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COVID-19 in health care workers – A systematic review and meta-analysis - 11/10/20

Doi : 10.1016/j.ajem.2020.05.113 
Ankit Kumar Sahu, MBBS, V.T. Amrithanand, MD , Roshan Mathew, Praveen Aggarwal, Jamshed Nayer, Sanjeev Bhoi
 Department of Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India 

Corresponding author at: Department of Emergency Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.Department of Emergency MedicineAll India Institute of Medical SciencesAnsari NagarNew Delhi110029India

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Abstract

Background and objectives

It is essential to know the proportion of health care workers (HCW) who are COVID 19 positive, as well as the severity and mortality among them.

Methods

This systematic review was performed according to the Preferred Reporting Items for Systematic review and meta-analysis. Databases including PubMed, EMBASE and Web of Science were searched from December-31, 2019 to April-23, 2020. The search was limited to the studies that reported the data on the number of COVID-19 positive healthcare workers, among the COVID-19 positive patients. Case reports, duplicate publications, reviews, and family-based studies were excluded. The methodological quality of studies was assessed by the Appraisal tool for Cross-Sectional Studies (AXIS) tool.

Results

In this systematic review and meta-analysis, we pooled eleven studies to investigate the above factors. The overall proportion of HCW who were SARS-CoV-2 positive among all COVID-19 patients was 10.1% (95%CI: 5.3–14.9). This proportion varied according to the country of study i.e. China (7 studies) - 4.2%, 95%CI:2.4–6.0; United States (3 studies) – 17.8%, 95%CI:7.5–28.0; and Italy (1 study) – 9.0%, 95%CI:8.6–9.4. The incidence of severe or critical disease in HCW (9.9%, 95%CI:0.8–18.9) was significantly lower (p < 0.001) than the incidence of severe or critical disease in all COVID-19 positive patients (29.4%, 95%CI:18.6–40.2). Similarly, the mortality among HCW (0.3%, 95%CI:0.2–0.4) was also significantly lower (p < 0.001) as compared to that of all patients (2.3%, 95%CI:2.2–2.4).

Conclusion

Health care workers who are COVID-19 positive constituted a significant proportion of all COVID-19 patients; but the severity and mortality were lower among them.

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Highlights

Meta-analysis of eleven studies showed that nearly 10% of COVID-19 positive patients are health care workers
The incidence of severe disease in health care workers (9.9%) was significantly lower than its incidence among all COVID-19 positive patients (29.4%)
The mortality among health care workers (0.3%) was also significantly lower as compared to that of all patients (2.3%)

Le texte complet de cet article est disponible en PDF.

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Vol 38 - N° 9

P. 1727-1731 - septembre 2020 Retour au numéro
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