Infection and mortality of healthcare workers worldwide from COVID-19: a systematic review

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.

Clinical Profile and Outcome of Surgery of Patients with Hydatid Cysts at the National Referral Hospital, Bhutan: An Observational Study

Background Hydatid disease a zoonosis caused by tapeworms (cestodes) of genus Echinococcus. Humans acquire this infection by ingestion of eggs of Echinococcus from infected dogs, sheep, goat, cattle or pigs. Hydatid cyst causes significant morbidity, mortality and socioeconomic loss. Objective The objective of this study was to describe the clinical profile and short-term outcome of surgical treatment of hydatidosis at Bhutan's largest hospital. Method This was a descriptive study conducted among patients ≥ 18 years at the National Referral Hospital, Thimphu, Bhutan from 01 January to 31 December 2017. Data on pre-surgery treatment, type and outcome of surgery and histopathology were collected. Data was entered analysed in EpiData. All variables are presented using descriptive statistics. Ethics approval was obtained from the Research Ethics Board of Health, Ministry of Health, Bhutan. Result There were 38 patients who underwent surgeries. The mean age of the sample was 36 (±17) years; cases were reported from almost all districts in the country. The most common symptoms at presentation was abdominal pain (27, 71.4%), nausea (21, 55.3%), abdominal distension (16, 41.1%). The median duration of symptoms was 6.0 months (IQR 3.0, 12.0). Liver was involved in 36 patients (94.7%). All underwent de-roofing and drainage through laparotomy (35; 92.1%), laparoscopy (2, 5.3%) or throracotomy (1, 2.6%). Histopathologic confirmation was obtained in 28 patients (73.7%). Twenty-three patients (60.5%) suffered from minor post-operative complications. Conclusion Patients with hydatid cyst present with abdominal pain, nausea abdominal distension. They suffer with symptoms for long periods till surgical treatment. The majority had favourable outcomes of surgery.