Impact of coronavirus syndromes on physical and mental health of health care workers: Systematic review and meta-analysis

Background: 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. Methods: 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, 12 statistic, quality assessment and sensitivity analysis. Results: 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). Limitations: Limited amount of evidence for some outcomes and suboptimal design in several studies included. Conclusions: SARS/MERS/COVID-19 have a substantial impact on the physical and mental health of HCW, which should become a priority for public health strategies.