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: 10558672
• 负责人: Bernard P. Chang
• 金额: $ 78.98万
• 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/10558672
• 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; Cessation of life; Data; Databases; Development; Disease Outbreaks; Emergency Department patient; Enrollment; Ensure; Environment; Exposure to; Fright; Future; Health Personnel; Health protection; 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; Symptoms; Testing; Vaccines; Work; acute care; acute traumatic stress disorder; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; coping; coronavirus disease; experience; follow-up; healing; indexing; infection rate; medical specialties; pandemic disease; pandemic impact; physical conditioning; prospective; protective factors; psychologic; psychological distress; psychological outcomes; psychological symptom; recruit; resilience; 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.

在过去的一年中，截至2021年2月，整个世界都被颠覆了。 在纽约市，已有超过1.12亿个确认的卡斯和250万人死亡。 美国大流行的美国震中，> 700,000例，> 89,000例住院和> 29,000 死亡。 Covid-19，可能会超越大流行。 长期心理症状的存在和预测指标以及心血管健康的后果 在COVID-19大流行之后，急诊科（ED）HCW对于这项工作是必要的。 了解问题的范围，并为保护这些前线HCW的健康努力提供努力 危险生命以确保我们的安全性。 与其他几乎其他临床医生相比，心理局限性风险。 在共同时期急剧放大，被称为“平行大流行” HCW面临的精神和身体伤害均可了解持续的存在至关重要 在治疗了共同患者的HCW中看到的心理症状，以及下游对 我们的初步工作表明，HCW经历了重要的急性心理 在纽约市的最初的Covid Peak中的困扰。 2020年，我们发现急性应激障碍率高（65％），焦虑症（36％）和失眠（70％） 这些参与者的心理症状的持久性。 疾病（PTSD）和39％的失眠症在10周的随访中经历了（1）。 检查提供护理的ED HCW中持续心理症状的灵活性和预测因素 在COVID大流行期间； 开胃疾病的心血管疾病（ASCVD）风险；（3）检查潜在的保护因子（即 弹性应对）在与共同相关的心理症状的发展中。 对ED HCWS的心理和心血管健康进行了前瞻性的3年研究 研究基线（第0年）和每年的随访（1-3年），世界上最高的案例。 我们将进行彻底的心理测试电池，其中包括与共同相关PTSD，COVID-的度量 相关的恐惧，失眠和弹性应对。 我们的主要暴露和心理症状的预测因素将是计算出的“ Covid负担”，即 量化为2020年3月1日（我们医院指数案的日期）之间的轮班数量和研究 入学人数，在该招生中，COVID征收的15％的ED患者将信息干预。 为了保护精神和身体，在我们遇到这一和未来的公共卫生危机时，在HCWS中。