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

Int J Infect Dis. 2021 Mar:104:335-346. doi: 10.1016/j.ijid.2021.01.013. Epub 2021 Jan 11.

Abstract

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 SARS-CoV-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.

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

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • COVID-19 / epidemiology*
  • COVID-19 / mortality
  • COVID-19 / virology
  • Female
  • Health Personnel / statistics & numerical data*
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Occupational Exposure
  • Occupational Health*
  • Pandemics*
  • Personal Protective Equipment
  • Risk Factors
  • SARS-CoV-2 / isolation & purification*
  • Workplace
  • Young Adult