The impact of depression, anxiety, and stress on healthcare workers (HCWs) performance is widely acknowledged, posing a risk to patient well-being. With the emergence of the COVID-19 pandemic, it has become crucial to assess the influence of this crisis on the mental health of Syrian HCWs.

Our study revealed that female HCWs had significantly higher and more severe levels of anxiety (p < 0.0083) when compared to males HCWs, 5.8% vs. 5.2% had severe anxiety levels and 4.2% vs. 3.7% had extremely severe levels, respectively. Although our study found that gender have no impact on depression and stress levels, Lai et al. [16, 18] and Rossi et al. [17, 19] reported that women had more severe symptoms in three aspects of DASS-21. Contrary, Suryavanshi et al. [18, 20] found no association between gender and risk of mental distress.

We noticed that healthcare workers aged 18–29 (n = 556/700) had significantly elevated levels of depression and stress (p < 0.0083), although their anxiety levels were not significantly different. A study conducted in Spain yielded similar results, showing that individuals aged 18–25 (n = 551/976) experienced higher levels of depression, anxiety, and stress. Many healthcare workers in this age group were also university students who had to transition from in-person learning to online platforms like Zoom and Google Meet, which may have contributed to their mental health challenges [11].

During the pandemic, the healthcare workers worked in close contact with infected patients for extensive hours and under an increased volume of pressure. They were susceptible to infection, leading to further mental strains on HCWs [5,6,7, 21, 22]. HCWs who were in direct contact with COVID-19 patients had depression and anxiety prevalence of 47 and 50%, respectively [20]. Our study showed that caring for COVID-19 patients would increase stress levels among HCWs, regardless of whether they had or did not have protective equipment. Lenzo et al. [23] and Rossi et al. [19] documented higher rates of moderate, severe, and extremely severe levels of depression, anxiety, and stress among HCWs who worked with COVID-19 patients. Lai et al. [18] reported that the first-line HCWs responsible for COVID-19 patients had an elevated risk of developing mental distress compared to those in the second-line. A study compared the prevalence of mental distress between a hospital that admits COVID-19 patients and those that do not. As expected, HCWs in the COVID-19-admitting hospital had higher rates of depression, anxiety, and stress [24]. It is worth mentioning that Hummel et al. [10] found no significant association between direct contact with COVID-19 patients and anxiety, depression, or stress levels among medical professionals.

Our study revealed that healthcare workers, like many others, have been affected by the pandemic in terms of their quality of life. Out of the participants, 50% (n = 349) reported having a good quality of life. Additionally, 28% (n = 193) stated that their quality of life was neither good nor bad, while 12% (n = 38) reported having a poor quality of life, and 8% (n = 57) reported having a very good quality of life. ).

Suryavanshi et al. [20] assessed QoL using one-item quality of life (QoL-1) visual analogue scale. They conveyed that moderate to severe depression and anxiety were independently associated with low QoL. A study from Vietnam reported a low health-related QoL among HCWs who had direct contact with COVID-19 patients [24]. Another Vietnamese study anticipated a low health-related QoL in people suspected of COVID-19 (25). Finally, it is essential to highlight the impact of the pandemic on the general population. Hummel et al. conducted a study across eight European countries, examining the mental health of both medical and non-medical professionals. Their findings revealed that healthcare workers had lower rates of depression and anxiety compared to non-medical professionals. It is crucial for researchers to shed light on the pandemic and its effects on the shed light impact suggested that their medical knowledge may helped them to understand the pandemic and be able to cope with it [10].

To summarize, this study has certain limitations as it only suggests associations rather than definitive cause-and-effect relationships. There is a possibility of reporting bias as the data relied on self-reported information from healthcare workers, whom the challenging circumstances of the pandemic may have influenced. Furthermore, the study solely focused on healthcare workers and did not consider the mental well-being of the general population. Therefore, future longitudinal studies should be conducted to explore the levels and underlying causes of depression, anxiety, stress, and quality of life among healthcare workers and compare them to those of the general population.20:07.