The Relationship between Fatigue and Depression and Anxiety Symptoms Among Front Line Clinical Workers During the COVID 19 Pandemic

Background: Our study is to test the association between front-line clinical workers' fatigue and depression and anxiety during the COVID-19 epidemic. Methods: The study is a cross-sectional, online survey administered to 275 healthcare professionals in Wuhan from February 22, 2020 to February 29, 2020. All respondents completed a questionnaire via WeChat, which collected demographics and responses on the Self-Rating Anxiety Scale (SAS), the Center for Epidemiologic Studies Depression Scale (CES-D), and the Fatigue Scale-14 (FS-14). Outcomes: A total of 275 participants completed the survey, including 46 doctors (16·73%) and 229 nurses (83·27%). Depression was significantly positively associated with physical fatigue (OR 1·61, 95% CI 1·41-1·83), mental fatigue (OR 1·98, 95% CI 1·60-2·45), and the total score (OR 1·56, 95% CI 1·39-1·75) after adjusting for confounding factors. Significant positive associations were also observed between the symptoms of anxiety and physical fatigue (OR 1·64, 95% CI 1·44-1·87), mental fatigue (OR 2·11, 95% CI 1·71-2·60), and the total score (OR 1·58, 95% CI 1·42-1·71) in the adjusted model. Interpretation: The current study demonstrated that, among the front-line clinical workers in Wuhan, fatigue is significantly associated with depression and anxiety and mental fatigue contributes to a greater risk than physical fatigue on the mental health of clinical workers. Males and doctors were found to be more vulnerable to psychological problems such as depression and anxiety under fatigue, suggesting the need for targeted psychological interventions. Funding Statement: COVID-19 epidemic prevention and control related research projects of China Medical University. Declaration of Interests: The authors do not have any conflicts of interest to disclose. Ethics Approval Statement: The current study was approved by the human research ethics committee from the First Affiliated Hospital, China Medical University. The nature and purpose of the study was explained in detail before participants completed the written informed consent.