Occupational risk: COVID-19 infection among health workers is greater in general wards than in intensive care units

By Geisa Sant Ana, PhD student, Professor at Escola Superior de Ciências da Saúde (ESCS), Águas Claras, Brasília, DF, Brazil

A health care research team working in teaching and research institutions analyzed studies conducted in a number of countries and published in the journal Acta Paulista de Enfermagem (vol. 33) the paper entitled “Infection and death in healthcare workers due to COVID-19: a systematic review”. The aim of the study was to evaluate reasons for infection and death of health professionals who provided care for COVID-19 patients. The study evaluated also possible solution to reduce dissemination of the virus within the hospital environment.

A searching was conducted in the following databases: SCOPUS, VHL Regional Portal, PubMed and Embase, considering published literature up to Abril 14, 2020. Corpus of this study was composed by 28 articles. Results showed a greater infection rate among health professionals working on general wards (77%) than those working on ICUs (5%) – where the risk is known to be greater due to invasive procedures and nebulizer treatment that contribute for aerosol-based transmission of COVID-19. Among risk factors for contagious authors identified the scarcity of PPE, the insufficient ability of health care workers to adopt adequate using of protective measures, and work overload. Overload of health system was also linked to these risk factors given that hospitals did not have enough PPE and workforce.

Image: VitalikRadko.

Other relevant risk factors were poor hand hygiene, close contact with potentially infected patients/coworkers, work overload that led to greater length of stay in an environment with high viral load, risk for aerosol-generating procedures, late diagnosis of COVID-19, and inadequate air renovation in negative pressure room. The method used was a systematic review that responds to a clear question, defines a searching strategy, inclusion and exclusion criteria, and statistically compares all data. This type of study aims at summarizing evidences on a topic by collecting what have been published on specific topics, and its main goal is to help and provide evidences for health professionals daily routine.

Data of infection and deaths of health care professionals due to COVID-19 are related to initial period of the pandemic characterized by an outbreak of acute respiratory failure that emerged in December 2019 in Wuhan, China, which was declared by the World Health Organization as pandemic in March 11, 2020 after the virus spread rapidly in European and American countries. Conclusions of this investigation are related to studies conducted in China, the United States, Italy, Australia, United Kingdom, Singapore, Sweden, and Thailand. According to each country, the number of infected workers ranged from 1,716 to 17,306. Concerning deaths, there are data of up to 605 healthcare workers who died of COVID-19 all over the world. Evidences found were editorials, cross-sectional, and cohort studies.

References

FERIOLI, M., et al. Protecting healthcare workers from SARS-CoV-2 infection: practical indications. European Respiratory Review [online]. 2020, vol. 29, no. 157, 190142, ISSN: 1600-0617 [viewed 09 October 2020]. DOI: 10.1183/16000617.0068-2020. Available from: https://err.ersjournals.com/content/29/155/200068

YE, G., et al. Environmental contamination of SARS-CoV-2 in healthcare premises. Journal of Infection [online]. 2020, vol. 81, no. 2, pp. e1-e5, ISSN: 0163-4453 [viewed 09 October 2020]. DOI: 10.1016/j.jinf.2020.04.034. Available from: https://www.sciencedirect.com/science/article/pii/S0163445320302607

WANG, J., ZHOU, M. and LIU, F. Reasons for healthcare workers becoming infected with novel coronavirus disease 2019 (COVID-19) in China. J Hosp infect [online]. 2020, vol. 105, no. 1, pp. 100-101, ISSN: 0195-6701 [viewed 09 October 2020]. DOI: 10.1016/j.jhin.2020.03.002. Available from: https://www.journalofhospitalinfection.com/article/S0195-6701(20)30101-8/fulltext

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