@article{3d0094844bd440ec9a1320a81b190b34,
title = "Factors associated with longitudinal psychological and physiological stress in health care workers during the covid-19 pandemic: Observational study using apple watch data",
abstract = "Background: The COVID-19 pandemic has resulted in a high degree of psychological distress among health care workers (HCWs). There is a need to characterize which HCWs are at an increased risk of developing psychological effects from the pandemic. Given the differences in the response of individuals to stress, an analysis of both the perceived and physiological consequences of stressors can provide a comprehensive evaluation of its impact. Objective: This study aimed to determine characteristics associated with longitudinal perceived stress in HCWs and to assess whether changes in heart rate variability (HRV), a marker of autonomic nervous system function, are associated with features protective against longitudinal stress. Methods: HCWs across 7 hospitals in New York City, NY, 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 to measure 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: A total of 361 participants (mean age 36.8, SD 10.1 years; female: n=246, 69.3%) were enrolled. Multivariate analysis found New York City's COVID-19 case count to be associated with increased longitudinal stress (P=.008). Baseline emotional support, quality of life, and resilience were associated with decreased longitudinal stress (P<.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=.03) and resilience (P=.006). Participants in the highest tertial of baseline emotional support and resilience had a significantly different circadian pattern of longitudinally collected HRV compared to subjects in the low or medium tertial. 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.",
keywords = "App, Covid-19, Emotion, Health care worker, Heart rate, Heart rate variability, Mental health, Nervous system, Observational, Physiology, Psychological, Psychology, Quality of life, Resilience, Stress, Support, Wearable device",
author = "Hirten, {Robert P.} and Matteo Danieletto and Lewis Tomalin and Choi, {Katie Hyewon} and Micol Zweig and Eddye Golden and Sparshdeep Kaur and Drew Helmus and Anthony Biello and Renata Pyzik and Claudia Calcagno and Robert Freeman and Sands, {Bruce E.} and Dennis Charney and Bottinger, {Erwin P.} and Murrough, {James W.} and Laurie Keefer and Mayte Suarez-Farinas and Nadkarni, {Girish N.} and Fayad, {Zahi A.}",
note = "Funding Information: RPH declares consulting fees from HealthMode, Inc, Janssen Pharmaceuticals, and Takeda Pharmaceuticals; research support from Intralytix Inc; a Crohn{\textquoteright}s and Colitis Foundation Career Development Award (grant number 607934); and research support from a National Institutes of Health K23 Career Development Award (grant number 1K23DK129835-01). DC is a coinventor on patents filed by the Icahn School of Medicine at Mount Sinai (ISMMS), relating to the treatment for treatment-resistant depression, suicidal ideation, and other disorders. ISMMS has entered into a licensing agreement with Janssen Pharmaceuticals, Inc, and it has and will receive payments from Janssen under the license agreement related to these patents for the treatment of treatment-resistant depression and suicidal ideation. Consistent with the ISMMS Faculty Handbook (the medical school policy), DC is entitled to a portion of the payments received by the ISMMS. Since SPRAVATO has received regulatory approval for treatment-resistant depression, the ISMMS and thus, through the ISMMS, DC, will be entitled to additional payments, beyond those already received, under the license agreement. DC is a named coinventor on several patents filed by the ISMMS for a cognitive training intervention to treat depression and related psychiatric disorders. The ISMMS has entered into a licensing agreement with Click Therapeutics, Inc, and has and will receive payments related to the use of this cognitive training intervention for the treatment of psychiatric disorders. In accordance with the ISMMS Faculty Handbook, DC has received a portion of these payments and is entitled to a portion of any additional payments that the medical school might receive from this license with Click Therapeutics. DC is a named coinventor on a patent application filed by the ISMMS for the use of intranasally administered Neuropeptide Y for the treatment of mood and anxiety disorders. This intellectual property has not been licensed. DC is a named coinventor on a patent application in the United States and several issued patents outside the United States filed by the ISMMS related to the use of ketamine for the treatment of posttraumatic stress disorder. This intellectual property has not been licensed. EPB reports consultancy agreements with Deloitte and Roland Berger; ownership interest in Digital Medicine E B{\"o}ttinger GmbH, EBCW GmbH, and Ontomics, Inc; receives honoraria from Bayer, Bosch Health Campus, Sanofi, and Siemens; and serves as a scientific advisor/member of Bosch Health Campus and Seer Biosciences Inc. LK declares research funding from Abbvie and Pfizer, consulting for Abbvie and Pfizer, and equity ownership/stock options in MetaMe Health and Trellus Health. GNN reports employment with, consultancy agreements with, and ownership interest in Pensieve Health and Renalytix AI; receives consulting fees from AstraZeneca, BioVie, GLG Consulting, and Reata; and serves as a scientific advisor/member of Pensieve Health and Renalytix AI. ZAF discloses consulting fees from Alexion, GlaxoSmithKline, and Trained Therapeutix Discovery; and research funding from Daiichi Sankyo, Amgen, Bristol Myers Squibb, and Siemens Healthineers. ZAF receives financial compensation as a board member and advisor to Trained Therapeutix Discovery and owns equity in Trained Therapeutix Discovery as a cofounder. In the past 5 years, JWM has provided consultation services and/or served on advisory boards for Allergan, Boehreinger Ingelheim, Clexio Biosciences, Fortress Biotech, FSV7, Global Medical Education, Otsuka, Sage Therapeutics, and Engrail Therapeutics. JWM is named on a patent pending for Neuropeptide Y as a treatment for mood and anxiety disorders and on a patent pending for the use of KCNQ channel openers to treat depression and related conditions. The remaining authors have no competing interests to declare. Publisher Copyright: {\textcopyright} 2021 Journal of Medical Internet Research. All rights reserved.",
year = "2021",
month = sep,
doi = "10.2196/31295",
language = "English",
volume = "23",
journal = "Journal of Medical Internet Research",
issn = "1439-4456",
publisher = "JMIR Publications Inc.",
number = "9",
}