In order to give a concise description of the development of the epidemic from January 15 to February 10, 2020 we presented the growth of cases in Figure 1(the data were available at: http://www.nhc.gov.cn/xcs/yqfkdt/gzbd_index.shtml;http://wsjkw.sh.gov.cn/yqtb/index.html). It showed the development trend of the COVID-19 epidemic in China between the end of January and the beginning of February 2020. During the survey period(February 8-February 10), 702 questionnaires were sent out, 694 (98.9%) were received and qualified. Six hundreds and fifty-six female(94.5%) participated in the questionnaire, and the highest proportion of people was 18-40 years(73%). The proportion of nurse and physician was the highest, accounting for 45.1% and 22.3%, respectively. The proportion of first-line personnel was 19.5%, second-line personnel was 7.2%, and third-line was 73.5%. The median score of PHQ-9 among all the staff was 1 (IQR,0-4), the median PDSS score was 2 (IQR,0-5). For the score of PHQ-9 among female staff was higher than that of male(p=0.03); the score of nurse was much higher than that of physician(p<0.0001) and staff with degree of undergraduate have much more score of PHQ-9 than that of postgraduate degree(p=0.03). For the score of PDSS, nurse was still much higher than that of physician(p<0.0001). Among the different work lines, the first-line scored the highest: PHQ-9 score was 4 (0-8); PDSS score was 4 (1-9), which were significantly higher than the second-line and third-line staff (P < 0.001). See more details in Table 1.
Table 1. The demographic characteristics of people included in this analysis(n=694)
Demographic characteristics
|
Number(Percent)
|
PQH-9 (M, Q1-Q3)
|
P value
|
PDSS (M, Q1-Q3)
|
P value
|
Gender
|
|
|
0.031
|
|
0.308
|
Male
|
38(5.5%)
|
0(0-2)
|
|
2(0-5)
|
|
Female
|
656(94.5%)
|
1(0-4)
|
|
2(0-5)
|
|
Age
|
|
|
0.026
|
|
0.063
|
18-30 years
|
253(36.5%)
|
1(0-4)
|
|
2(0-5)
|
|
31-40 years
|
253(36.5%)
|
1(0-4)
|
|
2(0-5)
|
|
41-50 years
|
150(21.6%)
|
0(0-3)
|
|
2(0-5)
|
|
≥51 years
|
38(5.5%)
|
0(0-1.25)
|
|
1(0-3)
|
|
Working years
|
|
|
0.005
|
|
0.015
|
0-5 years
|
185(26.7%)
|
1(0-3)
|
|
2(0-4)
|
|
6-10 years
|
170(24.5%)
|
1(0-5.25)
|
|
3(1-6)
|
|
11-15 years
|
122(17.6%)
|
1(0-4)
|
|
2(0-5)
|
|
>15 years
|
217(31.3%)
|
0(0-3)
|
|
2(0-5)
|
|
Occupations
|
|
|
<0.0001
|
|
<0.0001
|
Physician
|
155(22.3%)
|
0(0-3)
|
|
2(0-5)
|
|
Nurse
|
313(45.1%)
|
2(0-6)
|
|
3(1-6)
|
|
Technician and researcher
|
101(14.6%)
|
0(0-2)
|
|
2(0-4)
|
|
Administrator
|
70(10.1%)
|
0(0-2)
|
|
1.5(0-4)
|
|
Logistic and Supporter &
|
55(7.9%)
|
0(0-1)
|
|
0(0-4)
|
|
Technical title
|
|
|
0.004
|
|
0.006
|
Junior
|
454(65.4%)
|
1(0-4)
|
|
2.5(0-5)
|
|
Intermediate
|
170(24.5%)
|
0(0-3)
|
|
2(0-4)
|
|
Senior
|
70(10.1%)
|
0(0-2)
|
|
1(0-4.25)
|
|
Educational level
|
|
|
0.029
|
|
0.063
|
≤undergraduate
|
548(79.0%)
|
1(0-4)
|
|
2(0-5)
|
|
≥postgraduate
|
146(21.0%)
|
0(0-2)
|
|
2(0-4)
|
|
Work lines
|
|
|
<0.0001
|
|
<0.0001
|
First line
|
135(19.5%)
|
4(0-8)
|
|
4(1-9)
|
|
Second line
|
49(7.2%)
|
1(0-3)
|
|
2(1-5)
|
|
Third line
|
510(73.5%)
|
0(0-3)
|
|
2(0-4)
|
|
&, means logistics personnel, equipment and technical support personnel.
