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Hirten RP, Danieletto M, Tomalin L, Choi KH, Zweig M, Golden E, Kaur S, Helmus D, Biello A, Pyzik R, Calcogna C, Freeman R, Sands BE, Charney D, Bottinger EP, Murrough JW, Keefer L, Suarez-Farinas M, Nadkarni GN, Fayad ZA
Factors Associated With Longitudinal Psychological and Physiological Stress in Health Care Workers During the COVID-19 Pandemic: Observational Study Using Apple Watch Data
Factors Associated with Longitudinal Psychological and Physiological Stress in Health Care Workers During the COVID-19 Pandemic: Observational Study
Robert P Hirten;
Matteo Danieletto;
Lewis Tomalin;
Katie Hyewon Choi;
Micol Zweig;
Eddye Golden;
Sparshdeep Kaur;
Drew Helmus;
Anthony Biello;
Renata Pyzik;
Claudia Calcogna;
Robert Freeman;
Bruce E Sands;
Dennis Charney;
Erwin P Bottinger;
James W Murrough;
Laurie Keefer;
Mayte Suarez-Farinas;
Girish N Nadkarni;
Zahi A Fayad
ABSTRACT
Background:
The Coronavirus Disease 2019 (COVID-19) pandemic has resulted in a high degree of psychological distress in health care workers (HCWs). There is a need to characterize which HCWs are at an increased risk of developing psychological sequela from the pandemic.
Objective:
In the current study the objectives were to determine characteristics associated with longitudinal perceived stress in HCWs and to determine whether changes in heart rate variability (HRV), a measure of autonomic nervous system (ANS) function, associate with features protective against longitudinal stress.
Methods:
HCWs across seven hospitals in New York City (NYC) were prospectively followed in an ongoing observational digital study using the custom Warrior Watch Study App. Participants wore an Apple Watch for the duration of the study measuring HRV throughout the follow up period. Surveys measuring perceived stress, resilience, emotional support, quality of life, and optimism were collected at baseline and longitudinally.
Results:
Three hundred and sixty-one participants (mean [SD] age, 36.8 [10.1] years; 246 [69.3%] female) were enrolled. Multivariate analysis found NYC COVID-19 case count to be associated with increased longitudinal stress (P=0.008). Baseline emotional support, quality of life and resilience were associated with decreased longitudinal stress (P <0.001). A significant reduction in stress during the 4-week period after COVID-19 diagnosis was observed in the highest tertial of emotional support (P =0.03) and resilience (P =0.006). Participants in the highest tertial of baseline emotional support and resilience had significantly reduced amplitude and acrophase of the circadian pattern of longitudinally collected HRV.
Conclusions:
High resilience, emotional support, and quality of life place HCWs at reduced risk of longitudinal perceived stress and have a distinct physiological stress profile. Our findings support the use of these characteristics to identify HCWs at risk of the psychological and physiological stress effects of the pandemic.
Citation
Please cite as:
Hirten RP, Danieletto M, Tomalin L, Choi KH, Zweig M, Golden E, Kaur S, Helmus D, Biello A, Pyzik R, Calcogna C, Freeman R, Sands BE, Charney D, Bottinger EP, Murrough JW, Keefer L, Suarez-Farinas M, Nadkarni GN, Fayad ZA
Factors Associated With Longitudinal Psychological and Physiological Stress in Health Care Workers During the COVID-19 Pandemic: Observational Study Using Apple Watch Data