Psychological symptoms in healthcare workers following the COVID-19 pandemic and relationship to long-term cardiovascular risk

COVID-19 大流行后医护人员的心理症状及其与长期心血管风险的关系

• 批准号: 10365638
• 负责人: Bernard P. Chang
• 金额: $ 79.88万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-02-01 至 2027-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10365638
• 关键词: Accident and Emergency department; Acute; Address; Admission activity; American Heart Association; Anxiety; Atherosclerosis; Buffers; COVID-19; COVID-19 pandemic; COVID-19 patient; COVID-19 treatment; Cardiovascular Diseases; Cardiovascular system; Caring; Case Study; Cessation of life; Data; Databases; Development; Disease Outbreaks; Emergency Department patient; Enrollment; Ensure; Environment; Exposure to; Fibrinogen; Fright; Future; Health; Health Personnel; Hospitalization; Hospitals; Hour; Individual; Intervention; Life Expectancy; Link; Long COVID; Measures; Mental Health; New York; New York City; Participant; Personal Satisfaction; Physicians; Physiological; Policies; Post-Traumatic Stress Disorders; Prevalence; Psyche structure; Psychological Stress; Psychological Tests; Psychophysiology; Public Health; Risk; Safety; Schedule; Sleeplessness; Societies; Specific qualifier value; Stress; Subgroup; Surveys; Sustainable Development; Symptoms; Testing; Vaccines; Work; acute care; acute traumatic stress disorder; base; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; coping; coronavirus disease; experience; follow-up; healing; hospital organization; indexing; infection rate; medical specialties; pandemic disease; physical conditioning; prospective; protective factors; psychologic; psychological distress; psychological outcomes; psychological symptom; recruit; safety net; shift work

Over the past year, the entire world has been upended by the COVID-19 pandemic. As of February 2021, there have been over 112 million confirmed cases and over 2.5 million deaths globally. In New York City, the initial US epicenter of the pandemic, there have been >700,000 cases, >89,000 hospitalizations, and >29,000 deaths. Healthcare workers (HCWs) have experienced alarming rates of anxiety, stress, and insomnia due to COVID-19, which are likely to persist beyond the pandemic. In the proposed work, we will examine the presence and predictors of long-term psychological symptoms and the consequences for cardiovascular health among emergency department (ED) HCWs following the COVID-19 pandemic. This work is necessary to understand the scope of the problem and to inform efforts to protect the health of these frontline HCWs who have risked their lives to ensure our safety. Pre-COVID, ED HCWs were already known to be at greater psychological risk than nearly every other subgroup of clinicians. Psycho-physiologic stress factors have been dramatically magnified during the COVID period, in what has been referred to as a “parallel pandemic” of surging mental and physical harm faced by HCWs. It is critical to understand the presence of sustained psychological symptoms seen in HCWs who treated COVID patients, as well as downstream impacts on cardiovascular health. Our preliminary work showed that HCWs experienced significant acute psychological distress during the initial COVID peak in New York City. In a survey of hospital HCWs conducted in April 2020, we found high rates of acute stress disorder (65%), anxiety (36%), and insomnia (70%). Early evidence points to persistence of psychological symptoms. In these participants, 25% experienced post-traumatic stress disorder (PTSD) and 39% experienced insomnia at a 10 week follow-up. In the proposed study, we will (1) examine the prevalence and predictors of sustained psychological symptoms in ED HCWs who provided care during the COVID pandemic; (2) characterize the relationship of psychological symptoms to 3-year progression of atherosclerotic cardiovascular disease (ASCVD) risk; and (3) examine a potential protective factor (i.e., resilient coping) in the development of COVID-related psychological symptoms. To achieve these aims, we will conduct a prospective 3-year study of psychological and cardiovascular health in ED HCWs exposed to some of the highest COVID case rates in the world. At study baseline (Year 0) and at each annual follow-up (Years 1-3), we will conduct a thorough psychological test battery that includes measures of COVID-related PTSD, COVID- related fear, insomnia, and resilient coping. Each participant’s ASCVD risk score will be computed annually. Our primary exposure and predictor of psychological symptoms will be the computed “Covid burden,” quantified as the number of shifts worked between March 1, 2020 (date of our hospital’s index case) and study enrollment, in which COVID admissions exceeded 15% of total ED patients. Findings will inform interventions to protect mental and physical wellbeing in HCWs as we navigate this and future public health crises.

在过去的一年里，截至 2021 年 2 月，整个世界都被 COVID-19 大流行所颠覆。 纽约市的确诊病例已超过 1.12 亿，死亡人数超过 250 万人。 美国是大流行的中心，已有超过 700,000 例病例，超过 89,000 例住院治疗，超过 29,000 例 医护人员 (HCW) 由于焦虑、压力和失眠而经历了惊人的死亡人数。 COVID-19 很可能在大流行结束后持续存在，在拟议的工作中，我们将研究它。 长期心理症状的存在和预测因素以及对心血管健康的影响 在 COVID-19 大流行后，这项工作对于急诊室 (ED) 医护人员来说是必要的。 了解问题的范围，并告知保护这些一线医护人员健康的努力 在新冠疫情发生之前，急诊室医护人员冒着生命危险确保我们的安全。 心理风险高于几乎所有其他亚组的防御者 心理生理压力因素。 在新冠疫情期间，这种情况急剧放大，被称为“平行流行病” 医护人员面临的精神和身体伤害激增，了解持续性伤害的存在至关重要。 治疗新冠肺炎患者的医护人员中出现的心理症状，以及对患者的下游影响 我们的初步工作表明，医护人员经历了显着的急性心理健康。 纽约市新冠疫情最初高峰期间的困扰 在四月份对医院医护人员进行的一项调查中。 2020 年，我们发现急性应激障碍 (65%)、焦虑 (36%) 和失眠 (70%) 的发病率很高。 指出这些参与者中 25% 的人经历过创伤后压力。 在 10 周的随访中，我们将 (1) 进行随访。 检查提供护理的急诊室医护人员持续心理症状的患病率和预测因素 (2) 描述心理症状与3年进展的关系 动脉粥样硬化性心血管疾病 (ASCVD) 风险；(3) 检查潜在的保护因素（即， 弹性应对）在新冠病毒相关心理症状的发展中的作用 为了实现这些目标，我们将 对接触某些物质的急诊医护人员的心理和心血管健康进行了一项为期 3 年的前瞻性研究 在研究基线（第 0 年）和每年的随访（第 1-3 年）中，新冠病例发生率是世界上最高的。 我们将进行全面的心理测试，其中包括与新冠肺炎相关的创伤后应激障碍（PTSD）、新冠肺炎- 每年都会计算每位参与者的 ASCVD 风险评分。 我们对心理症状的主要暴露和预测将是计算出的“新冠负担”， 量化为 2020 年 3 月 1 日（我们医院索引病例的日期）与研究之间的轮班次数 入院人数中，新冠肺炎入院人数超过急诊科患者总数的 15%。调查结果将为干预措施提供依据。 在我们应对当前和未来的公共卫生危机时，保护医护人员的身心健康。