The status of depression and panic disorder among different groups of participants
There were 143 (20.6%) of them had depression, 39 (5.6%) of them had severe depression status; 81 (11.7%) of them had panic disorder, 47 (6.7%) of people had severe panic disorder. The depression rate was 18%(27/155) in physician while it was 32%(100/313) in nurse. The panic disorder rate for physician was 6%(9/155) and 19%(59/313) for nurse. For the severity degree of depression status among different occupations, nurse was much severe than that of physician(p<0.0001). For the severity of panic disorder, nurse still had much severe degree than that of physician(p=0.0004). Among the different work lines, the first-line staff had the highest degree of depression and panic disorder than that of the non first-line (P<0.001). See more in Table 2.
Table 2. The distribution of PHQ-9 and PDSS scores among participants with different characters
Variables
|
Number
|
PQH-9
|
P
value
|
PDSS
|
P
value
|
D0
N (%)
|
D1
N (%)
|
D2
N (%)
|
D3
N (%)
|
P0
N (%)
|
P1
N (%)
|
P2
N (%)
|
P3
N (%)
|
P4
N (%)
|
Gender
|
|
|
|
|
|
0.204
|
|
|
|
|
|
0.472
|
Male
|
38
|
34(89)
|
2(5)
|
0(0)
|
2(5)
|
|
27(71)
|
10(26)
|
0(0)
|
1(3)
|
0(0)
|
|
Female
|
656
|
517(79)
|
102(16)
|
17(3)
|
20(3)
|
|
409(62)
|
167(25)
|
34(5)
|
36(5)
|
10(2)
|
|
Age
|
|
|
|
|
|
0.278
|
|
|
|
|
|
0.601
|
18-30 years
|
253
|
194(77)
|
42(17)
|
8(3)
|
9(4)
|
|
154(61)
|
65(26)
|
14(6)
|
15(6)
|
5(2)
|
|
31-40 years
|
253
|
203(80)
|
32(13)
|
8(3)
|
10(4)
|
|
155(61)
|
69(27)
|
12(5)
|
13(5)
|
4(2)
|
|
41-50 years
|
150
|
119(79)
|
27(18)
|
1(1)
|
3(2)
|
|
95(63)
|
38(25)
|
8(5)
|
8(5)
|
1(1)
|
|
≥51 years
|
38
|
35(92)
|
3(8)
|
0(0)
|
0(0)
|
|
32(84)
|
5(13)
|
0(0)
|
1(3)
|
0(0)
|
|
Working years
|
|
|
|
|
|
0.055
|
|
|
|
|
|
0.139
|
0-5 years
|
185
|
158(85)
|
19(10)
|
3(2)
|
5(3)
|
|
121(65)
|
47(25)
|
5(3)
|
11(6)
|
1(1)
|
|
6-10 years
|
170
|
120(71)
|
36(21)
|
6(4)
|
8(5)
|
|
96(56)
|
47(28)
|
15(9)
|
7(4)
|
5(3)
|
|
11-15 years
|
122
|
96(79)
|
16(13)
|
5(4)
|
5(4)
|
|
75(61)
|
32(26)
|
4(3)
|
8(7)
|
3(2)
|
|
>15 years
|
217
|
177(82)
|
33(15)
|
3(1)
|
4(2)
|
|
144(66)
|
51(24)
|
10(5)
|
11(5)
|
1(0)
|
|
Educational level
|
|
|
|
|
|
0.056
|
|
|
|
|
|
0.219
|
≤undergraduate
|
548
|
424(77)
|
88(16)
|
16(3)
|
20(4)
|
|
336(61)
|
141(26)
|
29(5)
|
32(6)
|
10(2)
|
|
≥postgraduate
|
146
|
127(87)
|
16(11)
|
1(1)
|
2(1)
|
|
