The Toll it Takes: Mental Health Burden and Associated Factors During COVID-19 Outbreak among Healthcare Workers in Lahore, Pakistan

Objective: To assess psychological impact of COVID-19 pandemic among healthcare workers (HCWs) in a University Teaching Hospital, the main referral center for COVID-19 in Lahore Pakistan, by quantifying symptoms of acute stress disorder, depression, anxiety, insomnia and to explore their potential risk factors. Study Design: Descriptive Analytical study. Place and Duration of the Study: King Edward Medical University from March 30th-April 15th 2020. Methods: Following Institutional Review Board approval and informed consent, Demographic form, Patient Health Questionnaire, Generalized Anxiety Disorder scale, Insomnia Severity Index, and the stress reactions questionnaire were used for data collection. Descriptive statistics were computed. Binary logistic regression was done to determine potential risk factors for mental health outcomes. Results: Three hundred and thirty-seven healthcare workers participated with 79% physicians and 20% were nurses and paramedical staff. The prevalence of anxiety, depressive symptoms, acute stress disorder and insomnia was 36.2%, 30%, 27.9% &1.5% respectively. Women, frontline HCWs and junior staff had more anxiety, depression and insomnia symptoms with physicians reporting more acute stress symptoms compared to nurses. Binary logistic regression showed that being a junior staff member and a frontline worker appeared to be an independent risk factors for depression and anxiety (but not insomnia). Conclusion: High psychological distress among healthcare workers during COVID-19 reported in Pakistan. Failure to provide adequate psychosocial support can significantly impair their functioning and compromise patient care.