4.7 Review

COVID-19 and healthcare workers: A systematic review and meta-analysis

Journal

INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES
Volume 104, Issue -, Pages 335-346

Publisher

ELSEVIER SCI LTD
DOI: 10.1016/j.ijid.2021.01.013

Keywords

COVID-19; SARS-CoV2; Healthcare workers; Meta-analysis; Occupational health; Infectious disease transmission

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This study aimed to describe the clinical outcomes and risk factors for SARS-CoV-2 infection in healthcare workers, finding that 51.7% of healthcare workers tested positive for COVID-19, with a hospitalization rate of 15.1% and a mortality rate of 1.5%. Healthcare workers who were infected with COVID-19 had increased relative risks related to personal protective equipment, workplace setting, profession, exposure, contacts, and testing compared to those without infection.
Background: The COVID-19 pandemic has focused attention on the challenges and risks faced by frontline healthcare workers (HCW). This study aimed to describe the clinical outcomes and risk factors for SARSCoV-2 infection in HCW. Methods: Three databases were surveyed and 328 articles were identified. Of these, 225 articles did not meet inclusion criteria; therefore, 97 full-text article were reviewed. Finally, after further revision, 30 articles were included in the systematic review and 28 were used for meta-analysis. Results: Twenty-eight studies were identified involving 119,883 patients. The mean age of the patients was 38.37 years (95% CI 36.72-40.03) and males comprised 21.4% (95% CI 12.4-34.2) of the population of HCW. The percentage of HCW who tested positive for COVID-19 was 51.7% (95% CI 34.7-68.2). The total prevalence of comorbidities in seven studies was 18.4% (95% CI 15.5-21.7). The most prevalent symptoms were fever 27.5% (95% CI 17.6-40.3) and cough 26.1% (95% CI 18.1-36). The prevalence of hospitalisation was 15.1% (95% CI 5.6-35) in 13 studies and of death was 1.5% (95% CI 0.5-3.9) in 12 studies. Comparisons of HCW with and without infection showed an increased relative risk for COVID-19 related to personal protective equipment, workplace setting, profession, exposure, contacts, and testing. Conclusion: A significant number of HCW were reported to be infected with COVID-19 during the first 6 months of the COVID-19 pandemic, with a prevalence of hospitalisation of 15.1% and mortality of 1.5%. Further data are needed to track the continued risks in HCW as the pandemic evolves and health systems adapt. (c) 2021 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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