Table 1.
Characteristics of 30 studies included in systematic review.
| References | Month of data collectionI | Country income levelII | Study type | Frontline yes/no/mixed exposureIII | Study participantsIV | AgeV | Sample size | Diagnostic tool (item used for meta-analysis) |
|---|---|---|---|---|---|---|---|---|
| Abdelghani et al. (38) | Later months | Egypt, LMIC | Cross-sectional | Yes | Nurses and/or physicians | 34.6 (6.04) | 320 | Maslach Burnout Inventory-Human Services Survey for Medical Personnel [MBI-HSS (MP)] high level for emotional exhaustion and depersonalization and low levels for personal accomplishment)a |
| Abdelhafiz et al. (39) | Later months | Egypt, LMIC | Cross-sectional | Mixed exposure | Nurses and/or physicians | 33.42 (5.28) | 220 | Maslach Burnout Inventory-Human Services Survey (MBI-HSS) (moderate and high for emotional exhaustion and depersonalization were combined and low of personal accomplishment)a |
| Azoulay et al. (40) | Later months | 85 countries, mixed | Cross-sectional | Yes | Nurses and/or physicians | 45 (39–53) | 848 | Maslach Burnout Inventory (for overall burnout severe level, for emotional exhaustion and depersonalization moderate and severe were combined and for personal accomplishment low levels)a |
| Barello et al. (41) | Was not stated | Italy, HIC | Cross-sectional | Yes | Mixed healthcare workers | 40 (11) | 376 | Maslach Burnout Inventory (high and moderate scores were combined for emotional exhaustion and depersonalization and low for personal gratification)a |
| Barello et al. (42) | Later months | Italy, HIC | Cross-sectional | Yes | Mixed healthcare workers | 41 (11) | 532 | Maslach Burnout Inventory (only high level of Emotional exhaustion and depersonalization and low for personal accomplishment)a |
| Chen et al. (17) | First 3 months | China, UMIC | Cross-sectional | Mixed exposure | Mixed healthcare workers | 902 | 15 Items Chinese version of Maslach Burnout Inventoryb | |
| Chen et al. (32) | Later months | China and Taiwan, UMIC | Cross-sectional | Mixed exposure | Nurses and/or physicians | 33.1 (7.5) | 12,596 | Maslach Burnout Inventory-General Survey (moderate and high for emotional exhaustion and depersonalization were combined and high for lack of personal accomplishment)a |
| Di Monte et al. (43) | Later months | Italy, HIC | Cross-sectional | No | Nurses and/or physicians | 55.13 (11.40) | 102 | Maslach Burnout Inventory, high and moderate combined for emotional exhaustion and depersonalization and low for personal accomplishmenta |
| Dobson et al. (44) | Later months | Australia, HIC | Cross-sectional | Mixed exposure | Mixed healthcare workers | 19–29: 75 (23.7%), 30–39: 100 (31.6%), 40–49: 69 (21.8%), 50 or over: 72 (22.8%) | 320 | Stanford Professional Fulfillment Index (symptoms of burnout)c |
| Duarte et al. (45) | Later months | Portugal, HIC | Cross-sectional | Mixed exposure | Mixed healthcare workers | 38 (10) | 2,008 | Copenhagen Burnout Inventory (high levels for each of three different dimensions: personal burnout, work-related, and client-related burnoutc |
| Elhadi et al. (36) | Later months | Libya, UMIC | Cross-sectional | No | Mixed healthcare workers | 33.08 (7.25) | 532 | The English version of the Abbreviated Maslach Burnout Inventory (aMBI; for overall burnout presence of both emotional exhaustion and depersonalization, high level of emotional exhaustion and depersonalization, and low level of personal accomplishment)b |
| Evanoff et al. (46) | Later months | Washington University in St. Louis, HIC | Cross-sectional | Mixed exposure | Mixed healthcare workers | 915 | Professional Fulfillment Index (PFI; high overall burnout score >1.33)c | |
| Giusti et al. (47) | Later months | Italy, HIC | Cross-sectional | Mixed exposure | Mixed healthcare workers | 44.6 (13.5) | 330 | Maslach Burnout Inventory (high and moderate combined for emotional exhaustion and depersonalization and low for personal accomplishment)a |
| Gómez-Galán et al. (48) | Later months | USA, HIC | Cross-sectional | Yesd | Nurses and/or physicians | The Stanford Professional Fulfillment Index (SPFI; presence of burnout)c | ||
| Hu et al. (33) | First 3 months | China, UMIC | Cross-sectional | Yes | Nurses and/or physicians | 30.99 (6.17) | 2,014 | 22 Items Chinese version of the Maslach Burnout Inventory: Human Services Survey (MBI-HSS)for Medical Personnel (MP; moderate and high for emotional exhaustion, depersonalization were combined for n and low of personal accomplishment was reported for n)b |
| Kholmogorova et al. (49) | Later months | Russia, UMIC | Cross-sectional (not stated) | Yes | Mixed healthcare workers | 36.1 (21–61) | 120 | Maslach Burnout Inventory (three dimensions were categorized as low, middle, and high level. Middle and high levels for emotional exhaustion, depersonalization, and high reduction of personal achievements were reported for n)a |
| Lázaro-Pérez et al. (50) | Later months | Spain, HIC | Descriptive study | Not clearly stated | Mixed healthcare workers | <41: 75 (47.8%) 41–60: 66 (42.0%) >60: 16 (10.2%) | 157 | Maslach and Jackson's scale (for Emotional Exhaustion and Depersonalization medium/high values and for personal accomplishment, low value were used for n)a |
| Liu et al. (8) | First 3 months | China, UMIC | Cross-sectional | Mixed exposure | Nurses and/or physicians | 20–29: 198 30–39: 40 40–49: 191 >50: 85 |
