There’s been no shortage of public support and international acclaim for those who work on the front lines in the battle against SARS-CoV-2, more commonly known as COVID-19. Still, symptoms of depression, anxiety and insomnia are known to disproportionately affect healthcare workers, especially in times of crisis.

To better understand the deleterious effects of the COVID-19 pandemic on nurses, doctors and other medical staff, a team of researchers has collected and quantified mental health measurements from healthcare workers in 34 hospitals across China in new research published in JAMA Network Open.

The researchers used a series of self-reporting questionnaires to assess thoughts and behaviors among medical workers, with a focus on depression, anxiety and insomnia, grouping participants according to absent, mild, moderate or severe symptoms.

The results confirm what many have suspected or known intuitively: healthcare workers on the front line of the crisis experience significantly greater levels of depression, anxiety and insomnia than their colleagues who are not in direct contact with the virus or the ill. Roughly half the participants reported experiencing symptoms of depression and anxiety, while about one third had trouble sleeping. A telling 71% of respondents reported experiencing general and lasting distress.

The study also highlighted the exaggerated effect felt by nurses, women, those working in Wuhan—ground-zero for the COVID-19 pandemic—and so-called frontline medical practitioners: those directly involved in the diagnosis, treatment and care of patients with the disease. Additionally, women “having an intermediate professional title were associated with severe symptoms of depression, anxiety, and distress,” while health-care workers in tertiary hospitals were significantly more anxious and depressed than those working in secondary hospitals. Working on the front line correlated with increased risk of all measures: depression, anxiety, insomnia and distress.

Future studies will benefit from including a greater range of participants, the current study having a mostly female population hailing from Hubei province. Additionally, it will be important to study the evolution of symptoms over time: longitudinal research that begins early will be of great benefit for understanding how individuals experience symptoms over time.

This and similar studies are doubly important. Not only do they help inform the general population and scientific community of the psychological hazards of the medical profession in times of crisis, but also help us to understand how symptoms are experienced by these individuals and what can be done to improve their wellbeing.

The study, “Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019“, was authored by Jianbo Lai, Simeng Ma, Ying Wang, Zhongxiang Cai, Jianbo Hu,Ning Wei,Jiang Wu, Hui Du, Tingting Chen, Ruiting Li, Huawei Tan, Lijun Kang, Lihua Yao, Manli Huang, Huafen Wang, Gaohua Wang, Zhongchun Liu, and Shaohua Hu.