100(68)
|
36(25)
|
5(3)
|
5(3)
|
0(0)
|
|
Occupations
|
|
|
|
|
|
<0.0001
|
|
|
|
|
|
0.0004
|
Physician
|
155
|
128(83)
|
22(14)
|
1(1)
|
4(3)
|
|
103(66)
|
43(28)
|
3(2)
|
5(3)
|
1(1)
|
|
Nurse
|
313
|
213(68)
|
68(22)
|
14(4)
|
18(6)
|
|
169(54)
|
85(27)
|
22(7)
|
29(9)
|
8(3)
|
|
Technician and researcher
|
101
|
94(93)
|
7(7)
|
0(0)
|
0(0)
|
|
75(74)
|
23(23)
|
3(3)
|
0(0)
|
0(0)
|
|
Administrator
|
70
|
62(89)
|
6(9)
|
2(3)
|
0(0)
|
|
50(71)
|
12(17)
|
5(7)
|
2(3)
|
1(1)
|
|
Supporters*
|
55
|
54(98)
|
1(2)
|
0(0)
|
0(0)
|
|
39(71)
|
14(25)
|
1(2)
|
1(2)
|
0(0)
|
|
Technical title
|
|
|
|
|
|
0.027
|
|
|
|
|
|
0.163
|
Junior
|
454
|
347(76)
|
73(16)
|
14(3)
|
20(4)
|
|
270(59)
|
123(27)
|
23(5)
|
29(6)
|
9(2)
|
|
Intermediate
|
170
|
142(84)
|
25(15)
|
3(2)
|
0(0)
|
|
117(69)
|
36(21)
|
8(5)
|
8(5)
|
1(1)
|
|
Senior
|
70
|
62(89)
|
6(9)
|
0(0)
|
2(3)
|
|
49(70)
|
18(26)
|
3(4)
|
0(0)
|
0(0)
|
|
Work lines
|
|
|
|
|
|
<0.0001
|
|
|
|
|
|
<0.0001
|
First line
|
135
|
78(58)
|
30(22)
|
11(8)
|
16(12)
|
|
62(46)
|
35(26)
|
14(10)
|
16(12)
|
8(6)
|
|
Second line
|
49
|
40(82)
|
7(14)
|
1(2)
|
1(2)
|
|
32(65)
|
13(27)
|
2(4)
|
2(4)
|
0(0)
|
|
Third line
|
510
|
433(85)
|
67(13)
|
5(1)
|
5(1)
|
|
342(67)
|
129(25)
|
18(4)
|
19(4)
|
2(0)
|
|
PHQ-9: D0, normal; D1 for mild depression; D2 for moderate depression; D3 for severe depression. PDSS: P0, normal; P1, borderline; P2, slightly panic; P3, moderately panic; P4, markedly panic.
* Supporters, means logistics personnel, equipment and technical support personnel.
Risk factors for the staff with severe depression and panic disorder in designated hospital
By binary logistic regression test, univariate analysis showed that compared with staff with undergraduate, postgraduate staff had a lower risk of serious depression; participants with intermediate technical title had a lower risk than junior title; compared with physicians, nurses had a higher risk; the first-line workers had much more risk of severe depression than the third-line. After multivariate analysis, only found that the first-line workers had much more risk for severe depression than the third-line workers(P<0.001). Other variables have no statistical significance, see Table 3. For the first-line staff, the risk of severe depression was 6.6 times[(95%CI 3.1-14.3), P<0.001] higher than the non first-line(the combination of second line and third line).
