COVID-19 pandemic-related mortality, infection, symptoms, complications, comorbidities, and other aspects of physical health among healthcare workers globally: An umbrella review

Abstract

Background: The COVID-19 pandemic has continued to cause unprecedented concern across the globe since the beginning of the outbreak. Healthcare workers, particularly those working on the front line, remain one of the most affected groups. Various studies have investigated different aspects of the physical health of healthcare workers; however, limited evidence on the overall physical health of healthcare workers has been collectively examined.

Aim: To examine the various aspects of physical health and well-being of healthcare workers during the COVID-19 pandemic.

Design: An umbrella review.

Methods: We conducted a comprehensive literature search on Academic Search Premier, CINAHL, Cochrane Library and MEDLINE and supplemented the search with Google Scholar. Key terms related to 'COVID-19', 'physical health', 'healthcare worker' and 'systematic review' were used in the search. Systematic reviews with or without meta-analyses were included if they were published in the English language, could be obtained in full-text format, and assessed the physical health impacts of the COVID-19 pandemic on healthcare workers were included. The methodological quality of eligible studies was assessed using the Joanna Briggs Institute's checklist for systematic reviews. The data were narratively synthesised in line with the 'Synthesis Without Meta-analysis' guideline.

Results: Thirteen systematic reviews (represented as K = 13) that synthesized data from 1230 primary studies/reports and 1,040,336 participants met the inclusion criteria. The findings indicate a death rate of between 0.3 and 54.2 per 100 infections (K = 4). The overall case-fatality rate was estimated to be 0.87% (approximately 9 deaths per 1000 infections, K = 3). The overall infection rate among healthcare workers ranged from 3.9% to 11% (K = 5), with the highest rate associated with healthcare workers involved in screening. Considering geographic regions, the highest number of infections was reported in Europe (78.2% of 152,888 infected healthcare workers, K = 1). More nurses and female healthcare workers were infected, while deaths occurred mainly among men and medical doctors. The commonly reported symptoms included cough (56-80%, K = 3), fever (57-85%, K = 3), and headache (7-81%, K = 3), while hypertension was the most prevalent comorbidity (7%, K = 1). Additionally, a high prevalence of poor sleep quality (41-43%, K = 2), work-related stress (33-44.86%, K = 5) and personal protective equipment-associated skin injuries (48.2-97%, K = 2) affected the healthcare workers. The most reported preventive measures included laboratory testing, clinical diagnosis, adequate personal protective equipment, self-isolation, and training/orientation for infection control.

Conclusion: Healthcare workers experienced considerable COVID-19-related physical health issues, including mortalities. This requires targeted interventions and health policies to support healthcare workers worldwide to ensure timely management of the pandemic.

Tweetable abstract: This umbrella review highlights the global mortalities, infections, and other aspects of physical health of healthcare workers during the COVID-19 pandemic.

Keywords: COVID-19; Healthcare workers; Mortality; Review of review; Well-being.

Fig. 1

PRISMA flow chart indicating the study selection process.