Infection and mortality of healthcare workers worldwide from COVID-19: a systematic review
Soham Bandyopadhyay, Ronnie E. Baticulon, Murtaza Kadhum, Muath Alser, Daniel Ojuka, Yara Badereddin, Archith Kamath, Sai Arathi Parepalli, Grace Brown, Sara Iharchane, Sofia Gandino, Zara Markovic-Obiago, Samuel Scott, Emery Manirambona, Asif Machhada, Aditi Aggarwal, Lydia Benazaize, Mina Ibrahim, David Kim, Isabel Tol, Elliott H Taylor, A. Knighton, Dorothy Bbaale, Duha Jasim, Heba Alghoul, Henna Reddy, Hibatullah Abuelgasim, Kiran Saini, Alicia Sigler, Leenah Abuelgasim, Mario Moran-Romero, Mary Kumarendran, Najlaa Abu Jamie, Omaima Ali, Raghav Sudarshan, Riley A. Dean, Rumi Kisyova, Sonam Kelzang, Sophie Roche, Tazin Ahsan, Yethrib Mohamed, Andile Dube, Grace Paidamoyo Gwini, Rashidah Gwokyala, Robin Brown, M. R. Khan, Zoe Li, Salvador Sun Ruzats, Somy Charuvila, Noel Peter, Khalil Khalidy, Nkosikhona Moyo, Osaid Alser, Arielis Solano, Eduardo Robles‐Pérez, Aiman Tariq, Mariam Gaddah, Spyros Kolovos, Faith C. Muchemwa, Abdullah Saleh, Amanda A. Gosman, Rafael Pinedo‐Villanueva, Anant Jani, Roba Khundkar
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.