The Trends of Psychosomatic Symptoms and Perceived Stress Among Healthcare Workers During the COVID-19 Pandemic in China: Four Cross-Sectional Nationwide Surveys, 2020-2023

Introduction: Three years have passed since the COVID-19 outbreak. Global healthcare workers made significant contributions while enduring extra workloads and immediate health threats. However, an unseen wave of vast infection was detected in China last December, and healthcare workers were faced with inevitable challenges and heavy stress. This study aggregated four waves of the psychosomatic survey lasting to last month, emphasizing healthcare workers but the rest of society. We aimed to present a dynamic mental health map and, most importantly, provide a timely report of the current situation in our colleagues.Methods: The current study successfully conducted four national cross-sectional online surveys from February and March 2020, Apr 2022, and Jan 2023. The Psychosomatic Symptom Scale (PSSS) and Perceived Stress Scale-10 (PSS-10) were used to assess psychosomatic symptoms and perceived stress.Results: 14945 participants participated in the surveys, including 8578 healthcare workers and 6367 others. The prevalence of psychosomatic syndrome, reflected by PSSS, was 19.3% (first wave), 22.9% (second wave), 36.4% (third wave), and 60.7% (fourth wave) among healthcare workers, compared to 24.0% (first wave), 35.7% (second wave), 34.2% (third wave) and 50.5% (fourth wave) among the others. In addition, healthcare workers exhibited lower PSSS total scores at the beginning (waves 1 and 2), but scores were higher at later waves (waves 3 and 4) (all p < 0.05). Despite their infection status, they now suffer from more severe psychosomatic symptoms than the rest of society.Conclusions: Healthcare workers in China experienced severe psychosomatic symptoms and tremendous stress now. There is an urgent need to utilize social support for them.Funding: This work was supported by the Medical Innovation Teams of Jiangsu province (CXTDB2017005, YYG).Declaration of Interests: The authors declare that they have no conflicts of interests.Ethics Approval: All participants provided their online informed consent. This study was approved by the Medical Ethics Committee of ZhongDa Hospital of Southeast University (approval number 2020ZDSYLL011-P01).