COVID-19 in healthcare workers: A review of existing literature

Background: Healthcare workers (HCWs) are particularly at a risk of acquiring COVID-19 infection. The pattern of disease and outcome in HCWs has not been studied adequately. This review was done to determine the prevalence of COVID-19 in HCWs and to find out the clinical profile and mortality of COVID-19 in HCWs. Materials and Methods: A systematic search of all published or in press studies from January 1, 2020, to July 15, 2020, with confirmed COVID-19 HCWs was done in PubMed, Scopus, and Google Scholar and in other key journals using terms such as "2019-nCoV," "novel coronavirus 2019," "COVID-19," "SARS-CoV-2," "Wuhan coronavirus," "health care worker," "health care professional," "physician," and "medical staff." Results: We analyzed 43 research articles, mostly cross-sectional studies with 20 studies from China, and included 13,725 COVID-19-positive HCWs. Proportion of COVID-19-positive HCWs (n = 8405) among all HCWs (n = 276,392) were 3.04% (95% confidence interval [CI]: 0.62-9.76), while the proportion of positive HCWs (n = 9458) among all COVID-19-positive patients (n = 230,626) were 4.1% (95% CI: 1.44-12.46). The mean age of HCWs was 42.78 +/- 6.82 years, 34.47% were males, and 51.04% were nurses. Most COVID-19-positive HCWs were asymptomatic (64.41%), while severe disease occurred in 4.08% with a mortality of 0.80% (47/5823). The incidence of severe disease and mortality among HCWs (n = 9458) and general population (n = 230,626) was extracted from nine studies, and it was seen that severe disease (1.7%) or mortality (0.04%) in HCWs was significantly less as compared to non-HCWs population (8.26% and 1.23%, respectively) (P < 0.001). Conclusion: There is a considerable risk of contracting COVID-19 infection among HCWs which re-emphasizes the strong need of personal protective measures. However, the incidence of severe disease and deaths is significantly low among HCWs, which may somewhat reduce apprehension and be morale boosting for HCWs all across the world.