Table 3. The risk factors for severe case of depression (PHQ-9 score≥10)
Variables
|
Category
|
Severe cases
|
Total cases (%)
|
P value*
|
AOR(95%CI)
|
P value
|
Age
|
18-30 years
|
17
|
253(7%)
|
NA
|
|
|
31-40 years
|
18
|
253(7%)
|
0.861
|
|
|
41-50 years
|
4
|
150(3%)
|
0.087
|
|
|
≥51 years
|
0
|
38(0%)
|
0.998
|
|
|
Gender
|
Male
|
2
|
38(5%)
|
NA
|
|
|
Female
|
37
|
656(6%)
|
0.922
|
|
|
Working years
|
0-5 years
|
8
|
185(4%)
|
NA
|
|
|
6-10 years
|
14
|
170(8%)
|
0.133
|
|
|
11-15 years
|
10
|
122(8%)
|
0.164
|
|
|
>15 years
|
7
|
217(3%)
|
0.564
|
|
|
Educational level
|
≤undergraduate
|
36
|
548(7%)
|
NA
|
1
|
NA
|
≥postgraduate
|
3
|
146(2%)
|
0.047
|
0.59(0.12--2.99)
|
0.524
|
Technical title
|
Junior
|
34
|
454(7%)
|
NA
|
1
|
NA
|
Intermediate
|
3
|
170(2%)
|
0.013
|
0.32(0.08--1.25)
|
0.102
|
Senior
|
2
|
70(3%)
|
0.171
|
0.56(0.09--3.50)
|
0.537
|
Occupations
|
Physician
|
5
|
155(3%)
|
NA
|
1
|
NA
|
Nurse
|
32
|
313(10%)
|
0.012
|
0.94(0.20--4.38)
|
0.937
|
Technician and researcher
|
0
|
101(0%)
|
0.996
|
0.00(0.00--∞)
|
0.996
|
Administrator
|
2
|
70(3%)
|
0.883
|
0.85(0.12--6.06)
|
0.867
|
Logistics and supporter
|
0
|
55(0%)
|
0.997
|
0.00(0.00--∞)
|
0.997
|
Work lines
|
First line
|
27
|
135(20%)
|
NA
|
1
|
NA
|
Second line
|
2
|
49(4%)
|
0.019
|
0.27(0.06--1.25)
|
0.093
|
Third line
|
10
|
510(2%)
|
0.000
|
0.12(0.06--0.27)
|
0.000
|
*, refers to the P value for each category vs the reference. AOR, Adjusted odds ratio; CI, confidence interval.
By univariate logistic regression test, the risk for severe panic disorder in nurse was much higher than that in physician, and second-line workers was significantly lower than that in first-line. After multivariate analysis, the risk for severe panic disorder in the first-line staff was significantly higher than that in the third line(P=0.001). Other variables had no statistical significance, see Table 4. For the first-line personnel, the risk of serious panic is 2.6 fold[(95%CI 1.4-4.9), P=0.003] higher than that of the non first-line(the combination of the second line and third line).
Table 4. The risk factors for severe case of panic disorder (PDSS score≥11)
Variables
|
Category
|
Severe cases
|
Total cases (%)
|
P value*
|
AOR(95%CI)
|
P value
|
Age
|
18-30 years
|
20
|
253 (8%)
|
NA
|
|
|
|
31-40 years
|
17
|
253 (7%)
|
0.609
|
|
|
|
41-50 years
|
9
|
150 (6%)
|
0.476
|
|
|
|
≥51 years
|
1
|
38 (3%)
|
0.266
|
|
|
Gender
|
Male
|
1
|
38 (3%)
|
NA
|
|
|
|
Female
|
46
|
656 (7%)
|
0.317
|
|
|
Working years
|
0-5 years
|
12
|
185 (6%)
|
NA
|
|
|
|
6-10 years
|
12
|
170 (7%)
|
0.830
|
|
|
|
11-15 years
|
11
|
122 (9%)
|
0.412
|
|
|
|
>15 years
|
12
|
217 (6%)
|
0.687
|
|
|
Educational level
|
≤undergraduate
|
42
|
548 (8%)
|
NA
|
1
|
NA
|
|
≥postgraduate
|
5
|
146 (3%)
|
0.078
|
1.23(0.33--4.49)
|
0.759
|
Technical title
|
Junior
|
38
|
454 (8%)
|
NA
|
|
|
|
Intermediate
|
9
|
170 (5%)
|
0.199
|
|
|
|
Senior
|
0
|
70 (0%)
|
0.997
|
|
|
Occupations
|
Physician
|
6
|
155 (4%)
|
NA
|
1
|
NA
|
|
Nurses
|
37
|
313 (12%)
|
0.008
|
2.96(0.89--9.87)
|
0.077
|
|
Technician and researchers
|
0
|
101 (0%)
|
0.996
|
0.00(0.00--∞)
|
0.996
|
|
Administrators
|
3
|
70 (4%)
|
0.883
|
1.52(0.32--7.32)
|
0.600
|
|
Logistics and supporters
|
1
|
55 (2%)
|
0.477
|
0.68(0.07--6.71)
|
0.740
|
Work lines
|
First line
|
24
|
135 (18%)
|
NA
|
1
|
NA
|
|
Second line
|
2
|
49 (4%)
|
0.032
|
0.34(0.08--1.53)
|
0.160
|
|
Third line
|
21
|
510 (4%)
|
0.000
|
0.32(0.17--0.63)
|
0.001
|
*, refers to the P value for each category vs the reference. AOR, Adjusted odds ratio; CI, confidence interval.