Infection and mortality of healthcare workers worldwide from COVID-19: a systematic 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 , Saini Kirandeep , Sigler Alicia , 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 Paida , Gwokyala 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: December 2020

Objectives

To estimate COVID-19 infections and deaths in healthcare workers (HCWs) from a global perspective during the early phases of the pandemic.

Design

Systematic review.

Methods

Two parallel searches of academic bibliographic databases and grey literature were undertaken until 8 May 2020. Governments were also contacted for further information where possible. There were no restrictions on language, information sources used, publication status and types of sources of evidence. The AACODS checklist or the National Institutes of Health study quality assessment tools were 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%, n=14 058) and nurses (38.6%, n=10 706), but deaths were mainly in men (70.8%, n=550) and doctors (51.4%, n=525). Limited data suggested that general practitioners and mental health nurses were the highest risk specialities for deaths. There were 37.2 deaths reported per 100 infections for HCWs aged over 70 years. Europe had the highest absolute numbers of reported infections (119 628) and deaths (712), but the Eastern Mediterranean region had the highest number of reported deaths per 100 infections (5.7).

Conclusions

COVID-19 infections and deaths among HCWs follow that of the general population around the world. The reasons for gender and specialty differences require further exploration, as do the low rates reported in 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.