Healthcare worker fatigue during COVID-19, SARS, and MERS: a meta-analysis 2026 Chalder et al

Sly Saint

Sly Saint

Senior Member (Voting Rights)

Abstract​

Background
The physical and psychological impact of caring for patients during a coronavirus public health emergency had adverse effects on healthcare workers (HCW), including fatigue.
Aims
To examine the prevalence of fatigue among HCW during severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS) or Coronavirus disease 19 (COVID-19) and identify associated risk and protective factors.
Methods
Systematic searches of Embase, PsycINFO, Ovid-MEDLINE, CINAHL, HMIC and the Cochrane Library were conducted to July 2024. Inclusion criteria were English-language quantitative reports of fatigue in HCW during COVID-19, SARS and MERS. Random-effects meta-analyses were used to estimate pooled prevalence. Subgroup analyses examined fatigue by role, frontline status and personal protective equipment (PPE).
Results
Eighty-eight articles (n = 74 914) met our inclusion criteria; 32 were eligible for meta-analysis. The pooled prevalence of fatigue was 55% (95% CI 46–65%, k = 32). Mental fatigue was reported by 58% (95% CI 17–90%, k = 4), while 53% (95% CI 38–67%, k = 11) experienced fatigue related to PPE use. No significant differences were observed between doctors and nurses (P = 0.327) or frontline and non-frontline staff (P = 0.103). Risk factors included stress, anxiety, depressive symptoms, workload and extended working hours, while resilience, self-efficacy and sufficient rest were protective. Substantial heterogeneity (I2 ∼99%) and reliance on cross-sectional designs limited causal inference.
Conclusions
Our study indicated that over half of HCW reported fatigue and highlighted its multifactorial nature. Organizational-level interventions, such as optimized shift patterns, mandated rest breaks and psychological support are essential to mitigate fatigue, safeguard wellbeing and ensure safe healthcare provision.

 
Sly Saint said:
Risk factors included stress, anxiety, depressive symptoms, workload and extended working hours, while resilience, self-efficacy and sufficient rest were protective
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TC throwing healthcare workers during pandemics under the same bus she happily threw us all under.

I will never forget the video of her laughing and telling a physio whose patient reported being in bed for weeks after GET 'that must be a really health anxious patient'.

I suppose these are just really health anxious healthcare workers...

This is why I refuse to fill in Chalder fatigue questionaires on principle.
 
I find this interesting in the methods:

Exclusion criteria were (i) compassion fatigue, decision fatigue, emotional exhaustion, emotional fatigue, moral fatigue or pandemic fatigue (defined as ‘disengagement with recommended protective behaviours, or seeking relevant information, general complacency and detachment’); (ii) ‘burnout’; (iii) newspaper articles, conference papers, abstracts, editorials, opinions or commentaries; and (iv) protocols, qualitative designs, systematic reviews/meta-analyses, case reports, vaccination or ‘transmission’ studies. To separate ‘virus-related fatigue’ from ‘work-related fatigue’, articles including HCW infected with a named virus were omitted.
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To reduce variability in the fatigue outcomes, only ‘chronic’ data were included in analyses where both ‘acute’ and ‘chronic’ fatigue data were measured by the OFER Scale. To maintain the independence of observations, only physical fatigue was entered into the overall analysis. Mental fatigue was calculated as an independent outcome.
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Studies using the terms ‘exhaustion’, ‘fatigue’ and ‘chronic fatigue’ were used interchangeably for ‘fatigue’ and entered all analyses.
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One study contained fatigue data during MERS and COVID-19 [43]. Therefore, only COVID-19 data were used in fatigue prevalence.
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