BMJ Global Health (Dec 2020)
Infection and mortality of healthcare workers worldwide from COVID-19: a systematic review
- Rafael Pinedo-Villanueva,
- Murtaza Kadhum,
- Noel Peter,
- Roba Khundkar,
- Abdullah Saleh,
- Archith Kamath,
- Anant Jani,
- Zara Markovic-Obiago,
- Zoe Li,
- Soham Bandyopadhyay,
- Ronnie E Baticulon,
- Muath Alser,
- Daniel K Ojuka,
- Yara Badereddin,
- Sai Arathi Parepalli,
- Grace Brown,
- Sara Iharchane,
- Sofia Gandino,
- Samuel Scott,
- Emery Manirambona,
- Asif Machhada,
- Aditi Aggarwal,
- Lydia Benazaize,
- Mina Ibrahim,
- David Kim,
- Isabel Tol,
- Elliott H Taylor,
- Alexandra Knighton,
- Dorothy Bbaale,
- Duha Jasim,
- Heba Alghoul,
- Henna Reddy,
- Hibatullah Abuelgasim,
- Kirandeep Saini,
- Alicia Sigler,
- Leenah Abuelgasim,
- Mario Moran-Romero,
- Mary Kumarendran,
- Najlaa Abu Jamie,
- Omaima Ali,
- Raghav Sudarshan,
- Riley Dean,
- Sonam Kelzang,
- Sophie Roche,
- Tazin Ahsan,
- Yethrib Mohamed,
- Andile Maqhawe Dube,
- Grace Paida Gwini,
- Rashidah Gwokyala,
- Robin Brown,
- Mohammad Rabiul Karim Khan Papon,
- Salvador Sun Ruzats,
- Somy Charuvila,
- Khalil Khalidy,
- Nkosikhona Moyo,
- Osaid Alser,
- Arielis Solano,
- Eduardo Robles-Perez,
- Aiman Tariq,
- Mariam Gaddah,
- Spyros Kolovos,
- Faith C Muchemwa,
- Amanda Gosman,
- Rumi Kisyova
Affiliations
- Rafael Pinedo-Villanueva
- Centre for Statistics in Medicine, University of Oxford, Oxford, Oxfordshire, UK
- Murtaza Kadhum
- core surgical trainee
- Noel Peter
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, Oxfordshire, UK
- Roba Khundkar
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, Oxfordshire, UK
- Abdullah Saleh
- Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
- Archith Kamath
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, Oxfordshire, UK
- Anant Jani
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, Oxfordshire, UK
- Zara Markovic-Obiago
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, Oxfordshire, UK
- Zoe Li
- Swansea Bay University Health Board, Port Talbot, Neath Port Talbot, UK
- Soham Bandyopadhyay
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, Oxfordshire, UK
- Ronnie E Baticulon
- Philippine General Hospital, University of the Philippines Manila College of Medicine, Manila, Metro Manila, The Philippines
- Muath Alser
- Kasr Al Ainy School of Medicine, Cairo University Kasr Alainy Faculty of Medicine, Cairo, Egypt
- Daniel K Ojuka
- Department of Surgery, University of Nairobi College of Health Sciences, Nairobi, Kenya
- Yara Badereddin
- Faculty of Pharmacy, Al Azhar University-Gaza, Gaza, State of Palestine
- Sai Arathi Parepalli
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, Oxfordshire, UK
- Grace Brown
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, Oxfordshire, UK
- Sara Iharchane
- Dipartimento di medicina clinica e sperimentale, University of Insubria, Varese, Lombardia, Italy
- Sofia Gandino
- Dipartimento di medicina clinica e sperimentale, University of Insubria, Varese, Lombardia, Italy
- Samuel Scott
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, Oxfordshire, UK
- Emery Manirambona
- University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda
- Asif Machhada
- North Bristol NHS Trust, Westbury on Trym, Bristol, UK
- Aditi Aggarwal
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, Oxfordshire, UK
- Lydia Benazaize
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, Oxfordshire, UK
- Mina Ibrahim
- North Bristol NHS Trust, Westbury on Trym, Bristol, UK
- David Kim
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, Oxfordshire, UK
- Isabel Tol
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, Oxfordshire, UK
- Elliott H Taylor
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, Oxfordshire, UK
- Alexandra Knighton
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, Oxfordshire, UK
- Dorothy Bbaale
- Mbarara University of Science and Technology, Mbarara, Mbarara, Uganda
- Duha Jasim
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, Oxfordshire, UK
- Heba Alghoul
- Islamic University of Gaza, Gaza, State of Palestine
- Henna Reddy
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, Oxfordshire, UK
- Hibatullah Abuelgasim
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, Oxfordshire, UK
- Kirandeep Saini
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, Oxfordshire, UK
- Alicia Sigler
- Shriners Ambulatory Clinic, Tijuana, Mexico
- Leenah Abuelgasim
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, Oxfordshire, UK
- Mario Moran-Romero
- Department of Plastic Surgery, Hospital General Dr. Manuel Gea Gonzalez, National Autonomous University of Mexico, Mexico City, Mexico
- Mary Kumarendran
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, Oxfordshire, UK
- Najlaa Abu Jamie
- Palestinian Ministry of Health, Gaza, State of Palestine
- Omaima Ali
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, Oxfordshire, UK
- Raghav Sudarshan
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, Oxfordshire, UK
- Riley Dean
- University of California San Diego, La Jolla, California, USA
- Sonam Kelzang
- Gelephu Central Regional Referral Hospital, Gelephu, Bhutan
- Sophie Roche
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, Oxfordshire, UK
- Tazin Ahsan
- Sheikh Hasina National Institute of Burn and Plastic Surgery, Dhaka, Bangladesh
- Yethrib Mohamed
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, Oxfordshire, UK
- Andile Maqhawe Dube
- National University of Science and Technology Faculty of Medicine, Bulawayo, Zimbabwe
- Grace Paida Gwini
- National University of Science and Technology Faculty of Medicine, Bulawayo, Zimbabwe
- Rashidah Gwokyala
- Gulu University Faculty of Medicine, Gulu, Uganda
- Robin Brown
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, Oxfordshire, UK
- Mohammad Rabiul Karim Khan Papon
- Sheikh Hasina National Institute of Burn and Plastic Surgery, Dhaka, Bangladesh
- Salvador Sun Ruzats
- University of Huddersfield, Huddersfield, Kirklees, UK
- Somy Charuvila
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, Oxfordshire, UK
- Khalil Khalidy
- Islamic University of Gaza, Gaza, State of Palestine
- Nkosikhona Moyo
- National University of Science and Technology Faculty of Medicine, Bulawayo, Zimbabwe
- Osaid Alser
- Oxford University Global Surgery Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, Oxfordshire, UK
- Arielis Solano
- ConnectMed International, Dominican Republic, Dominican Republic
- Eduardo Robles-Perez
- Instituto Mexicano del Seguro Social, Ciudad de Mexico, Mexico
- Aiman Tariq
- Jinnah Post Graduate Medical Centre, Karachi, Pakistan
- Mariam Gaddah
- Lancaster Medical School, Lancaster University, Lancaster, Lancashire, UK
- Spyros Kolovos
- Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, Oxford University, Oxford, Oxfordshire, UK
- Faith C Muchemwa
- Parirenyatwa Hospital, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
- Amanda Gosman
- Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
- Rumi Kisyova
- North Bristol NHS Trust, Westbury on Trym, Bristol, UK
- DOI
- https://doi.org/10.1136/bmjgh-2020-003097
- Journal volume & issue
-
Vol. 5,
no. 12
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.
