When health professionals look death in the eye: the mental health of professionals who deal daily with the 2019 coronavirus outbreak
Identifieur interne : 000513 ( Pmc/Corpus ); précédent : 000512; suivant : 000514When health professionals look death in the eye: the mental health of professionals who deal daily with the 2019 coronavirus outbreak
Auteurs : Modesto Leite Rolim Neto ; Hiure Gomes Almeida ; Joana D'Arc Esmeraldo ; Camila Bezerra Nobre ; Woneska Rodrigues Pinheiro ; Cícera Rejane Tavares De Oliveira ; Itamara Da Costa Sousa ; Onélia Maria Moreira Leite Lima ; Nádia Nara Rolim Lima ; Marcial Moreno Moreira ; Carlos Kennedy Tavares Lima ; Jucier Gonçalves Júnior ; Claúdio Gleideston Lima Da SilvaSource :
- Psychiatry Research [ 0165-1781 ] ; 2020.
Abstract
Nurses, doctors, healthcare workers, and other medical professionals who are testing for and treating patients with COVID-19 are at a higher risk of contracting it than the general public. The combination of stress and possible exposure puts healthcare professionals, from physicians and nurses, to specialists, at greater risk of contracting COVID-19 and potentially spreading it to others. Health professionals directly involved in the diagnosis, treatment, and care of patients with COVID-19 develop the insertion of psychic spaces for the installation of pain and psychological suffering and other mental health symptoms. The foreseeable shortage of supplies and an increasing flow of suspected and real cases of COVID-19 contribute to the pressures and concerns of health professionals.
Url:
DOI: 10.1016/j.psychres.2020.112972
PubMed: 32302817
PubMed Central: 7152886
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PMC:7152886Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">When health professionals look death in the eye: the mental health of professionals who deal daily with the 2019 coronavirus outbreak</title><author><name sortKey="Neto, Modesto Leite Rolim" sort="Neto, Modesto Leite Rolim" uniqKey="Neto M" first="Modesto Leite Rolim" last="Neto">Modesto Leite Rolim Neto</name><affiliation><nlm:aff id="aff0001">School of Medicine of Juazeiro do Norte (FMJ/Estácio) – Juazeiro do Norte, Ceará, Brazil</nlm:aff></affiliation><affiliation><nlm:aff id="aff0004">School of Medicine, Federal University of Cariri (UFCA) – Barbalha, Ceará, Brazil</nlm:aff></affiliation></author><author><name sortKey="Almeida, Hiure Gomes" sort="Almeida, Hiure Gomes" uniqKey="Almeida H" first="Hiure Gomes" last="Almeida">Hiure Gomes Almeida</name><affiliation><nlm:aff id="aff0001">School of Medicine of Juazeiro do Norte (FMJ/Estácio) – Juazeiro do Norte, Ceará, Brazil</nlm:aff></affiliation></author><author><name sortKey="Esmeraldo, Joana D Arc" sort="Esmeraldo, Joana D Arc" uniqKey="Esmeraldo J" first="Joana D'Arc" last="Esmeraldo">Joana D'Arc Esmeraldo</name><affiliation><nlm:aff id="aff0001">School of Medicine of Juazeiro do Norte (FMJ/Estácio) – Juazeiro do Norte, Ceará, Brazil</nlm:aff></affiliation></author><author><name sortKey="Nobre, Camila Bezerra" sort="Nobre, Camila Bezerra" uniqKey="Nobre C" first="Camila Bezerra" last="Nobre">Camila Bezerra Nobre</name><affiliation><nlm:aff id="aff0001">School of Medicine of Juazeiro do Norte (FMJ/Estácio) – Juazeiro do Norte, Ceará, Brazil</nlm:aff></affiliation></author><author><name sortKey="Pinheiro, Woneska Rodrigues" sort="Pinheiro, Woneska Rodrigues" uniqKey="Pinheiro W" first="Woneska Rodrigues" last="Pinheiro">Woneska Rodrigues Pinheiro</name><affiliation><nlm:aff id="aff0002">Regional University of Cariri – URCA, Crato, Ceará, Brazil</nlm:aff></affiliation></author><author><name sortKey="De Oliveira, Cicera Rejane Tavares" sort="De Oliveira, Cicera Rejane Tavares" uniqKey="De Oliveira