Document Type : Original Article


1 Department of Medical Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

2 Research Center for Trauma in Police Operations, Directorate of Health, Rescue and Treatment, Police Force, Tehran, Iran Research Center for Behavioral and Cognitive Science in Police, Directorate of Health, Rescue and Treatment, Police Force, Tehran, Iran, Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran

3 Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran

4 Behavioral Sciences Research Center, Research Institute for Lifestyle, Baqiyatallah University of Medical Sciences, Tehran, Iran School of Nursing, Baqiyatallah University of Medical Sciences, Tehran, iran

5 Research Center for Trauma in Police Operations, Directorate of Health, Rescue and Treatment, Police Force, Tehran, Iran Research Center for Behavioral and Cognitive Science in Police, Directorate of Health, Rescue and Treatment, Police Force, Tehran, Iran


BACKGROUND: Nurses are in close contact with COVID‑19 patients and due to the high risk of 
infection, they experience fear and anxiety that can result in burnout. This study aimed to review the 
studies on burnout among nurses during the COVID‑19 epidemic.
MATERIALS AND METHODS: The study followed the guideline for Preferred Reporting Items 
for Systematic Review and Meta‑analysis (PRISMA). Using the keywords: “burnout,” “nurse,” and 
“COVID‑19” and with the help of Boolean operators, “AND” and “OR” the online databases, namely 
PubMed, Scopus, Google Scholar, Web of Science, and Science Direct were searched. Articles 
published from the first of February 2020 to 30 October, 2020 were retrieved. After the quality 
appraisal, the required data were extracted and analyzed.
RESULTS: Out of 85 articles identified in the initial search, and after removing duplicates and those 
that did not have the required data, seven articles entered the analysis. Among these articles, 
four (57.14%) reported moderate burnout and three articles (42.86) reported high level of burnout 
among nurses during the COVID‑19 pandemic.
CONCLUSIONS: A majority of the studies reported that nurses experienced a moderate level of 
burnout during the COVID‑19 pandemic. Given the prevalence of burnout in nurses and because 
nurses are the largest portion of the healthcare providers who are in close contact with patients 
infected by COVID‑19, it is necessary for health care policymakers to adopt strategies for preventing 
or reducing burnout among nurses.


