This systematic review and meta-analysis has identified the top 10 physical and mental health outcomes in health care workers infected or exposed to coronavirus syndromes (Severe Acute Respiratory Syndrome -SARS-, Middle East Respiratory Syndrome -MERS-, Novel coronavirus -COVID-19-).
The physical and mental health burden associated with SARS/MERS/COVID-19 in health care workers is high.
These findings could inform public health strategies to detect the most frequent physical and mental health outcomes in health care workers, monitor their course and implement preventive/treatment measures to mitigate their effect in this vulnerable population
Health care workers (HCW) are at high risk of developing physical/mental health outcomes related to coronavirus syndromes. Nature and frequency of these outcomes are undetermined.
PRISMA/MOOSE-compliant (PROSPERO-CRD42020180205) systematic review of Web of Science/grey literature until 15th April 2020, to identify studies reporting physical/mental health outcomes in HCW infected/exposed to Severe Acute Respiratory Syndrome -SARS-, Middle East Respiratory Syndrome -MERS-, Novel coronavirus -COVID-19-. Proportion random effect meta-analyses, I 2 statistic, quality assessment and sensitivity analysis.
115 articles were included (n=60,458 HCW, age 36.1±7.1, 77.1% female). Physical health outcomes: 75.9% HCW infected by SARS/MERS/COVID-19 reported fever (95%CI=65.9%-83.7%, k=12, n=949), 47.9% cough (95%CI=39.2%-56.8%, k=14, n=970), 43.6% myalgias (95%CI=31.9%-56.0%, k=13, n=898), 42.3% chills (95%CI=20.2%-67.9%, k=7, n=716), 41.2% fatigue (95%CI=18.2%-68.8%, k=6, n=386), 34.6% headaches (95%CI=23.1%-48.2%, k=11, n=893), 31.2% dyspnoea (95%CI=23.2%-40.5%, k=12, n=1003), 25.3% sore throat (95%CI=18.8%-33.2%, k=8, n=747), 22.2% nausea/vomiting (95%CI=14.9%-31.8%, k=6, n=662), 18.8% diarrhoea (95%CI=11.9%-28.4%, k=9, n=824). Mental health outcomes: 62.5% HCW exposed to SARS/MERS/COVID-19 reported general health concerns (95%CI=57.0%-67,8%, k=2, n=2254), 43.7% fear (95%CI=33.9%-54.0%, k=4, n=584), 37.9% insomnia (95%CI=30.9%-45.5%, k=6, n=5067), 37.8% psychological distress (95%CI=28.4%-48.2%, k=15, n=24,346), 34.4% burnout (95%CI=19.3%-53.5%, k=3, n=1337), 29.0% anxiety features (95%CI=14.2%-50.3%, k=6, n=9191), 26.3% depressive symptoms (95%CI=12.5%-47.1%, k=8, n=9893), 20.7% post-traumatic stress disorder features (95%CI=13.2%-31%, k=11, n=3826), 16.1% somatisation (95%CI=0.2%-96.0%, k=2, n=2184), 14.0% stigmatisation feelings (95%CI=6.4%-28.1%, k=2, n=411).