Background and Objectives: The COVID-19 pandemic has negatively impacted the health care system. Front-line health care workers (HCWs) are at a higher risk of mental health adverse outcomes. The aim of this study was to evaluate the frequency of the symptoms of depression and anxiety and associated demographic and occupational factors among front-line HCWs in Latvia. Materials and Methods: A cross-sectional quantitative study was performed in a population of HCWs during the first wave of the COVID-19 pandemic in Latvia. The participants were interviewed between 28 April 2020 and 2 June 2020. Answers from 864 HCWs were obtained. The participants reported their demographics, work-related information, contacts with COVID-19-positive patients and completed two standardised questionnaires that assessed the symptoms of anxiety (GAD-7) and depression (PHQ-9). The gathered data were analysed by a chi-squared test and binary logistic regression. The data analysis was performed using SPSS v25. Results: A total of 209 (24.8%) participants had depression symptoms and 145 (17.2%) had anxiety symptoms. Health care workers older than 50 had a lower risk of both depression (OR 0.422 (95% CI, 0.262–0.680)) and anxiety (OR 0.468 (95% CI, 0.270–0.813)). General practitioners had more frequent symptoms of depression and anxiety than participants who worked at hospitals (32.8% (n = 63) versus 19.4% (n = 73) and 27.1% (n = 52) versus 10.3% (n = 39), respectively (p = 0.037; p < 0.000)). Working more than 48 h during the week was associated with a higher risk of depression (OR 2.222 (95% CI, 1.315–3.753)) and anxiety (OR 2.416 (95% CI, 1.272–4.586)). Conclusions: The vulnerability of the health care system before the COVID-19 pandemic led to significant mental health adverse outcomes of HCWs during the COVID-19 pandemic in Latvia. A further cohort study is needed to evaluate the dynamics of mental health and other predisposing factors of HCWs.

IntroductionStudies from the beginning of 2020 show that symptoms of depression and anxiety are increasing among health care workers. It is important to assess the dynamics of health care workers mental health.ObjectivesTo assess the dynamic of symptoms of depression and anxiety among health care workers over a 3-month period during the COVID-19 pandemia in Latvia.Methods A longitudinal cohort study of symptoms of depression and anxiety in the population of physicians, physician assistants and nurses in Latvia during the COVID-19 pandemia. Symptoms of depression were assessed using the Patient Health Questionnaire-9 (PHQ-9) scale, symptoms of anxiety were assessed using the General Anxiety Disorder (GAD-7) scale, cut-off score for both scales was 10. Initial data was collected on April-May 2020 with a 3 month follow-up.. Data was analyzed using SPSS- Related-Samples McNemar test.Results348 physicians were initially included (women 83,9%, mean age 45,17±14,02) and 376 physicians assistants and nurses (women 88,2%, mean age 39,99±12,97). After the 3-month follow up 189 physicians (women 88,40%, mean age 45,01±13,57) and 141 physicians assistants and nurses were left (women 88,00%, mean age 39,96 ±12,59). During the 3 months symptoms of depression among physicians rose from 26,80% (n=94) to 27,5% (n=52), symptoms of anxiety from 17,70% (n=62) to 20,6% (n=39). Depression symptoms among physician assistants and nurses dropped from 25,50% (n=96) to 23,9% (n=34), symptoms of anxiety stayed almost the same 18,20% (n=68) to 18,30% (n=26). Symptoms of depression among physicians changed from 26,80% (n=94) to 27,5% (n=52), symptoms of anxiety from 17,70% (n=62) to 20,6% (n=39), changes were not statistically significant (p=0,281; p=0,725). Symptoms of depression among physician assistants and nurses changed from 25,50% (n=96) to 23,9% (n=34), symptoms of anxiety from 18,20% (n=68) to 18,30% (n=26), changes were not statistically significant (p=0,405; p=0,664).ConclusionsNo change in the dynamics of symptoms of depression and anxiety among health care workers over a 3-month period during the COVID-19 pandemia in Latvia was observed.