C" first="Cícera Rejane Tavares" last="De Oliveira">Cícera Rejane Tavares De Oliveira</name><affiliation><nlm:aff id="aff0002">Regional University of Cariri – URCA, Crato, Ceará, Brazil</nlm:aff></affiliation></author><author><name sortKey="Sousa, Itamara Da Costa" sort="Sousa, Itamara Da Costa" uniqKey="Sousa I" first="Itamara Da Costa" last="Sousa">Itamara Da Costa Sousa</name><affiliation><nlm:aff id="aff0002">Regional University of Cariri – URCA, Crato, Ceará, Brazil</nlm:aff></affiliation></author><author><name sortKey="Lima, Onelia Maria Moreira Leite" sort="Lima, Onelia Maria Moreira Leite" uniqKey="Lima O" first="Onélia Maria Moreira Leite" last="Lima">Onélia Maria Moreira Leite Lima</name><affiliation><nlm:aff id="aff0003">Postgraduate Program in Health Sciences, School of Medicine of ABC, Santo André, São Paulo, Brazil</nlm:aff></affiliation></author><author><name sortKey="Lima, Nadia Nara Rolim" sort="Lima, Nadia Nara Rolim" uniqKey="Lima N" first="Nádia Nara Rolim" last="Lima">Nádia Nara Rolim Lima</name><affiliation><nlm:aff id="aff0005">Suicidology Research Group, Universidade Federal do Ceará (UFC) – Fortaleza, Ceará, Brazil</nlm:aff></affiliation></author><author><name sortKey="Moreira, Marcial Moreno" sort="Moreira, Marcial Moreno" uniqKey="Moreira M" first="Marcial Moreno" last="Moreira">Marcial Moreno Moreira</name><affiliation><nlm:aff id="aff0001">School of Medicine of Juazeiro do Norte (FMJ/Estácio) – Juazeiro do Norte, Ceará, Brazil</nlm:aff></affiliation><affiliation><nlm:aff id="aff0004">School of Medicine, Federal University of Cariri (UFCA) – Barbalha, Ceará, Brazil</nlm:aff></affiliation><affiliation><nlm:aff id="aff0003">Postgraduate Program in Health Sciences, School of Medicine of ABC, Santo André, São Paulo, Brazil</nlm:aff></affiliation></author><author><name sortKey="Lima, Carlos Kennedy Tavares" sort="Lima, Carlos Kennedy Tavares" uniqKey="Lima C" first="Carlos Kennedy Tavares" last="Lima">Carlos Kennedy Tavares Lima</name><affiliation><nlm:aff id="aff0003">Postgraduate Program in Health Sciences, School of Medicine of ABC, Santo André, São Paulo, Brazil</nlm:aff></affiliation></author><author><name sortKey="Junior, Jucier Goncalves" sort="Junior, Jucier Goncalves" uniqKey="Junior J" first="Jucier Gonçalves" last="Júnior">Jucier Gonçalves Júnior</name><affiliation><nlm:aff id="aff0006">Department of Internal Medicine, Santa casa de Misericórdia de Fortaleza, Fortaleza, Ceará, Brazil</nlm:aff></affiliation></author><author><name sortKey="Da Silva, Claudio Gleideston Lima" sort="Da Silva, Claudio Gleideston Lima" uniqKey="Da Silva C" first="Claúdio Gleideston Lima" last="Da Silva">Claúdio Gleideston Lima Da Silva</name><affiliation><nlm:aff id="aff0001">School of Medicine of Juazeiro do Norte (FMJ/Estácio) – Juazeiro do Norte, Ceará, Brazil</nlm:aff></affiliation><affiliation><nlm:aff id="aff0004">School of Medicine, Federal University of Cariri (UFCA) – Barbalha, Ceará, Brazil</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">32302817</idno><idno type="pmc">7152886</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7152886</idno><idno type="RBID">PMC:7152886</idno><idno type="doi">10.1016/j.psychres.2020.112972</idno><date when="2020">2020</date><idno type="wicri:Area/Pmc/Corpus">000513</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000513</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">When health professionals look death in the eye: the mental health of professionals who deal daily with the 2019 coronavirus outbreak</title><author><name sortKey="Neto, Modesto Leite Rolim" sort="Neto, Modesto Leite Rolim" uniqKey="Neto M" first="Modesto Leite Rolim" last="Neto">Modesto Leite Rolim Neto</name><affiliation><nlm:aff id="aff0001">School