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Infection and mortality of healthcare workers worldwide from COVID-19: a scoping review (lay summary)

This is a lay summary of the research article published under the DOI: 10.1101/2020.06.04.20119594

Published onApr 06, 2023
Infection and mortality of healthcare workers worldwide from COVID-19: a scoping review (lay summary)
·

Abstract

Objectives To estimate COVID-19 infections and deaths in healthcare workers (HCWs) from a global perspective.

Design Scoping review.

Methods

Two parallel searches of academic bibliographic databases and grey literature were undertaken. Governments were also contacted for further information where possible. Due to the time-sensitive nature of the review and the need to report the most up-to-date information for an ever-evolving situation, there were no restrictions on language, information sources utilised, publication status, and types of sources of evidence. The AACODS checklist was 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%) and nurses (38.6%), but deaths were mainly in men (70.8%) and doctors (51.4%). Limited data suggested that general practitioners and mental health nurses were the highest risk specialities for deaths. There were 37.17 deaths reported per 100 infections for healthcare workers aged over 70. Europe had the highest absolute numbers of reported infections (119628) and deaths (712), but the Eastern Mediterranean region had the highest number of reported deaths per 100 infections (5.7).

Conclusions

HCW COVID-19 infections and deaths follow that of the general world population. The reasons for gender and speciality differences require further exploration, as do the low rates reported from 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.

Lay summary

Title

Healthcare workers, general practitioners hardest hit by COVID-19

Brief summary of the what & so what (result and why it matters) [+- 20 words]

In the devastating COVID-19 pandemic, healthcare workers across the world put their own lives at risk to save others. This study is the first to assess just how badly the healthcare profession has been hit by the pandemic, and the professionals most at risk for infection and death.

Why was this study done? (problem statement and background)

From a cluster of patients with pneumonia symptoms linked to a wet market in Wuhan, China, in late December 2019, the coronavirus disease (COVID-19) has rapidly evolved into a full-blown global pandemic. At the time of this study, May 2020, over five million people had been infected, and more than 300,000 people had died.

On the frontlines of this global crisis are healthcare workers (HCWs) who diagnose and treat a growing number of acutely ill patients, often having to make critical decisions under intense physical and psychological pressure. This has put HCWs at considerable risk of infection and death, but the exact numbers of those affected were unknown.

What was the purpose of this study? (Aims and objectives)

This study therefore estimated the global numbers of COVID-19 infections and cases of death in HCWs.

What did the researchers do (summary or overview of methods, the big picture)

The researchers looked for data in academic literature and a mix of other sources (known as grey literature), which included government-provided data from all over the world, news media websites, and preprints on the medRxiv website.

What were the results of the study?

The study found that 152 888 HCW had been infected with COVID-19, and 1413 had died from the disease. Infections were mainly in women (71.6%) and nurses (38.6%), but deaths were mainly in men (70.8%) and doctors (51.4%). 

Within the data available, the study found that general practitioners (GPs) were at the highest risk of death amongst doctors, while the highest risk of death in nursing was in the mental health sectors. 

How do these findings add to what was already known? (impact on the current science)

As far as the researchers know, this is the first study to examine COVID-19 infection and death amongst HCWs globally.

What are the potential weaknesses/uncertainties/controversies of the study? (If the paper talks about them at all, but most important for where they mention where future research is needed, or where the data was lacking)

Their work is however limited by the data available which included a wide range of data sources that made it difficult to compare. Different countries were also at different stages of their epidemics when they collected data.

“How will these findings help solve a challenge in Africa?” (question speaking to the impact of the research on society as a whole, outside of the scientific community).

COVID-19 infections and deaths in healthcare workers follow that of the general world population. The reasons for gender and speciality differences require further exploration, as do the low rates reported from Africa and India.

Number of words:

Glossary terms for translation and coining:

  1. COVID-19: An infectious disease that affects the respiratory (breathing system). It is caused by the SARS-CoV-2 virus that was first detected in Wuhan, China in 2019.

  2. Pandemic: A disease that can be found all over a country, large parts of the earth or all over the world. Related to “epidemic”, which is a widespread occurrence of a disease in a community at a particular time.

  3. Diagnosis: Medical diagnosis is the process of determining which disease or condition explains a person's symptoms and signs.

