The following article is a part of conference coverage from the American Academy of PAs 2021 Conference (AAPA 2021), held virtually from May 23 to May 26, 2021. The team at the Clinical Advisor will be reporting on the latest news and research conducted by leading PAs. Check back for more from AAPA 2021.


Anxiety related to the COVID-19 pandemic was positively correlated with burnout symptoms in NY state frontline workers, according to findings reported by researchers from Wagner College in Staten Island, NY, at the American Academy of PAs 2021 Conference (AAPA 2021).

The pandemic increased mental health conditions in frontline workers because of greater workloads, longer shifts and exhaustion, safety concerns stemming from inadequate equipment, high threat of exposure, and increased need to make ethically challenging decisions. The study was designed to understand the role of cognitive, behavioral, and psychological symptoms of COVID-19–related anxiety on burnout among frontline workers in New York state.

Continue Reading

The research team generated a digital survey that was sent to various frontline medical workers and police and fire departments and shared on social media groups and pages relevant to frontline workers. The survey consisted of 17 demographic questions and 15 questions from the Coronavirus Anxiety Scale (CAS) and the COVID-19 Burnout Scale (CBS). A Pearson correlation was used to measure the strength of the association between the CAS and CBS.

Out of 255 initial respondents, 195 completed the survey and met the inclusion criteria. The majority of the respondents were physician assistants (36%) followed by nurses (27%), physicians (15.4%), emergency medical service professionals (8.72%), nurse practitioners (4.6%), and certified registered nurse anesthetists (4.1%). Police and firefighters accounted for 3.6% and 1% of the overall group, respectively. The majority of health care providers worked in internal medicine or intensive care during the pandemic.

“Overall, we did find a significant moderate positive correlation between COVID-19 pandemic-associated anxiety and burnout in NY frontline workers,” said coauthor Alison Maciocia, a PA student at Wagner. The Pearson correlation between the CAS and CBS was 0.646 (P <.0005). Burnout symptoms that were moderately correlated with COVID-19 anxiety included sleeping issues, feeling hopeless and helpless/trapped, and feeling helpless and depressed (Table).

Table. Correlation Between COVID-19 Anxiety and Burnout Symptoms Among 195 New York Frontline Workers

Burnout VariablesSpearman Correlation Coefficient, rho
Trouble falling or staying asleep x felt difficulties sleeping0.716
Lost interest in eating x felt nauseous or had stomach problems0.624
Hopeless x helpless0.757
Hopeless x trapped0.743
Trapped x helpless0.722
Helpless x depressed0.701
Trapped x depressed0.676
Tired x depressed0.674
Hopeless x depressed0.668
Depressed x difficulty sleeping0.621
Tired x hopeless0.616
Helpless x worthless/like a failure0.614
Trapped x worthless/like a failure0.600
*All results are significant at P <.0005

“Because we did find a moderate association, we think it would be important to utilize counseling because mental health is just as important as physical health,” Maciocia said. The team concluded that future work should focus on efforts to prevent pandemic-associated stress through healthy work design and a supportive workplace. Maciocia noted mindfulness techniques and digital mental health service apps as tools workforces should consider promoting.

Virtual attendees of the meeting praised the study authors for their research, especially the inclusion of all frontline workers.

Visit Clinical Advisor’s meetings section for complete coverage of AAPA 2021.


Ross K, Gilsenan K, Reyes J, et al. Relationship between COVID-19 pandemic-associated anxiety and burnout in NY frontline workers. Poster presented at: American Academy of PAs 2021 Conference; May 23-26, 2021. Poster 158.