of Medicine of Juazeiro do Norte (FMJ/Estácio) – Juazeiro do Norte, Ceará, Brazil</nlm:aff></affiliation><affiliation><nlm:aff id="aff0004">School of Medicine, Federal University of Cariri (UFCA) – Barbalha, Ceará, Brazil</nlm:aff></affiliation></author><author><name sortKey="Almeida, Hiure Gomes" sort="Almeida, Hiure Gomes" uniqKey="Almeida H" first="Hiure Gomes" last="Almeida">Hiure Gomes Almeida</name><affiliation><nlm:aff id="aff0001">School of Medicine of Juazeiro do Norte (FMJ/Estácio) – Juazeiro do Norte, Ceará, Brazil</nlm:aff></affiliation></author><author><name sortKey="Esmeraldo, Joana D Arc" sort="Esmeraldo, Joana D Arc" uniqKey="Esmeraldo J" first="Joana D'Arc" last="Esmeraldo">Joana D'Arc Esmeraldo</name><affiliation><nlm:aff id="aff0001">School of Medicine of Juazeiro do Norte (FMJ/Estácio) – Juazeiro do Norte, Ceará, Brazil</nlm:aff></affiliation></author><author><name sortKey="Nobre, Camila Bezerra" sort="Nobre, Camila Bezerra" uniqKey="Nobre C" first="Camila Bezerra" last="Nobre">Camila Bezerra Nobre</name><affiliation><nlm:aff id="aff0001">School of Medicine of Juazeiro do Norte (FMJ/Estácio) – Juazeiro do Norte, Ceará, Brazil</nlm:aff></affiliation></author><author><name sortKey="Pinheiro, Woneska Rodrigues" sort="Pinheiro, Woneska Rodrigues" uniqKey="Pinheiro W" first="Woneska Rodrigues" last="Pinheiro">Woneska Rodrigues Pinheiro</name><affiliation><nlm:aff id="aff0002">Regional University of Cariri – URCA, Crato, Ceará, Brazil</nlm:aff></affiliation></author><author><name sortKey="De Oliveira, Cicera Rejane Tavares" sort="De Oliveira, Cicera Rejane Tavares" uniqKey="De Oliveira C" first="Cícera Rejane Tavares" last="De Oliveira">Cícera Rejane Tavares De Oliveira</name><affiliation><nlm:aff id="aff0002">Regional University of Cariri – URCA, Crato, Ceará, Brazil</nlm:aff></affiliation></author><author><name sortKey="Sousa, Itamara Da Costa" sort="Sousa, Itamara Da Costa" uniqKey="Sousa I" first="Itamara Da Costa" last="Sousa">Itamara Da Costa Sousa</name><affiliation><nlm:aff id="aff0002">Regional University of Cariri – URCA, Crato, Ceará, Brazil</nlm:aff></affiliation></author><author><name sortKey="Lima, Onelia Maria Moreira Leite" sort="Lima, Onelia Maria Moreira Leite" uniqKey="Lima O" first="Onélia Maria Moreira Leite" last="Lima">Onélia Maria Moreira Leite Lima</name><affiliation><nlm:aff id="aff0003">Postgraduate Program in Health Sciences, School of Medicine of ABC, Santo André, São Paulo, Brazil</nlm:aff></affiliation></author><author><name sortKey="Lima, Nadia Nara Rolim" sort="Lima, Nadia Nara Rolim" uniqKey="Lima N" first="Nádia Nara Rolim" last="Lima">Nádia Nara Rolim Lima</name><affiliation><nlm:aff id="aff0005">Suicidology Research Group, Universidade Federal do Ceará (UFC) – Fortaleza, Ceará, Brazil</nlm:aff></affiliation></author><author><name sortKey="Moreira, Marcial Moreno" sort="Moreira, Marcial Moreno" uniqKey="Moreira M" first="Marcial Moreno" last="Moreira">Marcial Moreno Moreira</name><affiliation><nlm:aff id="aff0001">School of Medicine of Juazeiro do Norte (FMJ/Estácio) – Juazeiro do Norte, Ceará, Brazil</nlm:aff></affiliation><affiliation><nlm:aff id="aff0004">School of Medicine, Federal University of Cariri (UFCA) – Barbalha, Ceará, Brazil</nlm:aff></affiliation><affiliation><nlm:aff id="aff0003">Postgraduate Program in Health Sciences, School of Medicine of ABC, Santo André, São Paulo, Brazil</nlm:aff></affiliation></author><author><name sortKey="Lima, Carlos Kennedy Tavares" sort="Lima, Carlos Kennedy Tavares" uniqKey="Lima C" first="Carlos Kennedy Tavares" last="Lima">Carlos Kennedy Tavares Lima</name><affiliation><nlm:aff id="aff0003">Postgraduate Program in Health Sciences, School of Medicine of ABC, Santo André, São