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Anxiety during the COVID-19 pandemic in hospital staff: systematic review plus meta-analysis
  1. Samira Raoofi1,
  2. Fatemeh Pashazadeh Kan2,
  3. Sima Rafiei3,
  4. Saghar Khani4,
  5. Hossein Hosseinifard5,
  6. Fatemeh Tajik6,
  7. Maryam Masoumi7,
  8. Neda Raoofi8,
  9. Saba Ahmadi9,
  10. Sepideh Aghalou10,
  11. Fatemeh Torabi1,
  12. Afsaneh Dehnad11,
  13. Zahra Hoseinipalangi9,
  14. Sepide Rezaei1,
  15. Hosein Shabaninejad12 and
  16. Ahmad Ghashghaee13
  1. 1Student Research Committee, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
  2. 2Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
  3. 3Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran (the Islamic Republic of)
  4. 4Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
  5. 5Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran (the Islamic Republic of)
  6. 6Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran
  7. 7Clinical Research and Development Center, Qom University of Medical Sciences, Qom, Iran
  8. 8Cardiovascular Research Center Kermanshah, Kermanshah, Iran
  9. 9Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
  10. 10Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Science, Tehran, Iran
  11. 11School of Health Management and Information Sciences, Center for Educational Research in Medical Sciences (CERMS), Iran University of Medical Sciences, Tehran, Iran
  12. 12Population Health Sciences Institute (PHSI), Newcastle University, Newcastle, UK
  13. 13Social Determinants of Health Research Center, Research Institute for Prevention of Non-communicable Disease, Qazvin University of Medical Sciences, Qazvin, Iran
  1. Correspondence to Ahmad Ghashghaee, Department of Health Information Management, Iran University of Medical Sciences, Tehran 1996713883, Iran (the Islamic Republic of); ahmad.ghashghaee1996{at}


Background This study was conducted to systematically review the existing literature examining the prevalence of anxiety among hospital staff and identifying the contributing factors to address the complications of this disorder and develop effective programmes for reducing the complications of this mental health problem.

Methods We searched the electronic databases including PubMed, EMBASE, Scopus, Web of Science and Google Scholar from January 2020 to February 2021. To perform meta-analysis, the random effects model was used. To assess the statistical heterogeneity of the included studies, the I2 index was used, and 95% CI was estimated. Data analysis was performed by R software.

Results In the final analysis, 46 articles with the total sample size of 61 551 hospital staff members were included. Accordingly, anxiety prevalence among healthcare workers (HCWs) was 26.1% (95% CI 19% to 34.6%). The prevalence rates of anxiety in health technicians and medical students were 39% (95% CI 13% to 73%) and 36% (95% CI 15% to 65%), respectively, indicating a much higher prevalence than other hospital staff members. Furthermore, a positive significant relationship between prevalence of anxiety among HCWs and their age was approved (p<0.001). The prevalence rate of anxiety was higher among women 37.7% (95% CI 25.4% to 51.8%) than men 27.2% (95% CI 18.2% to 38.6%).

Conclusion The findings show a moderately high prevalence rate of anxiety in hospital staff. Due to the high prevalence of this mental health problem in health technicians, medical students and frontline health workers, it is highly suggested that healthcare institutions offer mental health programmes for these working groups in order to appropriately manage anxiety during the COVID-19 pandemic.

  • COVID-19
  • hospital care
  • depression
  • psychological care

Data availability statement

Available on request.

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

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Data availability statement

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  • Contributors Category 1: Conception and design of study—SR, AG and FPK. Acquisition of data—ZH, FPK, SR, SK, FT, NR, SAhmadi and SAghalou. Analysis and/or interpretation of data—HH, SR and FT. Category 2: Drafting the manuscript—SR, AG and AD. Revising the manuscript critically for important intellectual content—SR, AD, AG, FPK, MM and HS. Approval of the version of the manuscript to be published—SR, AG, SR and HH.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.