Other keywords for ease of understanding:

  1. Scoping review: A scoping review is a relatively new approach to evidence synthesis and differs from systematic reviews in its purpose and aims. The purpose of a scoping review is to provide an overview of the available research evidence without producing a summary answer to a discrete research question.

  2. oronasal secretions: this just means the mucus and saliva secreted from the mouth (oro-) and the nose (nasal).


Final summary for translation
Title

Healthcare workers, general practitioners hardest hit by COVID-19

In the devastating COVID-19 pandemic, healthcare workers across the world put their own lives at risk to save others. This study is the first to assess just how badly the healthcare profession has been hit by the pandemic, and the professionals most at risk for infection and death.

From a cluster of patients with pneumonia symptoms linked to a wet market in Wuhan, China, in late December 2019, the coronavirus disease (COVID-19) has rapidly evolved into a full-blown global pandemic. At the time of this study, May 2020, over five million people had been infected, and more than 300,000 people had died.

On the frontlines of this global crisis are healthcare workers (HCWs) who diagnose and treat a growing number of acutely ill patients, often having to make critical decisions under intense physical and psychological pressure. This has put HCWs at considerable risk of infection and death, but the exact numbers of those affected were unknown.

This study therefore estimated the global numbers of COVID-19 infections and cases of death in HCWs.

The researchers looked for data in academic literature and a mix of other sources (known as grey literature), which included government-provided data from all over the world, news media websites, and preprints on the medRxiv website.

The study found that 152 888 HCW had been infected with COVID-19, and 1413 had died from the disease. Infections were mainly in women (71.6%) and nurses (38.6%), but deaths were mainly in men (70.8%) and doctors (51.4%). 

Within the data available, the study found that general practitioners (GPs) were at the highest risk of death amongst doctors, while the highest risk of death in nursing was in the mental health sectors. 

As far as the researchers know, this is the first study to examine COVID-19 infection and death amongst HCWs globally.

Their work is however limited by the data available which included a wide range of data sources that made it difficult to compare. Different countries were also at different stages of their epidemics when they collected data.

COVID-19 infections and deaths in healthcare workers follow that of the general world population. The reasons for gender and speciality differences require further exploration, as do the low rates reported from Africa and India.

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

AbstractObjectivesTo estimate COVID-19 infections and deaths in healthcare workers (HCWs) from a global perspective.DesignScoping review.MethodsTwo parallel searches of academic bibliographic databases and grey literature were undertaken. Governments were also contacted for further information where possible. Due to the time-sensitive nature of the review and the need to report the most up-to-date information for an ever-evolving situation, there were no restrictions on language, information sources utilised, publication status, and types of sources of evidence. The AACODS checklist was used to appraise each source of evidence.Outcome measuresPublication characteristics, country-specific data points, COVID-19 specific data, demographics of affected HCWs, and public health measures employedResultsA total of 152,888 infections and 1413 deaths were reported. Infections were mainly in women (71.6%) and nurses (38.6%), but deaths were mainly in men (70.8%) and doctors (51.4%). Limited data suggested that general practitioners and mental health nurses were the highest risk specialities for deaths. There were 37.17 deaths reported per 100 infections for healthcare workers aged over 70. Europe had the highest absolute numbers of reported infections (119628) and deaths (712), but the Eastern Mediterranean region had the highest number of reported deaths per 100 infections (5.7).ConclusionsHCW COVID-19 infections and deaths follow that of the general world population. The reasons for gender and speciality differences require further exploration, as do the low rates reported from 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.Summary BoxWhat is already known on this topicIn China, studies documented over 3,300 confirmed cases of infected healthcare workers in early March. In the United States, as high as 19% of patients had been identified as healthcare workers. There are no studies that perform a global examination of COVID-19 infections and deaths in the health workforce.What this study addsTo our knowledge, this is the first study assessing the number of healthcare workers who have been infected with or died from COVID-19 globally. The data from our study suggest that although infections were mainly in women and nurses, COVID-19 related deaths were mainly in men and doctors; in addition, our study found that Europe had the highest numbers of infection and death, but the lowest case-fatality-rate, while the Eastern Mediterranean had the highest case-fatality-rate.

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