Paulo, Brazil</nlm:aff></affiliation></author><author><name sortKey="Junior, Jucier Goncalves" sort="Junior, Jucier Goncalves" uniqKey="Junior J" first="Jucier Gonçalves" last="Júnior">Jucier Gonçalves Júnior</name><affiliation><nlm:aff id="aff0006">Department of Internal Medicine, Santa casa de Misericórdia de Fortaleza, Fortaleza, Ceará, Brazil</nlm:aff></affiliation></author><author><name sortKey="Da Silva, Claudio Gleideston Lima" sort="Da Silva, Claudio Gleideston Lima" uniqKey="Da Silva C" first="Claúdio Gleideston Lima" last="Da Silva">Claúdio Gleideston Lima Da Silva</name><affiliation><nlm:aff id="aff0001">School of Medicine of Juazeiro do Norte (FMJ/Estácio) – Juazeiro do Norte, Ceará, Brazil</nlm:aff></affiliation><affiliation><nlm:aff id="aff0004">School of Medicine, Federal University of Cariri (UFCA) – Barbalha, Ceará, Brazil</nlm:aff></affiliation></author></analytic><series><title level="j">Psychiatry Research</title><idno type="ISSN">0165-1781</idno><idno type="eISSN">1872-7123</idno><imprint><date when="2020">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Highlights</title><p><list list-type="simple" id="celist0001"><list-item id="celistitem0001"><label>•</label><p id="para0001">Nurses, doctors, healthcare workers, and other medical professionals who are testing for and treating patients with COVID-19 are at a higher risk of contracting it than the general public.</p></list-item><list-item id="celistitem0002"><label>•</label><p id="para0002">The combination of stress and possible exposure puts healthcare professionals, from physicians and nurses, to specialists, at greater risk of contracting COVID-19 and potentially spreading it to others.</p></list-item><list-item id="celistitem0003"><label>•</label><p id="para0003">Health professionals directly involved in the diagnosis, treatment, and care of patients with COVID-19 develop the insertion of psychic spaces for the installation of pain and psychological suffering and other mental health symptoms.</p></list-item><list-item id="celistitem0004"><label>•</label><p id="para0004">The foreseeable shortage of supplies and an increasing flow of suspected and real cases of COVID-19 contribute to the pressures and concerns of health professionals.</p></list-item></list></p></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Lai, J" uniqKey="Lai J">J. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Psychiatry Res</journal-id><journal-id journal-id-type="iso-abbrev">Psychiatry Res</journal-id><journal-title-group><journal-title>Psychiatry Research</journal-title></journal-title-group><issn pub-type="ppub">0165-1781</issn><issn pub-type="epub">1872-7123</issn><publisher><publisher-name>Elsevier B.V.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">32302817</article-id><article-id pub-id-type="pmc">7152886</article-id><article-id pub-id-type="publisher-id">S0165-1781(20)30669-7</article-id><article-id pub-id-type="doi">10.1016/j.psychres.2020.112972</article-id><article-id pub-id-type="publisher-id">112972</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>When health professionals look death in the eye: the mental health of professionals who deal daily with the 2019 coronavirus outbreak</article-title></title-group><contrib-group><contrib contrib-type="author" id="au0001"><name><surname>Neto</surname><given-names>Modesto Leite Rolim</given-names></name><email>modesto.neto@ufca.edu.br</email><xref rid="aff0001" ref-type="aff">a</xref><xref rid="aff0004" ref-type="aff">d</xref><xref rid="cor0001" ref-type="corresp">⁎</xref></contrib><contrib contrib-type="author" id="au0002"><name><surname>Almeida</surname><given-names>Hiure Gomes</given-names></name><xref rid="aff0001" ref-type="aff">a</xref></contrib><contrib