880 | 15 Items Chinese version of the Maslach Burnout Inventory (CMBI): n were reported as emotional exhaustion, depersonalization, or reduced personal accomplishment. Overall burnout combined of mild burnout (only one of the three dimensions is positive), moderate burnout (arbitrary two of the three dimensions are positive), and severe burnout (all the three dimensions are positive) reported as %b |
| Luceño-Moreno et al. (34) | Later months | Spain, HIC | Cross-sectional | Yes | Mixed healthcare workers | 43.88 (SD = 10.82, ranging between 19 and 68) | 1,422 | 22 Items Spanish adaptation of the Maslach Burnout Inventory-MBI-HSS (moderate and high for emotional exhaustion and depersonalization were combined for n and low of personal accomplishment was reported for n)b |
| Martínez-López et al. (51) | Later months | Spain, HIC | Online survey | Yes | Mixed healthcare workers | Average: 41.8 <30: 35 (22.3%)31–40: 40 (25.5%)41–50: 30 (19.1%)51–60: 36 (22.9%)>60: 16 (10.2%) | 157 | Maslach Burnout inventory (medium and high for emotional exhaustion and depersonalization were combined and low personal accomplishment was reported)a |
| Matsuo et al. (52) | Later months | Japan, HIC | Cross-sectional | Yes | Mixed healthcare workers | 30.5 (26–40) | 312 | Maslach Burnout Inventory (high levels of exhaustion (>3.5) plus either high cynicism (>3.5) or low professional efficacy (<2.5) were selected as the primary criteria for burnout)a |
| Miguel-Puga et al. (37) | Was not stated | Mexico, UMIC | Cross-sectional | Yes | Mixed healthcare workers | 19–58 years old | 204 | The short version of the Burnout Measure by Malach–Pines and number of healthcare workers who had high score of burnout (score ≥3.5) reported in three separate evaluations but we only report the third (=the last) occasionb |
| Park et al. (53) | Later months | The Republic of Korea, HIC | Cross-sectional | Mixed exposure | Nurses and/or physicians | Median (IQR): 41 (37–48) | 115 | The Maslach Burnout Inventory-Human Services Survey (MBI-HSS): standardized thresholds set out in the MBI-HSS manual was applied for emotional exhaustion and depersonalization; lack of personal accomplishment was reported for n. Overall burnout was defined as a high score in either the emotional exhaustion or depersonalization subscalea |
| Ruiz-Fernández et al. (54) | Later months | Spain, HIC | Cross-sectional | Mixed exposure | Nurses and/or physicians | 46.7 (10.2) | 506 | The Professional Quality of Life Questionnaire: percent of medium and high burn out were combined for %/number was not reportedc |
| Sayilan et al. (55) | Later months | Turkey, UMIC | Cross-sectional | Yes | Nurses and/or physicians | 28.03 (5.99) | 267 | The Maslach Burnout Inventory (three dimentions were categorized as low-moderate and high; moderate and high for emotional exhaustion and depersonalization (stated personalization in tables) were combined and low for personal accomplishment was reported for n)a |
| Roslan et al. (56) | Later months | Malaysia, UMIC | Cross-sectional (for prevalence of burnout) | Mixed exposure | Mixed healthcare workers | <40 years: 682 and 40 years and more than 40 years 211 | 893 | The Malay-Translated Copenhagen Burnout Inventory (CBI)c |
| Tan et al. (57) | Later months | Singapore, HIC | Cross-sectional | Mixed exposure | Mixed healthcare workers | 36.84 (9.95) | 3,075 | The Oldenburg Burnout Inventory (OLBI): burnout was determined with a cutoff of 2.25 for exhaustion and 2.10 for disengagementc |
| Khasne et al. (58) | Was not stated | India, LMIC | Prospective, cross-sectional | Mixed exposure | Mixed healthcare workers | 21–30: 380, 31–40: 784, 41–50: 478, 51–60: 225, more than 61:129 | 2,026 | The Copenhagen Burnout Inventory: personal burnout, work-related burnout, and client-related burnout namely pandemic-related burnoutc |
| de Wit et al. (35) | Later months | Canada, HIC | Mixed-methods study(cohort and qualitative) | Not clearly stated | Nurses and/or physicians | Median (IQR): 41 (35–50) | 468 | The single item measures of emotional exhaustion and depersonalization from the Maslach Burnout Inventory which have been shown to correlate to the emotional exhaustion and depersonalization domains from the Maslach Burnout Inventoryb |
| Zhang et al. (59) | First 3 months | China, UMIC | Prospective observational survey | Yes | Nurses and/or physicians | 30.28 (5.49) | 107 | Maslach Burnout Inventory (three dimensions were categorized as mild-moderate and severe: moderate and severe for emotional exhaustion; depersonalization were combined and severe lack of personal accomplishment was reported for n)a |
a
MBI.
b
Adapted MBI.
c
Other tools.
d
Medical critical care physicians.
I
Based on the date stated for termination of data collection: period were categorized as first 3 months of pandemic (January, February, and March of 2020), and afterwards, months.
II
HIC: high income, LMIC: lower middle income, UMIC: upper middle income countries. Income level derived from the latest updates of World Bank: https://data.worldbank.org/.
III
Participants in the study were divided into two groups: mixed healthcare workers, nurses and/or physicians.
IV
Based on the exposure of the participant to COVID-19 patients in workplace, there are three categorizations: yes (only participants with exposure to COVID-19 cases were studied), no (participants were not exposed to COVID-19 patients), and mixed exposure (both groups were studies).
V
Age is presented differently: mean (SD), range, mean (range), median (interquartile), range: N, and range: N(%).