Introduction: The coronavirus disease (COVID-19) pandemic severely affected healthcare services, including causing negative impacts on healthcare workers’ mental health. An observational study was conducted at Dr. Soetomo General Hospital aimed to measure the prevalence of anxiety, resilience, burnout and their correlations to stress biomarkers amongst healthcare workers in Surabaya, Indonesia, during the COVID-19 pandemic. Methods: Participants were residents who managed COVID-19 patients, chosen using random sampling. All participants had a 1-week shift working with COVID-19 patients in an isolation ward. The study used online questionnaires and laboratory data at the shift’s beginning and end. Along with collecting sociodemographic characteristics, State-Trait Anxiety Inventory (STAI), Brief Resiliency Scale (BRS), and Maslach Burnout Inventory (MBI) scales were administered online. At the same time, laboratory markers such as Neutrophil to lymphocyte ratio (NLR), Interleukin-6 (IL-6), cortisol, and CD4 values were studied. Results: 61 participants were included in the study. At the beginning of the shift, 59% of participants had moderate to severe anxiety, and 83.62% had normal to high resilience. The early proportion of the participants having burnout from combined MBI measures was 88.52%. MBI-EE median scores were lower in the married group (6.50 vs. 9.50, p-value=0.030). NLR value was significantly related to STAI-S and BRS (p-value=0.007 and 0.049, respectively). Conclusions: Most healthcare workers had anxiety and burnout, with normal levels of resilience. Our study found that NLR might be useful as a marker for anxiety and resilience.

Original languageEnglish
Pages (from-to)2117-2124
Number of pages8
JournalBali Medical Journal
Issue number2
Publication statusPublished - 1 Aug 2023


  • Anxiety
  • Biomarkers
  • Burnout
  • COVID-19
  • Health personnel


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