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Meta-Analysis
. 2020 Sep;38(9):1727-1731.
doi: 10.1016/j.ajem.2020.05.113. Epub 2020 Jun 6.

COVID-19 in health care workers - A systematic review and meta-analysis

Ankit Kumar Sahu  1 , V T Amrithanand  2 , Roshan Mathew  1 , Praveen Aggarwal  1 , Jamshed Nayer  1 , Sanjeev Bhoi  1
Affiliations
Meta-Analysis

COVID-19 in health care workers - A systematic review and meta-analysis

Ankit Kumar Sahu et al. Am J Emerg Med. 2020 Sep.

Abstract

Background and objectives: It is essential to know the proportion of health care workers (HCW) who are COVID 19 positive, as well as the severity and mortality among them.

Methods: This systematic review was performed according to the Preferred Reporting Items for Systematic review and meta-analysis. Databases including PubMed, EMBASE and Web of Science were searched from December-31, 2019 to April-23, 2020. The search was limited to the studies that reported the data on the number of COVID-19 positive healthcare workers, among the COVID-19 positive patients. Case reports, duplicate publications, reviews, and family-based studies were excluded. The methodological quality of studies was assessed by the Appraisal tool for Cross-Sectional Studies (AXIS) tool.

Results: In this systematic review and meta-analysis, we pooled eleven studies to investigate the above factors. The overall proportion of HCW who were SARS-CoV-2 positive among all COVID-19 patients was 10.1% (95%CI: 5.3-14.9). This proportion varied according to the country of study i.e. China (7 studies) - 4.2%, 95%CI:2.4-6.0; United States (3 studies) - 17.8%, 95%CI:7.5-28.0; and Italy (1 study) - 9.0%, 95%CI:8.6-9.4. The incidence of severe or critical disease in HCW (9.9%, 95%CI:0.8-18.9) was significantly lower (p < 0.001) than the incidence of severe or critical disease in all COVID-19 positive patients (29.4%, 95%CI:18.6-40.2). Similarly, the mortality among HCW (0.3%, 95%CI:0.2-0.4) was also significantly lower (p < 0.001) as compared to that of all patients (2.3%, 95%CI:2.2-2.4).

Conclusion: Health care workers who are COVID-19 positive constituted a significant proportion of all COVID-19 patients; but the severity and mortality were lower among them.

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Conflict of interest statement

Declaration of competing interest The authors did not have any conflicts of interest.

Figures

Fig. 1
Fig. 1
Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) flow diagram.
Fig. 2
Fig. 2
Forest plot showing the overall proportion of health care workers infected with COVID-19 among all patients of COVID-19.
Fig. 3
Fig. 3
Infographic showing the overall proportion of health care workers (HCW) who were COVID-19 positive among all COVID-19 patients, and the proportion of severe disease and mortality in HCW and all patients.
Fig. S1
Fig. S1
Summary proportion of ‘severe or critically diseased’ HCW among all COVID-19 positive HCW.
Fig. S2
Fig. S2
Summary proportion of ‘severe or critically diseased’ patients among all COVID-19 positive patients.
Fig. S3
Fig. S3
Summary proportion of COVID-19 positive HCW ‘died’ among all COVID-19 positive HCW.
Fig. S4
Fig. S4
Summary proportion of COVID-19 positive patients ‘died’ among all COVID-19 positive patients.
See this image and copyright information in PMC

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