Article Text
Abstract
Objectives To estimate COVID-19 infections and deaths in healthcare workers (HCWs) from a global perspective during the early phases of the pandemic.
Design Systematic review.
Methods Two parallel searches of academic bibliographic databases and grey literature were undertaken until 8 May 2020. Governments were also contacted for further information where possible. There were no restrictions on language, information sources used, publication status and types of sources of evidence. The AACODS checklist or the National Institutes of Health study quality assessment tools were used to appraise each source of evidence.
Outcome measures Publication characteristics, country-specific data points, COVID-19-specific data, demographics of affected HCWs and public health measures employed.
Results A total of 152 888 infections and 1413 deaths were reported. Infections were mainly in women (71.6%, n=14 058) and nurses (38.6%, n=10 706), but deaths were mainly in men (70.8%, n=550) and doctors (51.4%, n=525). Limited data suggested that general practitioners and mental health nurses were the highest risk specialities for deaths. There were 37.2 deaths reported per 100 infections for HCWs aged over 70 years. Europe had the highest absolute numbers of reported infections (119 628) and deaths (712), but the Eastern Mediterranean region had the highest number of reported deaths per 100 infections (5.7).
Conclusions COVID-19 infections and deaths among HCWs follow that of the general population around the world. The reasons for gender and specialty differences require further exploration, as do the low rates reported in Africa and India. Although physicians working in certain specialities may be considered high risk due to exposure to oronasal secretions, the risk to other specialities must not be underestimated. Elderly HCWs may require assigning to less risky settings such as telemedicine or administrative positions. Our pragmatic approach provides general trends, and highlights the need for universal guidelines for testing and reporting of infections in HCWs.
- review
- infections
- diseases
- disorders
- injuries
- public health
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Footnotes
Handling editor Soumyadeep Bhaumik
Twitter @SohamBGlobal, @ronibats, @Zwl21, @OsaidalserMD, @RafaPinedo_HE, @robakhundkar
Contributors RK is the guarantor. RK and SB conceived the project. SB, RK, and AJ contributed equally to the design of the project. All authors contributed to the collection of the data. SB, REB, MA, DKO, YB, AK, SAP, GB, DK, SC, MK, AJ, AM and RK drafted the manuscript. All remaining authors extensively reviewed the manuscript. All authors have approved the final manuscript and are willing to take responsibility for appropriate portions of the content.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
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Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available on request. All data relevant to the study are included in the article or uploaded as supplementary information. Any further data are available on request.
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