UMass Chan Medical School Faculty Publications


Symptoms of Anxiety, Burnout, and PTSD and the Mitigation Effect of Serologic Testing in Emergency Department Personnel During the COVID-19 Pandemic

UMMS Affiliation

Department of Emergency Medicine

Publication Date


Document Type



Emergency Medicine | Mental and Social Health | Psychiatry and Psychology | Public Health | Virus Diseases


STUDY OBJECTIVE: Among a comprehensive range of frontline emergency department health care personnel, we assessed symptoms of anxiety and burnout, specific coronavirus disease 2019 (COVID-19) work-related stressors, and risk for post-traumatic stress disorder (PTSD). We also determined whether COVID-19 serologic testing of HCP decreased their self-reported anxiety.

METHODS: In a prospective cohort study from May 13, 2020, to July 8, 2020, we used electronic surveys to capture participant self-reported symptoms before and after serologic testing for anti-SARS-CoV-2 immunoglobulin G antibodies. Participants were physicians, nurses, advanced practice providers, and nonclinical ED personnel at 20 geographically diverse United States EDs. We evaluated these domains: 1) the effects of the COVID-19 pandemic on overall stress and anxiety; 2) COVID-19-related work stressors; 3) burnout; and 4) PTSD risk (measured using the Primary Care-PTSD Screen for DSM-5, a 5-item screening instrument in which a score of > /=3 signifies high risk for PTSD). We also assessed perceptions of whether results of COVID-19 antibody testing decreased participants' self-reported anxiety.

RESULTS: Of 1,606 participants, 100% and 88% responded to the baseline and follow-up surveys, respectively. At baseline, approximately half (46%) reported symptoms of emotional exhaustion and burnout from their work, and 308 (19.2%, 95% confidence interval [CI] 17.3% to 21.1%) respondents screened positive for increased PTSD risk. Female respondents were more likely than males to screen positive (odds ratio [OR] 2.03, 95% CI 1.49 to 2.78). Common concerns included exposing their family and the health of coworkers diagnosed with COVID-19. After receiving antibody test results, 54% (95% CI 51.8 to 56.7) somewhat agreed, agreed, or strongly agreed that knowledge of their immune status had decreased their anxiety. A positive serology result indicating prior SARS-CoV-2 infection was associated with a higher likelihood of reporting decreased anxiety (2.83, 95% CI 1.37 to 5.83).

CONCLUSION: Symptoms of anxiety and burnout were prevalent across the spectrum of ED staff during the COVID-19 pandemic. One-fifth of ED personnel appeared to be at risk for PTSD. Increased provision of serologic testing may help to mitigate anxiety.


emergency department, health care personnel, anxiety, burnout, COVID-19, post-traumatic stress disorder, PTSD, serologic testing

DOI of Published Version



Rodriguez RM, Montoy JCC, Hoth KF, Talan DA, Harland KK, Eyck PT, Mower W, Krishnadasan A, Santibanez S, Mohr N; Project COVERED Emergency Department Network. Symptoms of Anxiety, Burnout, and PTSD and the Mitigation Effect of Serologic Testing in Emergency Department Personnel During the COVID-19 Pandemic. Ann Emerg Med. 2021 Feb 5:S0196-0644(21)00108-6. doi: 10.1016/j.annemergmed.2021.01.028. Epub ahead of print. PMID: 33846014; PMCID: PMC7862892. Link to article on publisher's site


John P. Haran and Gregory Volturo are collaborators in the Project COVERED Emergency Department Network.

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

Annals of emergency medicine

PubMed ID