Symptoms of Anxiety, Burnout, and PTSD and the Mitigation Effect of Serologic Testing in Emergency Department Personnel During the COVID-19 Pandemic

Robert M Rodriguez; Juan Carlos C Montoy; Karin F Hoth; David A Talan; Karisa K Harland; Patrick Ten Eyck; William Mower; Anusha Krishnadasan; Scott Santibanez; Nicholas Mohr

doi:10.1016/j.annemergmed.2021.01.028

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Symptoms of Anxiety, Burnout, and PTSD and the Mitigation Effect of Serologic Testing in Emergency Department Personnel During the COVID-19 Pandemic

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Symptoms of Anxiety, Burnout, and PTSD and the Mitigation Effect of Serologic Testing in Emergency Department Personnel During the COVID-19 Pandemic

Robert M Rodriguez, Juan Carlos C Montoy, Karin F Hoth, David A Talan, Karisa K Harland, Patrick Ten Eyck, William Mower, Anusha Krishnadasan, Scott Santibanez and Nicholas Mohr

Annals of emergency medicine, Vol.78(1), pp.35-43.e2

02/05/2021

DOI: 10.1016/j.annemergmed.2021.01.028

PMID: 33846014

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Abstract

Among a comprehensive range of frontline emergency department health care personnel, we assessed symptoms of anxiety and burnout, specific coronavirus disease 2019 (COVID-19) work-related stressors, and risk for post-traumatic stress disorder (PTSD). We also determined whether COVID-19 serologic testing of HCP decreased their self-reported anxiety. In a prospective cohort study from May 13, 2020, to July 8, 2020, we used electronic surveys to capture participant self-reported symptoms before and after serologic testing for anti-SARS-CoV-2 immunoglobulin G antibodies. Participants were physicians, nurses, advanced practice providers, and nonclinical ED personnel at 20 geographically diverse United States EDs. We evaluated these domains: 1) the effects of the COVID-19 pandemic on overall stress and anxiety; 2) COVID-19-related work stressors; 3) burnout; and 4) PTSD risk (measured using the Primary Care-PTSD Screen for DSM-5, a 5-item screening instrument in which a score of ≥3 signifies high risk for PTSD). We also assessed perceptions of whether results of COVID-19 antibody testing decreased participants' self-reported anxiety. Of 1,606 participants, 100% and 88% responded to the baseline and follow-up surveys, respectively. At baseline, approximately half (46%) reported symptoms of emotional exhaustion and burnout from their work, and 308 (19.2%, 95% confidence interval [CI] 17.3% to 21.1%) respondents screened positive for increased PTSD risk. Female respondents were more likely than males to screen positive (odds ratio [OR] 2.03, 95% CI 1.49 to 2.78). Common concerns included exposing their family and the health of coworkers diagnosed with COVID-19. After receiving antibody test results, 54% (95% CI 51.8 to 56.7) somewhat agreed, agreed, or strongly agreed that knowledge of their immune status had decreased their anxiety. A positive serology result indicating prior SARS-CoV-2 infection was associated with a higher likelihood of reporting decreased anxiety (2.83, 95% CI 1.37 to 5.83). Symptoms of anxiety and burnout were prevalent across the spectrum of ED staff during the COVID-19 pandemic. One-fifth of ED personnel appeared to be at risk for PTSD. Increased provision of serologic testing may help to mitigate anxiety.

Details

Title: Subtitle: Symptoms of Anxiety, Burnout, and PTSD and the Mitigation Effect of Serologic Testing in Emergency Department Personnel During the COVID-19 Pandemic
Creators: Robert M Rodriguez - Department of Emergency Medicine, University of California, San Francisco School of Medicine, San Francisco, CA. Electronic address: Robert.rodriguez@ucsf.edu
Juan Carlos C Montoy - Department of Emergency Medicine, University of California, San Francisco School of Medicine, San Francisco, CA
Karin F Hoth - Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA
David A Talan - Olive View-UCLA Education and Research Institute, Los Angeles, CA; Department of Emergency Medicine, University of California-Los Angeles Ronald Reagan Medical Center, Los Angeles, CA
Karisa K Harland - Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA
Patrick Ten Eyck - Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA
William Mower - Department of Emergency Medicine, University of California-Los Angeles Ronald Reagan Medical Center, Los Angeles, CA
Anusha Krishnadasan - Olive View-UCLA Education and Research Institute, Los Angeles, CA
Scott Santibanez - Division of Preparedness and Emerging Infections, Centers for Disease Control and Prevention, Atlanta, GA
Nicholas Mohr - Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IA
Contributors: Project COVERED Emergency Department Network (Author)
Resource Type: Journal article
Publication Details: Annals of emergency medicine, Vol.78(1), pp.35-43.e2
DOI: 10.1016/j.annemergmed.2021.01.028
PMID: 33846014
NLM abbreviation: Ann Emerg Med
ISSN: 0196-0644
eISSN: 1097-6760
Publisher: United States
Language: English
Date published: 02/05/2021
Academic Unit: Psychiatry; Epidemiology; Emergency Medicine; Iowa Neuroscience Institute; Biostatistics; Anesthesia; Injury Prevention Research Center; Law Faculty
Record Identifier: 9984066145402771

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