Outcome | Studies (samples) | N (pandemic) | N (comp.) | Standardized mean difference (95% CI) | I2 | 95% prediction intervala |
---|---|---|---|---|---|---|
Main analyses | ||||||
General population | ||||||
 Anxiety | 23 (26) | 49,746 | 132,145 | 0.40 (0.15–0.65) | 99% | − 0.87–1.67 |
 Depression | 25 (28) | 60,213 | 183,747 | 0.67 (0.07–1.27) | 100% | −2.02–3.36 |
 Stress | 11 (13) | 11,600 | 67,386 | 0.10 (−0.30–0.50) | 100% | −1.39–1.60 |
 Sleep-related symptoms | 4 (4) | 3332 | 7635 | 0.74 (−1.47–2.96) | 100% | −3.68–5.17 |
Healthcare workers | ||||||
 Anxiety | 13 (14) | 5508 | 22,204 | −0.08 (−0.66–0.49) | 99% | −1.75–1.58 |
 Depression | 7 (8) | 2226 | 4605 | −0.16 (− 0.59–0.26) | 97% | −1.41–1.09 |
 Stress | 3 (3) | 1570 | 2454 | 0.49 (−0.60–1.57) | 99% | / |
 Sleep-related symptoms | 4 (5) | 554 | 20,024 | 0.83 (−0.14–1.81) | 99% | −1.54–3.21 |
Patients | ||||||
 Anxiety | 6 (6) | 1845 | 12,458 | 0.31 (−0.07, 0.69) | 93% | −1.08–1.69 |
 Depression | 7 (7) | 2138 | 24,444 | 0.48 (−0.08–1.04) | 98% | −1.58–2.53 |
 Stress | 4 (4) | 435 | 10,061 | −0.10 (− 0.81–0.61) | 98% | −3.54–3.34 |
 Sleep-related symptoms | 2 (2) | 127 | 298 | −0.61 (−1.75–0.54) | 96% | / |
Sensitivity analysis – Quality of included pandemic studies (ie, exclusion of poor-quality studies) | ||||||
General population | ||||||
 Anxiety | 16 (17) | 38,323 | 81,350 | 0.53 (0.19–0.86) | 100% | −0.90–1.95 |
 Depression | 18 (19) | 48,790 | 136,884 | 0.83 (0.09–1.57) | 100% | −2.17–3.82 |
 Stress | 7 (8) | 9110 | 43,747 | 0.33 (−0.19–0.84) | 100% | −1.20–1.85 |
 Sleep-related symptoms | 3 (3) | 2659 | 6622 | 0.80 (−1.34–2.94) | 100% | / |
Healthcare workers | ||||||
 Anxiety | 4 (4) | 1655 | 4124 | −0.18 (−0.78–0.41) | 97% | −1.30–0.94 |
 Depression | 4 (4) | 1655 | 2356 | 0.03 (−0.42–0.47) | 90% | −0.73–0.79 |
 Stress | 2 (2) | 1376 | 1872 | −0.05 (− 0.37–0.26) | 95% | / |
 Sleep-related symptoms | 1 (1) | 123 | 4951 | −0.03 (− 0.21–0.15) | / | / |
Patients | ||||||
 Anxiety | 3 (3) | 1461 | 11,116 | 0.45 (−0.10–1.01) | 92% | / |
 Depression | 3 (3) | 1461 | 21,934 | 0.21 (−1.08–1.49) | 99% | / |
 Stress | 1 (1) | 51 | 51 | 0.18 (−0.21–0.57) | / | / |
 Sleep-related symptoms | 1 (1) | 51 | 207 | −0.03 (− 0.33–0.28) | / | / |
Sensitivity analysis – Level of comparability between included pandemic studies and comparative studies (ie, exclusion of level-3 and level-4 studies) | ||||||
General population | ||||||
 Anxiety | 12 (13) | 38,461 | 32,698 | 0.40 (0.06–0.74) | 99% | −0.77–1.57 |
 Depression | 14 (15) | 38,259 | 78,619 | 0.77 (−0.23–1.77) | 100% | −2.72–4.25 |
 Stress | 7 (8) | 8624 | 12,739 | −0.15 (− 0.76–0.46) | 99% | −1.84–1.53 |
 Sleep-related symptoms | 2 (2) | 2550 | 5609 | 1.54 (−1.18–4.27) | 100% | / |
Healthcare workers | ||||||
 Anxiety | 7 (8) | 3147 | 9511 | −0.54 (−1.23–0.15) | 99% | −2.11–1.03 |
 Depression | 4 (5) | 546 | 2576 | −0.38 (−1.56–0.79) | 98% | −2.60–1.84 |
 Stress | / | / | / | / | / | / |
 Sleep-related symptoms | 3 (4) | 423 | 19,804 | 1.01 (−0.17–2.18) | 99% | −1.61–3.63 |
Patients | ||||||
 Anxiety | 4 (4) | 1616 | 3184 | 0.23 (−0.33–0.79) | 92% | −2.47–2.93 |
 Depression | 4 (4) | 1704 | 3205 | 0 (−0.56–0.56) | 93% | −2.69–2.70 |
 Stress | 2 (2) | 127 | 217 | 0.15 (−0.08–0.37) | 0% | / |
 Sleep-related symptoms | 2 (2) | 127 | 298 | −0.61 (−1.75–0.54) | 96% | / |