Impact of the COVID-19 Pandemic on Healthcare Workers Risk of Infection and Outcomes in a Large, Integrated Health System

Overview

Journal Res Sq

Date 2020 Aug 26

PMID 32839766

Citations 1

Authors

Anita D Misra-Hebert

Lara Jehi

Xinge Ji

Amy S Nowacki

Steven Gordon

Paul Terpeluk

Mina K Chung

Reena Mehra

Katherine M Dell

Nathan Pennell

Aaron Hamilton

Alex Milinovich

Michael W Kattan

James B Young

Affiliations

Soon will be listed here.

Abstract

Understanding the impact of the COVID-19 pandemic on healthcare workers (HCW) is crucial. Utilizing a health system COVID-19 research registry, we assessed HCW risk for COVID-19 infection, hospitalization and intensive care unit (ICU) admission. Retrospective cohort study with overlap propensity score weighting. 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. SARS-CoV-2 test result, hospitalization, and ICU admission for COVID-19 infection. Of 72,909 individuals tested, 9.0% (551) of 6,145 HCW tested positive for SARS-CoV-2 compared to 6.5% (4353) of 66,764 non-HCW. The HCW were younger than 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). 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.

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