contrib-type="author" id="au0003"><name><surname>Esmeraldo</surname><given-names>Joana D'arc</given-names></name><xref rid="aff0001" ref-type="aff">a</xref></contrib><contrib contrib-type="author" id="au0004"><name><surname>Nobre</surname><given-names>Camila Bezerra</given-names></name><xref rid="aff0001" ref-type="aff">a</xref></contrib><contrib contrib-type="author" id="au0005"><name><surname>Pinheiro</surname><given-names>Woneska Rodrigues</given-names></name><xref rid="aff0002" ref-type="aff">b</xref></contrib><contrib contrib-type="author" id="au0006"><name><surname>de Oliveira</surname><given-names>Cícera Rejane Tavares</given-names></name><xref rid="aff0002" ref-type="aff">b</xref></contrib><contrib contrib-type="author" id="au0007"><name><surname>Sousa</surname><given-names>Itamara da Costa</given-names></name><xref rid="aff0002" ref-type="aff">b</xref></contrib><contrib contrib-type="author" id="au0008"><name><surname>Lima</surname><given-names>Onélia Maria Moreira Leite</given-names></name><xref rid="aff0003" ref-type="aff">c</xref></contrib><contrib contrib-type="author" id="au0009"><name><surname>Lima</surname><given-names>Nádia Nara Rolim</given-names></name><xref rid="aff0005" ref-type="aff">e</xref></contrib><contrib contrib-type="author" id="au0010"><name><surname>Moreira</surname><given-names>Marcial Moreno</given-names></name><xref rid="aff0001" ref-type="aff">a</xref><xref rid="aff0004" ref-type="aff">d</xref><xref rid="aff0003" ref-type="aff">c</xref></contrib><contrib contrib-type="author" id="au0011"><name><surname>Lima</surname><given-names>Carlos Kennedy Tavares</given-names></name><xref rid="aff0003" ref-type="aff">c</xref></contrib><contrib contrib-type="author" id="au0012"><name><surname>Júnior</surname><given-names>Jucier Gonçalves</given-names></name><xref rid="aff0006" ref-type="aff">f</xref></contrib><contrib contrib-type="author" id="au0013"><name><surname>da Silva</surname><given-names>Claúdio Gleideston Lima</given-names></name><xref rid="aff0001" ref-type="aff">a</xref><xref rid="aff0004" ref-type="aff">d</xref></contrib></contrib-group><aff id="aff0001"><label>a</label>School of Medicine of Juazeiro do Norte (FMJ/Estácio) – Juazeiro do Norte, Ceará, Brazil</aff><aff id="aff0002"><label>b</label>Regional University of Cariri – URCA, Crato, Ceará, Brazil</aff><aff id="aff0003"><label>c</label>Postgraduate Program in Health Sciences, School of Medicine of ABC, Santo André, São Paulo, Brazil</aff><aff id="aff0004"><label>d</label>School of Medicine, Federal University of Cariri (UFCA) – Barbalha, Ceará, Brazil</aff><aff id="aff0005"><label>e</label>Suicidology Research Group, Universidade Federal do Ceará (UFC) – Fortaleza, Ceará, Brazil</aff><aff id="aff0006"><label>f</label>Department of Internal Medicine, Santa casa de Misericórdia de Fortaleza, Fortaleza, Ceará, Brazil</aff><author-notes><corresp id="cor0001"><label>⁎</label>Correspondence author: School of Medicine, Federal University of Cariri, UFCA, Barbalha, Ceará, Brazil <email>modesto.neto@ufca.edu.br</email></corresp></author-notes><pub-date pub-type="pmc-release"><day>13</day><month>4</month><year>2020</year></pub-date><pmc-comment> PMC Release delay is 0 months and 0 days and was based on .</pmc-comment>
