Supplementary Material for: What We Have Learned from Two Decades of Epidemics and Pandemics: A Systematic Review and Meta-Analysis of the Psychological Burden of Frontline Healthcare Workers

In light of the current coronavirus disease 2019 (COVID-19) pandemic and potential future infectious disease outbreaks, a comprehensive understanding of the negative effects of epidemics and pandemics on healthcare workers’ mental health could inform appropriate support interventions. Thus, we aimed to synthesize and quantify the psychological and psychosomatic symptoms among frontline medical staff. We searched four databases up to March 19, 2020 and additional literature, with daily search alerts set up until October 26, 2020. Studies reporting psychological and/or psychosomatic symptoms of healthcare workers caring for patients with severe acute respiratory syndrome, H1N1, Ebola, Middle East respiratory syndrome, or COVID-19 were eligible for inclusion. Two reviewers independently conducted the search, study selection, quality appraisal, data extraction, and synthesis and involved a third reviewer in case of disagreement. We used random effects modeling to estimate the overall prevalence rates of psychological/psychosomatic symptoms and the <i>I</i>² statistic. We included 86 studies, reporting data from 75,991 participants. Frontline staff showed a wide range of symptoms, including concern about transmitting the virus to the family (60.39%, 95% CI 42.53–76.96), perceived stress (56.77%, 95% CI 34.21–77.95), concerns about own health (45.97%, 95% CI 31.08–61.23), sleeping difficulties (39.88%, 95% CI 27.70–52.72), burnout (31.81%, 95% CI 13.32–53.89), symptoms of depression (25.72%, 95% CI 18.34–33.86), symptoms of anxiety (25.36%, 95% CI 17.90–33.64), symptoms of posttraumatic stress disorder (24.51%, 95% CI 18.16–31.46), mental health issues (23.11%, 95% CI 15.98–31.10), and symptoms of somatization (14.68%, 95% CI 10.67–19.18). We found consistent evidence for the pervasive and profound impact of large-scale outbreaks on the mental health of frontline healthcare workers. As the CO­VID-19 crisis continues to unfold, guaranteeing easy access to support structures for the entire healthcare workforce is vitally important.

鉴于当前新型冠状病毒肺炎（coronavirus disease 2019，COVID-19）大流行以及未来可能发生的传染病暴发事件，全面了解传染病及大流行对医护人员心理健康的负面影响，可为制定适宜的支持干预措施提供依据。为此，本研究旨在综合分析并量化一线医护人员的心理及心身症状。本研究检索了截至2020年3月19日的4个数据库及其他相关文献，并设置每日检索预警直至2020年10月26日。纳入标准为：研究报道了照护严重急性呼吸综合征（severe acute respiratory syndrome）、H1N1、埃博拉（Ebola）、中东呼吸综合征（Middle East respiratory syndrome）或新型冠状病毒肺炎患者的医护人员的心理及/或心身症状。由2名评价者独立完成检索、文献筛选、质量评价、数据提取及综合分析，若存在分歧则邀请第三名评价者协助裁决。本研究采用随机效应模型估算心理/心身症状的总体患病率及I²统计量。本研究共纳入86项研究，涉及75991名研究对象。一线医护人员出现了多种症状，包括担心将病毒传染给家人（60.39%，95%CI 42.53~76.96）、知觉压力（56.77%，95%CI 34.21~77.95）、担忧自身健康（45.97%，95%CI 31.08~61.23）、睡眠障碍（39.88%，95%CI 27.70~52.72）、职业倦怠（31.81%，95%CI 13.32~53.89）、抑郁症状（25.72%，95%CI 18.34~33.86）、焦虑症状（25.36%，95%CI 17.90~33.64）、创伤后应激障碍（posttraumatic stress disorder）症状（24.51%，95%CI 18.16~31.46）、心理健康问题（23.11%，95%CI 15.98~31.10）及躯体化症状（14.68%，95%CI 10.67~19.18）。本研究结果一致证实，大规模传染病暴发对一线医护人员的心理健康存在广泛且深远的影响。随着新型冠状病毒肺炎疫情的持续发展，为全体医护人员提供便捷的支持体系至关重要。