LAUSR

Study Objective: Previous work has established that frontline health care workers (HCWs), such as emergency physicians and nurses, are vulnerable to the development of adverse behavioral, psychological, and physical sequelae, which may persist long after the disaster. We examine the prevalence and predictors of psychological distress in ED clinicians working during the COVID-19 pandemic. We examined psychological and physiological (sleep, resting heart rate, blood pressure) of a sample of frontline providers during the COVID-19 pandemic Methods: This was a sample of 52 clinicians (physicians, residents, nurses, PAs, NPs) who were frontline HCWs during the COVID-19 pandemic across a diverse (academic, community, urban, and suburban) range of four emergency departments in the New York Metropolitan area during July 2020-September 2020. Study design is a longitudinal prospective cohort design. At baseline, we conducted a psychological test battery including measures of COVID-19 related stress, PTSD (PCL-5), anxiety (GAD-5), depression (PHQ-9), and burnout (Maslach Burnout Inventory). We also assessed home blood pressure at wake/sleep, resting heart rate, and sleep duration using an accelerometer watch device (Fitbit). Results: Baseline demographics in our sample had more self-identified women participants (62%), caucasian (67%), with median age of 42. Sample was diverse, containing physicians/advanced practice providers (45%) nurses (43%) and residents (12%) At baseline, positive screens for psychological symptoms were common;48% for acute stress, 37% for depressive, and 30% for anxiety symptoms. Overall, housestaff rates for acute stress and depression did not differ from attendings or nurses. Overall participants had elevated levels of emotional exhaustion on burnout surveys (median 24, SD 3.5). Average sleep duration was 6.2 hours (SD 1.3), resting heart rate of 86 (SD 18.2), and home blood pressure of 128/76. Increased levels of emotional exhaustion was positively associated with elevated resting blood pressure (Pearson r=.32), and resting heart rate (r=.38), while negatively associated with sleep duration (r=.23). Conclusion: Our preliminary work and others have highlighted that HCWs are experiencing significant COVID-19-related psychological and physical distress. Future work and data will address key questions such as whether such elevated distress symptoms remain persistent with the evolution of the pandemic. This work and others emphasize the need for continued mental health support measures for HCWs both during and in the aftermath of the pandemic.