Int J Med Sci 2021; 18(5):1185-1188. doi:10.7150/ijms.51315 This issue

Research Paper

Impact on physical and mental health among medical personnel in Wuhan during COVID-19 outbreak: a cluster analysis

Jing Gao, MD1,2,3*, Jing Li, MD4*, Xia Han5, Yuan Yuan6, Chuan-Xing Li2✉, Dong-Quan Zhang6✉

1. Department of Respiratory Medicine, Gansu Provincial Hospital, Lanzhou, China.
2. Respiratory Medicine Unit, Department of Medicine & Centre for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.
3. Heart and Lung Centre, Department of Pulmonary Medicine, University of Helsinki and Helsinki University Hospital, Finland.
4. Department of Cardiology Medicine, Gansu Provincial Hospital, Lanzhou, China.
5. Department of Internal Medicine, Gansu Provincial Hospital, Lanzhou, China.
6. Department of Intensive Care, Gansu Province Hospital, Lanzhou, China.
*These authors contributed equally to this work.

This is an open access article distributed under the terms of the Creative Commons Attribution License ( See for full terms and conditions.
Gao J, Li J, Han X, Yuan Y, Li CX, Zhang DQ. Impact on physical and mental health among medical personnel in Wuhan during COVID-19 outbreak: a cluster analysis. Int J Med Sci 2021; 18(5):1185-1188. doi:10.7150/ijms.51315. Available from

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Graphic abstract

Background: Increased stress among medical personnel had been reported in previous virus outbreaks. The novel coronavirus disease (COVID-19) emerged in December 2019, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). No qualitative assessment has yet described the physical and mental health conditions of frontline medical personnel in the COVID-19 outbreaks.

Methods: Here, 251 frontline medical personnel involved in COVID-19 missions completed electronic questionnaires, consisting of 31 categorical variables related to their physical and mental health status, medical history and environmental conditions. We constructed a correlation amongst these variables through pairwise Kendall rank correlation coefficient test. Then, clusters of highly correlated variables were identified using the leading eigenvector. Finally, we used the network and clusters to clarify the correlations amongst variables.

Results: This qualitative study identified the six clusters. Cluster 1 was characterized by skin allergy. Cluster 2 was predominantly associated with anxiety. Cluster 3 consisted mostly of respiratory symptoms. The participants in cluster 4 had medical history. Cluster 5 and cluster 6 were characterized by disinfection and demography, respectively. Finally, we revealed three major findings. First, more than 80% of medical personnel worry about COVID-19-related infection and experience newly appearing anxiety (56.2%), airway or heart symptoms (34.3%) and skin allergies (20.3%). Second, COVID-19-related worry significantly associates with all variables in the anxiety and respiratory symptom clusters. Third, new-onset skin allergies did not associate with either disinfection or anxiety, but did associate with a previous history of allergies.

Conclusions: COVID-19-related worry leads to physical and mental health problems amongst medical personnel. Effective responses and interventions could relieve a series of new-onset physical and mental health problems.

Keywords: COVID-19, medical personnel, physical healthy, mental health, cluster