<pub-date pub-type="epub"><day>13</day><month>4</month><year>2020</year></pub-date><elocation-id>112972</elocation-id><permissions><copyright-statement>© 2020 Elsevier B.V. All rights reserved.</copyright-statement><copyright-year>2020</copyright-year><copyright-holder></copyright-holder><license><license-p>Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.</license-p></license></permissions><abstract abstract-type="author-highlights" id="abs0001"><title>Highlights</title><p><list list-type="simple" id="celist0001"><list-item id="celistitem0001"><label>•</label><p id="para0001">Nurses, doctors, healthcare workers, and other medical professionals who are testing for and treating patients with COVID-19 are at a higher risk of contracting it than the general public.</p></list-item><list-item id="celistitem0002"><label>•</label><p id="para0002">The combination of stress and possible exposure puts healthcare professionals, from physicians and nurses, to specialists, at greater risk of contracting COVID-19 and potentially spreading it to others.</p></list-item><list-item id="celistitem0003"><label>•</label><p id="para0003">Health professionals directly involved in the diagnosis, treatment, and care of patients with COVID-19 develop the insertion of psychic spaces for the installation of pain and psychological suffering and other mental health symptoms.</p></list-item><list-item id="celistitem0004"><label>•</label><p id="para0004">The foreseeable shortage of supplies and an increasing flow of suspected and real cases of COVID-19 contribute to the pressures and concerns of health professionals.</p></list-item></list></p></abstract><abstract id="abs0002"><sec><title>Background</title><p>: The fact that COVID-19 is transmissible from human to human and associated with high morbidity and potentially fatality can intensify the perception of personal danger. In addition, the foreseeable shortage of supplies and an increasing flow of suspected and real cases of COVID-19 contribute to the pressures and concerns of health professionals.</p></sec><sec><title>Method</title><p>: The studies were identified in well-known international journals found in two electronic databases: Scopus and Embase. The data were cross-checked with information from the main international newspapers.</p></sec><sec><title>Results</title><p>: Work-related stress is a potential cause of concern for health professionals. It has been associated with anxiety including multiple clinical activities, depression in the face of the coexistence of countless deaths, long work shifts with the most diverse unknowns and demands in the treatment with patients with COVID-19. Therefore, it is an important indicator of psychic exhaustion.</p></sec><sec><title>Conclusions</title><p>: As coronavirus cases increase and deaths surge in Italy, new figures show an "enormous" level of contagion among the country's medical personnel. At least 2,629 health workers have been infected with coronavirus since the outbreak onset in February, representing 8.3% of total cases. The percentage of infected health workers has almost doubled the number registered in China throughout the epidemic. Intensive care unit physicians are on their stress limit, especially when dealing with older patients and with death prospects. Doctors, not a relative, are inevitably the last people a dying COVID-19 patient will see.</p></sec></abstract><kwd-group id="keys0001"><title>Keywords</title><kwd>Health professionals</kwd><kwd>COVID-19</kwd><kwd>Psychic exhaustion</kwd></kwd-group></article-meta></front><body><p id="para0009">The novel coronavirus (COVID-19) outbreak continues to evolve, with more cases and quarantines popping up on news feeds everywhere. The closer it gets to their homes, the more people become worried. But what about people on the front lines? Nurses, doctors, healthcare workers, and other medical professionals who are testing for and treating patients with COVID-19 are at a higher risk of contracting it than the general public. What can they do to take care of themselves, physically and emotionally? (Magellan Health <xref rid="bib0001" ref-type="bibr">Insights, 2020</xref>). As if exposure to the COVID-19 during the global pandemic was not enough, healthcare workers face another risk: burnout due to overstress in an increasingly burdened healthcare system. The combination of stress and possible exposure puts healthcare professionals, from physicians and nurses to specialists, at greater risk of contracting COVID-19 and potentially spreading it to others (Health Care <xref rid="bib0002" ref-type="bibr">Finance, 2020</xref>).