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，整个世界都被19日的大流行颠覆了。截至2021年2月， 在全球范围内已确认超过1.12亿个案件，死亡人数超过250万。在纽约市，最初 美国大流行的美国震中，有> 700,000例，> 89,000例住院和> 29,000 死亡人数。医疗保健工人（HCWS）由于 Covid-19，可能会持续超出大流行。在拟议的工作中，我们将研究 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-19-19大流行之后，急诊科（ED）HCW中。这项工作是必要的 了解问题的范围，并告知保护这些前线HCW的健康的努力 冒着生命危险以确保我们的安全。预浮动，ED HCW已知在更大的 心理风险几乎比临床医生的其他亚组。心理生理压力因素已经 在共同时期大大放大，这被称为“平行大流行” HCWS面临的精神和身体伤害激增。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 心血管健康。我们的初步工作表明，HCWS经历了重要的急性心理学 在纽约市最初的共同峰值期间的困扰。在对4月进行的HCWS医院的调查中 2020年，我们发现急性应激障碍（65％），动画（36％）和失眠率（70％）。早期证据 指出了心理症状的持久性。在这些参与者中，有25％的人经历了创伤后压力 在10周的随访中，疾病（PTSD）和39％的失眠。在拟议的研究中，我们将（1） 检查提供护理的ED HCW中持续心理症状的患病率和预测因素 期间大流行期； （2）表征心理症状与3年进展的关系 动脉粥样硬化心血管疾病（ASCVD）风险； （3）检查潜在的受保护因素（即 弹性应对）在共同相关的心理症状的发展中。为了实现这些目标，我们将 对ED HCWS的心理和心血管健康进行了前瞻性的3年研究 世界上最高的案例率。在研究基线（0年）和每年的随访（1-3年）中， 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，失眠和韧性应对。每个参与者的ASCVD风险评分将每年计算。 我们的主要暴露和心理症状的预测指标将是计算出的“ Covid Burnen”， 量化为2020年3月1日（我们医院指数案件的日期）之间的轮班数量和研究 入学人数，其中共同入院超过了ED患者的15％。调查结果将为干预措施提供信息 在我们遇到这一和未来的公共卫生危机时，要保护HCWS的身心健康。