Erschienen in:
01.09.2020 | COVID-19 | Original Research
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Impact of the COVID-19 Pandemic on Healthcare Workers’ Risk of Infection and Outcomes in a Large, Integrated Health System
verfasst von:
Anita D. Misra-Hebert, MD, MPH, Lara Jehi, MD, MHCDS, Xinge Ji, MS, Amy S. Nowacki, PhD, Steven Gordon, MD, Paul Terpeluk, DO, Mina K. Chung, MD, Reena Mehra, MD, Katherine M. Dell, MD, Nathan Pennell, MD, PhD, Aaron Hamilton, MD, MBA, Alex Milinovich, BA, Michael W. Kattan, PhD, James B. Young, MD
Erschienen in:
Journal of General Internal Medicine
|
Ausgabe 11/2020
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Abstract
Background
Understanding the impact of the COVID-19 pandemic on healthcare workers (HCW) is crucial.
Objective
Utilizing a health system COVID-19 research registry, we assessed HCW risk for COVID-19 infection, hospitalization, and intensive care unit (ICU) admission.
Design
Retrospective cohort study with overlap propensity score weighting.
Participants
Individuals tested for SARS-CoV-2 infection in a large academic healthcare system (N = 72,909) from March 8–June 9, 2020, stratified by HCW and patient-facing status.
Main Measures
SARS-CoV-2 test result, hospitalization, and ICU admission for COVID-19 infection.
Key Results
Of 72,909 individuals tested, 9.0% (551) of 6145 HCW tested positive for SARS-CoV-2 compared to 6.5% (4353) of 66,764 non-HCW. The HCW were younger than the non-HCW (median age 39.7 vs. 57.5, p < 0.001) with more females (proportion of males 21.5 vs. 44.9%, p < 0.001), higher reporting of COVID-19 exposure (72 vs. 17%, p < 0.001), and fewer comorbidities. However, the overlap propensity score weighted proportions were 8.9 vs. 7.7 for HCW vs. non-HCW having a positive test with weighted odds ratio (OR) 1.17, 95% confidence interval (CI) 0.99–1.38. Among those testing positive, weighted proportions for hospitalization were 7.4 vs. 15.9 for HCW vs. non-HCW with OR of 0.42 (CI 0.26–0.66) and for ICU admission: 2.2 vs. 4.5 for HCW vs. non-HCW with OR of 0.48 (CI 0.20–1.04). Those HCW identified as patient facing compared to not had increased odds of a positive SARS-CoV-2 test (OR 1.60, CI 1.08–2.39, proportions 8.6 vs. 5.5), but no statistically significant increase in hospitalization (OR 0.88, CI 0.20–3.66, proportions 10.2 vs. 11.4) and ICU admission (OR 0.34, CI 0.01–3.97, proportions 1.8 vs. 5.2).
Conclusions
In a large healthcare system, HCW had similar odds for testing SARS-CoV-2 positive, but lower odds of hospitalization compared to non-HCW. Patient-facing HCW had higher odds of a positive test. These results are key to understanding HCW risk mitigation during the COVID-19 pandemic.