Infection and mortality of healthcare workers worldwide from COVID-19: a scoping review
Authors: Bandyopadhyay Soham , Baticulon Ronnie E , Kadhum Murtaza , Alser Muath , Ojuka Daniel K , Badereddin Yara , Kamath Archith , Parepalli Sai Arathi , Brown Grace , Iharchane Sara , Gandino Sofia , Markovic-Obiago Zara , Scott Samuel , Manirambona Emery , Machhada Asif , Aggarwal Aditi , Benazaize Lydia , Ibrahim Mina , Kim David , Tol Isabel , Taylor Elliott H , Knighton Alexandra , Bbaale Dorothy , Jasim Duha , Alghoul Heba , Reddy Henna , Abuelgasim Hibatullah , Sigler Alicia , Saini Kirandeep , Abuelgasim Leenah , Moran-Romero Mario , Kumarendran Mary , Jamie Najlaa Abu , Ali Omaima , Sudarshan Raghav , Dean Riley , Kisyova Rumi , Kelzang Sonam , Roche Sophie , Ahsan Tazin , Mohamed Yethrib , Dube Andile Maqhawe , Gwini Grace Paidamoyo , Gwokyalya Rashidah , Brown Robin , Papon Mohammad Rabiul Karim Khan , Li Zoe , Ruzats Salvador Sun , Charuvila Somy , Peter Noel , Khalidy Khalil , Moyo Nkosikhona , Alser Osaid , Solano Arielis , Robles-Perez Eduardo , Tariq Aiman , Gaddah Mariam , Kolovos Spyros , Muchemwa Faith C , Saleh Abdullah , Gosman Amanda , Pinedo-Villanueva Rafael , Jani Anant , Khundkar Roba 
Published: June 2020

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.

Summary Box

What is already known on this topic

In 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 adds

To 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.