</p><p id="para0010">Given this critical situation, health professionals directly involved in the diagnosis, treatment, and care of patients with COVID-19 develop the insertion of psychic spaces for the installation of pain and psychological suffering and other mental health symptoms. The growing number of confirmed and suspected cases, overwhelming workload, depletion of personal protective equipment, extensive media coverage, lack of specific medications and inadequate support feelings can contribute to the mental burden of these health professionals (<xref rid="bib0003" ref-type="bibr">State Council of China, 2020</xref>, <xref rid="bib0004" ref-type="bibr">Lai et al., 2020</xref>, <xref rid="bib0005" ref-type="bibr">Lee et al., 2007</xref>).</p><p id="para0011">Work-related stress is a potential cause of concern for health professionals. It has been associated with anxiety including multiple clinical activities, depression in the face of the coexistence of countless deaths, long work shifts with the most diverse unknowns and demands in the treatment with patients with COVID-19. Therefore, it is an important indicator of psychic exhaustion (<xref rid="bib0006" ref-type="bibr">Adams and Walls, 2020</xref>; <xref rid="bib0007" ref-type="bibr">Kushal et al., 2018</xref>). It is the classic rock-and-a-hard-place scenario – healthcare workers and caregivers are desperately needed during the global response to the outbreak, but they represent one of the most vulnerable populations in terms of contracting the highly virulent disease (<xref rid="bib0006" ref-type="bibr">Admas and Walls, 2020</xref>).</p><p id="para0012">The difficulty in assessing the extent to which health professionals have been affected emotionally is difficult because the Centers for Disease Control and Prevention (CDC), medical associations or unions of health professionals have not released worldwide data yet (<xref rid="bib0008" ref-type="bibr">Washington Post, 2020</xref>). Dozens of health care professionals on the front lines of the coronavirus pandemic have become ill with the coronavirus and more have been in quarantine after being exposed to it (<xref rid="bib0009" ref-type="bibr">Changing America, 2020</xref>).</p><p id="para0013">The fact that COVID-19 is transmissible from human to human (<xref rid="bib0010" ref-type="bibr">Li et al., 2020</xref>, <xref rid="bib0011" ref-type="bibr">Rothe et al., 2020</xref>) and associated with high morbidity and potentially fatality can intensify the perception of personal danger (<xref rid="bib0012" ref-type="bibr">Wang, Tang and Wie, 2020</xref>). In addition, the foreseeable shortage of supplies and increasing flow of suspected and real cases of COVID-19 contribute to the pressures and concerns of health professionals (<xref rid="bib0004" ref-type="bibr">Lai et al., 2020</xref>, <xref rid="bib0006" ref-type="bibr">Adams and Walls, 2020</xref>, <xref rid="bib0007" ref-type="bibr">Kushal et al., 2018</xref>, <xref rid="bib0013" ref-type="bibr">Chan-Yeung, 2004</xref>). Coronavirus generates a lot of uncertainty, and this has resonance with health professionals who suffer or have suffered from anxiety and obsessive-compulsive disorder (OCD) in the treatment of patients in hospitals. Panic attacks can also be a response to the stress load linked to the coronavirus outbreak demands (The <xref rid="bib0014" ref-type="bibr">Guardian, 2020</xref>, <xref rid="bib0004" ref-type="bibr">Lai et al., 2020</xref>, <xref rid="bib0006" ref-type="bibr">Adams and Walls, 2020</xref>, <xref rid="bib0005" ref-type="bibr">Lee et al., 2007</xref>).