countries during and after the COVID-19 pandemic.This was a multi-country serial cross-sectional study using data from the first and second survey waves of the COVID-19 HEalth caRe wOrkErS (HEROES) global study. The HEROES study prospectively collected data from HCWs at various health facilities. The target population included HCWs with both clinical and non-clinical roles. In most countries, healthcare centers were recruited based on convenience sampling. As an independent variable, daily COVID-19 incidence and mortality rates were calculated using confirmed cases and deaths reported by Johns Hopkins University. These rates represent the average for the 7 days preceding the participants' response date. The primary outcome was depressive symptoms, assessed by the Patient Health Questionnaire-9. A multilevel linear mixed model (LMM) was conducted to investigate the association of depressive symptoms with the average incidence and mortality rates.A total of 32,223 responses from the participants who responded to all measures used in this study on either the first or second survey, and on both the first and second surveys in 20 countries were included in the analysis. The mean age was 40.1 (SD = 11.1), and 23,619 responses (73.3%) were from females. The 9323 responses (28.9%) were nurses and 9119 (28.3%) were physicians. LMM showed that the incidence rate was significantly and positively associated with depressive symptoms (coefficient = 0.008, standard error 0.003, p = 0.003). The mortality rate was significantly and positively associated with depressive symptoms (coefficient = 0.049, se = 0.020, p = 0.017).This is the first study to show an association between COVID-19 incidence and mortality rates with depressive symptoms among HCWs during the first 2 years of the outbreak in multiple countries. This study's findings indicate that additional mental health support for HCWs was needed when the COVID-19 incidence and mortality rates increase during and after the early phase of the pandemic, and these findings may apply to future pandemics.Clinicaltrials.gov, NCT04352634.
Authors & Co-authors:
Asaoka Hiroki H
Watanabe Kazuhiro K
Miyamoto Yuki Y
Restrepo-Henao Alexandra A
van der Ven Els E
Moro Maria Francesca MF
Alnasser Lubna A LA
Ayinde Olatunde O
Balalian Arin A AA
Basagoitia Armando A
Durand-Arias Sol S
Eskin Mehmet M
Fernández-Jiménez Eduardo E
Ines Freytes Frey Marcela FFM
Giménez Luis L
Hoek Hans W HW
Jaldo Rodrigo Ezequiel RE
Lindert Jutta J
Maldonado Humberto H
Martínez-Alés Gonzalo G
Mediavilla Roberto R
McCormack Clare C
Narvaez Javier J
Ouali Uta U
Barrera-Perez Aida A
Calgua-Guerra Erwin E
Ramírez Jorge J
Rodríguez Ana María AM
Seblova Dominika D
da Silva Andrea Tenorio Correia ATC
Valeri Linda L
Gureje Oye O
Ballester Dinarte D
Carta Mauro Giovanni MG
Isahakyan Anna A
Jamoussi Amira A
Seblova Jana J
Solis-Soto Maria Teresa MT
Alvarado Ruben R
Susser Ezra E
Mascayano Franco F
Nishi Daisuke D
Study Outcome
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