1. Zu ZY, Jiang MD, Xu PP, Chen W, Ni QQ, Lu GM, et al. 
Coronavirus disease 2019 (COVID‑19): A perspective from China. 
Journal of Radiology 2020;296: E15‑25.
2. Guixia L, Hui Z. A study on burnout of nurses in the period of 
COVID‑19. Journal of Psychol Behav Sci. 2020; 9:31.
3. Zhu Z, Xu S, Wang H, Liu Z, Wu J, Li G, et al. COVID‑19 in Wuhan: 
Immediate psychological impact on 5062 health workers. Journal 
of MedRxiv. 2020; 1:1.
4. Hu D, Kong Y, Li W, Han Q, Zhang X, Zhu LX, et al. Frontline 
nurses’ burnout, anxiety, depression, and fear statuses and 
their associated factors during the COVID‑19 outbreak in 
Wuhan, China: A large‑scale cross‑sectional study. Journal of 
EClinicalMedicine 2020; 24:100424.
5. Coronini‑Cronberg S, John Maile E, Majeed A. Health inequalities: 
The hidden cost of COVID‑19 in NHS hospital trusts? Journal of 
the Royal Society of Medicin 2020; 113:179‑84.
6. Oberfeld B, Achanta A, Carpenter K, Chen P, Gilette NM, 
Langat P, et al. SnapShot: COVID‑19. Cell 2020; 181:954. e1.
7. Bao Y, Sun Y, Meng S, Shi J, Lu L. 2019‑nCoV epidemic: Address 
mental health care to empower society. Journal of Lancet 
2020;395: e37‑8.
8. Said NB, Chiang VC. The knowledge, skill competencies, and 
psychological preparedness of nurses for disasters: A systematic 
review. Journal of Int Emerg Nurs 2020; 48:100806.
9. Smith GD, Ng F, Li WH. COVID-19: Emerging compassion, 
courage and resilience in the face of misinformation and adversity. 
Journal of Clin Nurs 2020; 29:1425.
10. Xiang YT, Yang Y, Li W, Zhang L, Zhang Q, Cheung T, et al. 
Timely mental health care for the 2019 novel coronavirus outbreak 
is urgently needed. Lancet Psychiatry 2020; 7:228‑9.
11. Kisa S. Burnout among physicians and nurses during COVID‑19 
pandemic. European Journal of Environment and Public Health 
2020; 4:2.
12. BianchiR, Schonfeld IS. Burnout‐depression overlap: Nomological 
network examination and factor‐analytic approach. Scand J 
Psychol 2018; 59:532‑9.
13. Morgantini LA, Naha U, Wang H, Francavilla S, Acar Ö, Flores JM,
et al. Factors contributing to healthcare professional burnout 
during the COVID‑19 pandemic: A rapid turnaround global 
survey. Journal of PLoS One 2020;15: e0238217.
14. Sung CW, Chen CH, Fan CY, Su FY, Chang JH, Hung CC, et al.
Burnout in medical staffs during a coronavirus disease (COVID‑19) 
pandemic. Journal of the LANCET. 2020; 5:1.
15. Bradley M, Chahar P. Burnout of healthcare providers during 
COVID‑19. Cleve Clin J Med 2020; 1:9.
16. Wan Z, Lian M, Ma H, Cai Z, Xianyu Y. Factors associated with 
burnout among Chinese nurses during COVID‑19 epidemic: 
A cross‑sectional study. Journal of research square 2020; 1:18.
17. Sarboozi Hoseinabadi T, Kakhki S, Teimori G, Nayyeri S. 
Burnout and its influencing factors between frontline nurses 
and nurses from other wards during the outbreak of coronavirus 
disease ‑COVID‑19‑ in Iran. Invest Educ Enferm 2020;38: e3.
18. Murat, M., Köse, S. and Savaşer, S. Determination of stress, 
depression and burnout levels of front‐line nurses during the 
COVID-19 pandemic. International Journal of Mental Health 
Nursing 2021; 30:533‑543.
19. Chen R, Sun C, Chen JJ, Jen HJ, Kang XL, Kao CC, et al. 
A large‑scale survey on trauma, burnout, and posttraumatic 
growth among nurses during the COVID‑19 pandemic. Int J Ment 
Health Nurs 2021; 30:102‑16.
20. Hardiyono H. COVID‑19: Burnout on nurse. Journal of Espacios 
2020; 41:11‑18.
21. Mousavi SV, Ramezani M, Salehi I, Hossein Khanzadeh AA, 
Sheikholeslami F. The relationship between burnout dimensions 
and psychological symptoms (depression, anxiety and stress) among 
nurses. Journal of Holistic Nursing and Midwifery 2017; 27:37‑43.
22. Chen J, Li J, Cao B, Wang F, Luo L, Xu J. Mediating effects of 
self-efficacy, coping, burnout, and social support between job 
stress and mental health among young Chinese nurses. Journal 
of Advanced Nursing 2020; 76:163‑73.
23. Ross J. The exacerbation of burnout during COVID‑19: A major 
concern for nurse safety. J Perianesth Nurs 2020; 35:439‑40.
24. Papathanasiou IV, Tsaras K, Kleisiaris CF, Fradelos EC, 
Tsaloglidou A, Damigos D. Anxiety and depression in staff of 
mental units: The role of burnout. In: GeNeDis 2016. Cham: 
Springer; 2017. p. 185‑97.
25. Badu E, O’Brien AP, Mitchell R, Rubin M, James C, McNeil K, 
et al. Workplace stress and resilience in the Australian nursing 
workforce: A comprehensive integrative review. Int J Ment Health 
Nurs 2020; 29:5‑34.
26. Sasangohar F, Jones SL, Masud FN, Vahidy FS, Kash BA. Provider 
burnout and fatigue during the COVID‑19 pandemic: Lessons 
learned from a high‑volume intensive care unit. Anesth Analg 
2020; 131:106‑11