COVID-19 research briefs: Frontline health-care workers and their families are at an increased risk of hospitalization

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Published: 2020-12-13 © 2020 John Wiley & Sons, Inc.

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Clinical question
Does working in health care increase the risk of being hospitalized with COVID-19?

Bottom line
Frontline health-care workers and their families are at an increased risk of hospitalization from COVID-19. (LOE = 2c)

Shah ASV, Wood R, Gribben C, et al. Risk of hospital admission with coronavirus disease 2019 in health care workers and their households: nationwide linkage cohort study. BMJ 2020;371:m3582.

Study design: Cohort (retrospective)

Setting: Population-based

Research Brief #72: These researchers identified 158,445 health-care workers between the ages of 18 and 65 years who were employed by Scotland's National Health Service. They used Scottish employment databases to create linkages to other health-related databases and to identify members of their households (n = 229,905). Additionally, the researchers used these same databases to identify persons from the general population. They mined the databases to identify hospitalizations for COVID-19 between March 1, 2020 (when cases of COVID-19 were first identified in Scotland) and June 6, 2020. Among the health-care workers, 90,733 (57.3%) had direct patient contact (they use the term "patient-facing") and 79% were women. The authors identified 6346 total hospitalizations for COVID-19 during the study period, 2097 of which occurred in persons between 18 and 65 years of age. Of these, 1737 (82.8%) occurred in the general population, and health-care workers and their household members accounted for 243 (11.6%) and 117 (5.6%) hospitalizations, respectively. After adjusting for age, sex, ethnicity, socioeconomic factors, and comorbidities, the overall risk of hospitalization for all health-care workers and their households was similar to that of the general population. However, among patient-facing health-care workers, although the numbers were small, the risk of hospitalization was much higher (hazard ratio [HR] 3.30; 95% CI 2.13 - 5.13) as was the risk for their household members (HR 1.79; 1.10 - 2.91). These data support previous data regarding COVID-19 as a cause of excess mortality in the United States and illustrate the risk to health-care workers, their families, and the public. It's hard to imagine how any profit could be gained from falsely naming COVID-19 as a cause of death.

Henry C. Barry, MD, MS
Michigan State University
East Lansing, MI

Copyright © 2020 John Wiley & Sons, Inc.