healthcareCOVID: A national cross-sectional observational study identifying risk factors for developing suspected or confirmed COVID-19 in UK healthcare workers

  1. J Kua
  2. R Patel
  3. E Nurmi
  4. S Tian
  5. H Gill
  6. DJN Wong
  7. C Moorley
  8. D Nepogodiev
  9. I Ahmad
  10. K El-Boghdadly
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Abstract

Objective

To establish the prevalence and risk factors for the development of suspected or confirmed coronavirus disease 2019 (COVID-19) infection among healthcare workers (HCWs) in the United Kingdom (UK).

Design

Cross-sectional observational study.

Setting

UK-based primary and secondary care.

Participants

HCWs 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 6152 eligible responses, the composite endpoint was present in 1806 (29.4%) HCWs, of whom 49 (0.8%) were hospitalised, 459 (7.5%) tested positive for SARS-CoV-2, and 1776 (28.9%) reported self-isolation. 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 to 1.29)), “Sometimes” (1.7 (1.37 to 2.10)), “Often” (1.84 (1.28 to 2.63)), “Always” (2.93, (1.75 to 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. 1382 (22.5%) HCWs reported lacking access to PPE items while having clinical contact with suspected or confirmed COVID-19 cases. 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 1000 working days.

Conclusions

Suspected or confirmed COVID-19 was more common in HCWs than in the general population. Risk factors included inadequate PPE, which was reported by nearly a quarter of HCWs. Governments and policymakers must ensure adequate PPE is available as well as developing strategies to mitigate risk for high-risk HCWs during future COVID-19 waves.

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