healthcareCOVID: a national cross-sectional observational study identifying risk factors for developing suspected or confirmed COVID-19 in UK healthcare workers
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Abstract
To establish the prevalence, risk factors and implications of suspected or confirmed coronavirus disease 2019 (COVID-19) infection among healthcare workers in the United Kingdom (UK).
Design
Cross-sectional observational study.
Setting
UK-based primary and secondary care.
Participants
Healthcare workers aged ≥18 years working between 1 February and 25 May 2020.
Main outcome measures
A composite endpoint of laboratory-confirmed diagnosis of SARS-CoV-2, or self-isolation or hospitalisation due to suspected or confirmed COVID-19.
Results
Of 6,152 eligible responses, the composite endpoint was present in 1,806 (29.4%) healthcare workers, of whom 49 (0.8%) were hospitalised, 459 (7.5%) tested positive for SARS-CoV-2, and 1,776 (28.9%) reported self-isolation. Overall, between 11,870 and 21,158 days of self-isolation were required by the cohort, equalling approximately 71 to 127 working days lost per 1,000 working days. The strongest risk factor associated with the presence of the primary composite endpoint was increasing frequency of contact with suspected or confirmed COVID-19 cases without adequate personal protective equipment (PPE): ‘Never’ (reference), ‘Rarely’ (adjusted odds ratio 1.06, (95% confidence interval: [0.87–1.29])), ‘Sometimes’ (1.7 [1.37–2.10]), ‘Often’ (1.84 [1.28–2.63]), ‘Always’ (2.93, [1.75–5.06]). Additionally, several comorbidities (cancer, respiratory disease, and obesity); working in a ‘doctors’ role; using public transportation for work; regular contact with suspected or confirmed COVID-19 patients; and lack of PPE were also associated with the presence of the primary endpoint. A total of 1,382 (22.5%) healthcare workers reported lacking access to PPE items while having clinical contact with suspected or confirmed COVID-19 cases.
Conclusions
Suspected or confirmed COVID-19 was more common in healthcare workers than in the general population and is associated with significant workforce implications. Risk factors included inadequate PPE, which was reported by nearly a quarter of healthcare workers. Governments and policymakers must ensure adequate PPE is available as well as developing strategies to mitigate risk for high-risk healthcare workers during future COVID-19 waves.
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SciScore for 10.1101/2020.08.28.20182295: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Strengths and Limitations: Strengths of our study include a relatively large sample size and the inclusion of HCWs from all backgrounds and work environments to facilitate risk comparisons using a standardised survey. We …
SciScore for 10.1101/2020.08.28.20182295: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Strengths and Limitations: Strengths of our study include a relatively large sample size and the inclusion of HCWs from all backgrounds and work environments to facilitate risk comparisons using a standardised survey. We captured granular information that has otherwise been poorly reported in prevalence studies in HCWs. For example, medical history and details regarding the use, or lack thereof, of PPE have not been elsewhere reported. We did not limit our recruitment to primary or secondary care, and thus the associations we report are generalisable across a wide range of healthcare settings. Several limitations need to be addressed. First, data were gathered using a survey-based approach which risks selection and recall bias. We also could not capture data from HCWs who died from COVID-19 infection, or those who were too ill to respond. However, our methodology allowed us to rapidly capture both objective and subjective granular data from a large number of participants. Second, we were unable to determine a denominator to quantify a response rate for this observational study. Third, the use of a composite outcome to detect suspected or confirmed COVID-19 infection in HCWs may have resulted in an overestimation of prevalence. However, this definition is in keeping with that used in other studies5 and internationally.7 Availability of testing for HCWs was also limited during early phases of the pandemic, thus clinical diagnoses were often relied upon. On the other hand, data ...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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