Physiological and Perceived Stress, Anxiety, Depression and Burnout Among Icu Staff During the Covid-19 Pandemic in Sweden

PurposeTo measure physiological stress using hair cortisol concentrations (HCC) among ICU staff working during the COVID-19 pandemic in Sweden, and to evaluate its relationship with perceived stress (PS), anxiety and depression, and burnout.Materials and MethodsHCC was measured in hair samples of 274 individuals. We tested for differences between females vs. males, nurses vs. non-nursing, and ordinary vs. deployed staff. PS, anxiety, depression, and burnout were measured using validated questionnaires. We compared HCC among ICU staff to pre-pandemic healthcare workers.ResultsMedian HCC was 32.6 pg/mg [IQR 21.3-62.3]. There were no differences due to sex, profession and deployment status. HCC was higher compared to pre-pandemic healthcare workers (32.6 [21.3-62.3] vs. 27.3 [16.2-63.3], p=0.002). Anxiety was detected in 19% and depression in 4% of participants. PS score (23.5 [18.25-29.0]) was higher than previously reported normative data. Burnout occurred in 38.3% and was driven by low personal accomplishment. No correlations were found between HCC and PS, anxiety, depression and burnout.ConclusionsPhysiological stress measured as HCC was not different due to sex, profession or deployment status. Anxiety and burnout were frequent and depression was reported by a minority. HCC did not correlate with PS, anxiety, depression or burnout.