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. 2020 Dec;5(12):e003097.
doi: 10.1136/bmjgh-2020-003097.

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

Soham Bandyopadhyay  1 , Ronnie E Baticulon  2 , Murtaza Kadhum  1 , Muath Alser  3 , Daniel K Ojuka  4 , Yara Badereddin  5 , Archith Kamath  1 , Sai Arathi Parepalli  1 , Grace Brown  1 , Sara Iharchane  6 , Sofia Gandino  6 , Zara Markovic-Obiago  1 , Samuel Scott  1 , Emery Manirambona  7 , Asif Machhada  8 , Aditi Aggarwal  1 , Lydia Benazaize  1 , Mina Ibrahim  8 , David Kim  1 , Isabel Tol  1 , Elliott H Taylor  1 , Alexandra Knighton  1 , Dorothy Bbaale  9 , Duha Jasim  1 , Heba Alghoul  10 , Henna Reddy  1 , Hibatullah Abuelgasim  1 , Kirandeep Saini  1 , Alicia Sigler  11 , Leenah Abuelgasim  1 , Mario Moran-Romero  12 , Mary Kumarendran  1 , Najlaa Abu Jamie  13 , Omaima Ali  1 , Raghav Sudarshan  1 , Riley Dean  14 , Rumi Kissyova  8 , Sonam Kelzang  15 , Sophie Roche  1 , Tazin Ahsan  16 , Yethrib Mohamed  1 , Andile Maqhawe Dube  17 , Grace Paida Gwini  17 , Rashidah Gwokyala  18   19 , Robin Brown  1 , Mohammad Rabiul Karim Khan Papon  16 , Zoe Li  20 , Salvador Sun Ruzats  21 , Somy Charuvila  1 , Noel Peter  1 , Khalil Khalidy  10 , Nkosikhona Moyo  17 , Osaid Alser  1   22 , Arielis Solano  23 , Eduardo Robles-Perez  24 , Aiman Tariq  25 , Mariam Gaddah  26 , Spyros Kolovos  27 , Faith C Muchemwa  28 , Abdullah Saleh  29   30 , Amanda Gosman  29 , Rafael Pinedo-Villanueva  31   32 , Anant Jani  1 , Roba Khundkar  33   8
Affiliations

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

Soham Bandyopadhyay et al. BMJ Glob Health. 2020 Dec.

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.

Keywords: diseases; disorders; infections; injuries; public health; review.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Review and Meta-Analyses flow chart of the source selection process.
Figure 2
Figure 2
Summary of quality assessments of all 594 sources. NIH, National Institutes of Health.
Figure 3
Figure 3
Cumulative number of reported COVID-19 infections in healthcare workers worldwide over time and total number of reported cases of COVID-19 infections in healthcare workers worldwide on 8 May 2020.
Figure 4
Figure 4
Cumulative number of reported COVID-19 deaths in healthcare workers worldwide and total number of reported cases of COVID-19 deaths in healthcare workers worldwide.
Figure 5
Figure 5
COVID-19 infections (A) and deaths (B) in healthcare workers in WHO regions.
Figure 6
Figure 6
Number of reported healthcare worker infections and deaths due to COVID-19 per country up to 8 May 2020.
See this image and copyright information in PMC

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