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Observational Study
. 2022 Dec;115(12):467-478.
doi: 10.1177/01410768221107119. Epub 2022 Jul 7.

SARS-CoV-2 infection risk among 77,587 healthcare workers: a national observational longitudinal cohort study in Wales, United Kingdom, April to November 2020

Joe Hollinghurst  1 , Laura North  1 , Tamas Szakmany  2 , Richard Pugh  3 , Gwyneth A Davies  1 , Shanya Sivakumaran  1 , Rebecca Jarvis  4 , Martin Rolles  5 , W Owen Pickrell  6 , Ashley Akbari  1 , Gareth Davies  1 , Rowena Griffiths  1 , Jane Lyons  1 , Fatemeh Torabi  1 , Richard Fry  1 , Mike B Gravenor  7 , Ronan A Lyons  1
Affiliations
Observational Study

SARS-CoV-2 infection risk among 77,587 healthcare workers: a national observational longitudinal cohort study in Wales, United Kingdom, April to November 2020

Joe Hollinghurst et al. J R Soc Med. 2022 Dec.

Abstract

Objectives: To better understand the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among healthcare workers, leading to recommendations for the prioritisation of personal protective equipment, testing, training and vaccination.

Design: Observational, longitudinal, national cohort study.

Setting: Our cohort were secondary care (hospital-based) healthcare workers employed by NHS Wales (United Kingdom) organisations from 1 April 2020 to 30 November 2020.

Participants: We included 577,756 monthly observations among 77,587 healthcare workers. Using linked anonymised datasets, participants were grouped into 20 staff roles. Additionally, each role was deemed either patient-facing, non-patient-facing or undetermined. This was linked to individual demographic details and dates of positive SARS-CoV-2 PCR tests.

Main outcome measures: We used univariable and multivariable logistic regression models to determine odds ratios (ORs) for the risk of a positive SARS-CoV-2 PCR test.

Results: Patient-facing healthcare workers were at the highest risk of SARS-CoV-2 infection with an adjusted OR (95% confidence interval [CI]) of 2.28 (95% CI 2.10-2.47). We found that after adjustment, foundation year doctors (OR 1.83 [95% CI 1.47-2.27]), healthcare support workers [OR 1.36 [95% CI 1.20-1.54]) and hospital nurses (OR 1.27 [95% CI 1.12-1.44]) were at the highest risk of infection among all staff groups. Younger healthcare workers and those living in more deprived areas were at a higher risk of infection. We also observed that infection rates varied over time and by organisation.

Conclusions: These findings have important policy implications for the prioritisation of vaccination, testing, training and personal protective equipment provision for patient-facing roles and the higher risk staff groups.

Keywords: COVID-19; SARS-CoV-2; healthcare workers; infection risk; public health.

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Figures

Figure 1.
Figure 1.
CONSORT diagram for study size and cohort linkage.
Figure 2.
Figure 2.
(top) Number of healthcare workers and those testing positive for SARS-CoV-2. (bottom) Percentage of healthcare workers testing positive (combined) with stratifications for patient-facing status (patient-facing, non-patient-facing, undetermined). For illustrative purposes, where exact counts were masked or omitted in July and August a value of 0% was used.
See this image and copyright information in PMC

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