</p><p id="para0014">As coronavirus cases increase and deaths surge in Italy, new figures show an "enormous" level of contagion among the country's medical personnel. At least 2,629 health workers have been infected with coronavirus since the outbreak onset in February, representing 8.3% of total cases. The percentage of infected health workers has almost doubled the number registered in China throughout the epidemic (<xref rid="bib0015" ref-type="bibr">Aljazeera, 2020</xref>). Intensive care unit physicians are on their stress limit, especially when dealing with older patients and with death prospects. Doctors, not a relative, are inevitably the last people a dying COVID-19 patient will see (<xref rid="bib0017" ref-type="bibr">Lima et al., 2020</xref>, <xref rid="bib0018" ref-type="bibr">Carvalho et al., 2020</xref>, <xref rid="bib0019" ref-type="bibr">Moreira et al., 2020</xref>, <xref rid="bib0016" ref-type="bibr">Reteurs, 2020</xref>).</p><p id="para0015">Despite the common mental health problems and disorders found among health professionals in such settings, most of those working in isolation units and hospitals are not trained to provide mental health care. Evidence highlights some timely mental health care that needs to be developed urgently, such as: use of psychotropic drugs, prescribed by psychiatrists for severe psychiatric comorbidities; specialized psychiatric treatments and appropriate mental health services and facilities for patients with comorbid mental disorders; psychic treatment plans, psychiatric illness progress reports, and health status updates for professionals in the Intensive Care Unit; regular updates to address their sense of uncertainty and fear; psychological counseling using electronic devices and applications (such as smartphones and WeChat); provision of emotional and behavioral responses to extraordinary stress, and psychotherapy techniques such as those based on the stress adaptation model (<xref rid="bib0020" ref-type="bibr">Xiang et al., 2020</xref>, <xref rid="bib0021" ref-type="bibr">Maunder et al., 2003</xref>, <xref rid="bib0022" ref-type="bibr">Folkman and Greer, 2000</xref>).</p><sec id="sec0001"><title>Authors’ contributions</title><p id="para0016">MLRN, MMM, CKTL, CGLS, JGJ and NNRL designed the review, developed the inclusion criteria, screened titles and abstracts, appraised the quality of included papers, and drafted the manuscript.</p><p id="para0017">HGA, JDE, CBN, CRTO and WRP reviewed the study protocol and inclusion criteria and provided substantial input to the manuscript.</p><p id="para0018">MLRN, NNRL, ICS and OMMLL reviewed the study protocol. MMM read and screened articles for inclusion. All authors critically reviewed drafts and approved the final manuscript.</p></sec><sec id="sec0002"><title>Funding</title><p id="para0019">The Suicidology Research Group from Universidade Federal do Ceará (UFC) and Brazilian National Council for Scientific and Technological Development (CNPq) – institution linked to the Brazilian Department of Science, Technology and Innovation to encourage research in Brazil.</p></sec><sec sec-type="COI-statement"><title>Declaration of competing interest</title><p id="para0020">The authors declare that they have no competing interests.</p></sec></body><back><ref-list id="cebibl1"><title>References</title><ref id="bib0001"><mixed-citation publication-type="other" id="othref0001">Magellan Health Insights, 2020. 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