COVID-19 and staff mental health: is there an evidence? An Italian field study

Magnavita, N; Di Prinzio, R R; Chirico, F; Sacco, A; Quintavalle, G

Since the early months of the COVID-19 epidemic, a large number of scientific papers have considered the possibility that healthcare professionals (HCWs) were affected by depression, anxiety, post-traumatic stress, and psychological distress. The abundance of research has also made it possible to produce several systematic reviews and meta-analyzes. All the studies retrieved in these reviews, however, were cross-sectional. Depressive symptoms and anxiety in HCWs were compared to “normal values”, administrative staff, or external sample; moreover, some studies had no control group. No longitudinal study has been produced so far. Some studies had negative results. Overall, there is still little evidence of an increase in mental health problems and sleep disturbances in HCWs during the outbreak. To fill this gap, we investigated the mental health of workers who have been monitored for many years in an Italian local health unit. Mental health was investigated with standardized questionnaires. 82 HCWs who tested positive at the COVID-19 nasopharyngeal swab, 152 exposed workers who tested negative and 361 unexposed controls participated in the survey. Anxiety was reported by 16.6% of COVID-19 cases and depression by 20.3%, with a significant increase in the estimated risk (OR = 4.3; CI95%=2.4-7.4 for anxiety, OR = 3.5; CI95% =2.0-6.0 for depression). In test-positive cases, sleep was a significant moderating factor in the relationship between occupational stress or PJ and anxiety. Exposed, negative HCWS also had an increased OR for anxiety (1.84, CI95% 1.1-3.1) and depression (2.2 CI95% 1.4-3.5). The frequency of anxiety and depression disorders in the population examined was not higher than that recorded in the years preceding the epidemic during periodic occupational health checks in the workplace. Mental health support and organizational interventions must mainly concern workers with positive tests and should also tend to improve sleep quality. KEY MESSAGES: Health care workers who have had unprotected exposure to COVID-19 patients, and even more those who have contracted the infection, have sleep problems, anxiety and depression. The psychological support intervention for health care workers should include the promotion of sleep hygiene.