Sex differences in psychological impact on healthcare workers during the COVID-19 pandemic

Sex differences in the psychological burden of the COVID-19 pandemic are of particular interest among Iranian healthcare workers (HCWs), given the distinct cultural and societal roles of Iranian women compared to their Western counterparts. This study aimed to assess the sex disparities in psychological symptoms-including anxiety, perceived stress, and depression-among Iranian HCWs.

In this multicenter cross-sectional study, participants were recruited from four different hospitals and community health centers in Babol, northern Iran. Data were collected using grouped, validated psychological and behavioral scales.

Female HCWs reported significantly higher levels of perceived stress and anxiety than males (P = 0.001), while no significant sex differences were observed for depression, overall health-promoting lifestyle scores, self-efficacy, or self-esteem. However, males exhibited significantly higher levels of physical activity than females in the HPL subscale. After adjusting for potential confounders, the mean differences in perceived stress and anxiety scores between women and men were β = 2.32 (95% CI: 0.95-3.68, P = 0.001) and β = 1.72 (95% CI: 0.56-2.88, P = 0.004), respectively.

This study reveals a significant sex disparity in psychological outcomes, particularly in perceived stress and anxiety, with female HCWs experiencing a greater burden than males during the COVID-19 pandemic. Supportive interventions targeting the mental health of healthcare workers are therefore necessary.