Disease severity of COVID-19 in different phases of the pandemic: Do healthcare workers have better outcomes?
Xueying Yang,
Fanghui Shi,
Jiajia Zhang,
Haoyuan Gao,
Shujie Chen,
Bankole Olatosi,
Sharon Weissman,
Xiaoming Li
Affiliations
Xueying Yang
South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; Corresponding author at: Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA.
Fanghui Shi
South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
Jiajia Zhang
South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
Haoyuan Gao
South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
Shujie Chen
South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
Bankole Olatosi
South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
Sharon Weissman
South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; Department of Internal Medicine, School of Medicine, University of South Carolina, Columbia, SC 29208, USA
Xiaoming Li
South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
Background: This study aimed to characterize and compare the demographics, clinical profile, and COVID-19 outcomes between healthcare workers (HCWs) and non-HCWs COVID-19 patients diagnosed in different phases of the pandemic defined by the vaccine rollout policy and different variants that circulated in South Carolina (SC). Methods: Extracted from the statewide electronic health record data, we analyzed the clinical outcome of 34,502 HCWs and 1,071,020 non-HCWs adults diagnosed with SARS-CoV-2 between March 2, 2020 to April 14, 2022. Logistic regression models were used to explore the association between different pandemic phases and COVID-19 severity-related outcomes. Results: Substantial reductions in mortality were observed following the vaccine rollout in non-HCWs and HCWs. Compared to the pre-vaccination period, non-HCWs patients diagnosed during post-vaccination with Alpha predominance (adjusted odds ratio [aOR]: 1.10; 95%CI: 1.04–1.16) were more likely to be hospitalized, but the reduced mortality rates were observed in all post-vaccination periods. Regarding HCWs, a reduced mortality rate was only observed in the pre-Alpha (aOR: 0.33; 95%CI: 0.13–0.84) and Omicron periods (aOR: 0.21; 95%CI: 0.05–0.89). Conclusions: The declining protection effect of vaccines informs the importance of early promotion of the booster dose of the COVID-19 vaccine for HCWs who have more occupational exposure.
