Infection and mortality of healthcare workers worldwide from COVID-19 : A systematic review

Bandyopadhyay, S. and Baticulon, R.E. and Kadhum, M. and Alser, M. and Ojuka, D.K. and Badereddin, Y. and Kamath, A. and Parepalli, S.A. and Brown, G. and Iharchane, S. and Gandino, S. and Markovic-Obiago, Z. and Scott, S. and Manirambona, E. and Machhada, A. and Aggarwal, A. and Benazaize, L. and Ibrahim, M. and Kim, D. and Tol, I. and Taylor, E.H. and Knighton, A. and Bbaale, D. and Jasim, D. and Alghoul, H. and Reddy, H. and Abuelgasim, H. and Saini, K. and Sigler, A. and Abuelgasim, L. and Moran-Romero, M. and Kumarendran, M. and Jamie, N.A. and Ali, O. and Sudarshan, R. and Dean, R. and Kissyova, R. and Kelzang, S. and Roche, S. and Ahsan, T. and Mohamed, Y. and Dube, A.M. and Gwini, G.P. and Gwokyala, R. and Brown, R. and Papon, M.R.K.K. and Li, Z. and Ruzats, S.S. and Charuvila, S. and Peter, N. and Khalidy, K. and Moyo, N. and Alser, O. and Solano, A. and Robles-Perez, E. and Tariq, A. and Gaddah, M. and Kolovos, S. and Muchemwa, F.C. and Saleh, A. and Gosman, A. and Pinedo-Villanueva, R. and Jani, A. and Khundkar, R. (2020) Infection and mortality of healthcare workers worldwide from COVID-19 : A systematic review. BMJ Global Health, 5 (12): e003097. ISSN 2059-7908

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. © Author(s) (or their employer(s)) 2020.