Predictors for Severity of SARS-CoV-2 Infection Among Healthcare Workers

Fathiya El-Raey; Mohamed Alboraie; Naglaa Youssef; Ahmed Yousef; Ahmed A Abdelmoaty; Essam Hassan; Sahar M Hassany; Sherief Abd-Elsalam; Ramy Elsharkawy; Khaled Farrag; Mohamed Elbadry; Mohammed Tag-Adeen; Nermeen Abdeen; Omar Elshaarawy; Tamer Haydara; Adel Ahmed Hassan; Marwa El-Sayed; Yasser Fouad; Amin Abdel Baki; Samy Zaky

doi:10.2147/JMDH.S335226

Predictors for Severity of SARS-CoV-2 Infection Among Healthcare Workers

J Multidiscip Healthc. 2021 Oct 25:14:2973-2981. doi: 10.2147/JMDH.S335226. eCollection 2021.

Authors

Fathiya El-Raey¹, Mohamed Alboraie², Naglaa Youssef^{3

4}, Ahmed Yousef⁵, Ahmed A Abdelmoaty⁶, Essam Hassan⁷, Sahar M Hassany⁸, Sherief Abd-Elsalam⁹, Ramy Elsharkawy¹⁰, Khaled Farrag¹¹, Mohamed Elbadry¹², Mohammed Tag-Adeen¹³, Nermeen Abdeen¹⁴, Omar Elshaarawy¹⁵, Tamer Haydara¹⁶, Adel Ahmed Hassan¹⁷, Marwa El-Sayed¹⁸, Yasser Fouad¹⁹, Amin Abdel Baki²⁰, Samy Zaky²¹

Affiliations

¹ Department of Hepatogastroenterology and Infectious Diseases, Al-Azhar University, Damietta, Egypt.
² Department of Internal Medicine, Al-Azhar University, Cairo, Egypt.
³ Medical-surgical Nursing department, Faculty of Nursing, Cairo University, Cairo, Egypt.
⁴ Medical-surgical Nursing department, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.
⁵ Department of Public Health and Community Medicine, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt.
⁶ Tropical Medicine Department, Zagazig University, Zagazig, Egypt.
⁷ Department of Tropical Medicine, Fayoum University, Fayoum, Egypt.
⁸ Department of Tropical Medicine and Gastroenterology, Assiut University, Assiut, Egypt.
⁹ Tropical Medicine and Infectious Diseases Department, Tanta University, Tanta, Egypt.
¹⁰ Department of Tropical Medicine and Gastroenterology, Sohag University, Sohag, Egypt.
¹¹ Department of Tropical Medicine and Hygiene, National Medical Institute of Damanhour, Damanhour, Egypt.
¹² Endemic Medicine Department, Helwan University, Cairo, Egypt.
¹³ Department of Internal Medicine, South Valley University, Qena Faculty of Medicine, Qena, Egypt.
¹⁴ Department of Tropical Medicine, Alexandria University, Alexandria, Egypt.
¹⁵ Department of Hepatology, Gastroenterology and Liver Transplantation, National Liver Institute, Menoufia University, Menoufia, Egypt.
¹⁶ Department of Internal medicine, Gastroenterology & Hepatology Unit, Kafrelsheikh University, Kafr el-Sheikh, Egypt.
¹⁷ Infectious and Endemic Disease Department, Suez Canal University, Ismailia, Egypt.
¹⁸ Department of Microbiology and Immunology, Faculty of Medicine, South Valley University, Qena, 83523, Egypt.
¹⁹ Department of Endemic Medicine, Faculty of Medicine, Minia University, Minia, Egypt.
²⁰ Department: Hepatology, Gastroenterology and Infectious Diseases Department, National Hepatology and Tropical Medicine Research Institute (NHTMRI), Cairo, Egypt.
²¹ Department of Hepatogastroenterology and Infectious Diseases, Al-Azhar University, Cairo, Egypt.

Abstract

Background: Healthcare workers (HCWs) are still at higher risk of acquiring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections than the general population. Identifying risk factors associated with severe SARS-CoV-2 infections is of paramount importance to protect HCWs and the non-infected patients attending different healthcare facilities.

Purpose: To recognize the predictors for severity of SARS-CoV2 infection among HCWs working in either COVID-19 or non-COVID-19 healthcare settings. Also, to assess compliance of HCW to standard precautions of infection control and explore the possible risk factors for SARS-CoV-2 infection among HCWs.

Methods: A cross-sectional study was conducted among HCWs with suspected or confirmed SARS-CoV-2 infection, from different Egyptian governorates. They were asked to fill in a web-based self-reporting questionnaire. The questionnaire assessed the demographic and socio-economic characteristics of participants, compliance of HCWs to standard precautions of infection control and COVID-19 presentation.

Results: Our study enrolled 204 HCWs (52.3% physicians). Infection of SARS-CoV-2 was confirmed in 61.3% by RT- PCR; 35.8% were admitted to hospital, and of these, 3.9% were admitted to the intensive care unit. While 30.4% had mild disease, 48.5% had moderate disease, 17.2% had severe disease and 3.9% had critical disease. Regression analysis for variables predicting COVID-19 severity among study healthcare workers showed that associated chronic diseases and management at home were the main independent variables predicting severity of their SARS-COV-2 infection, while the variables age, sex, residence, occupation or drug history of immunosuppressives had no role in severity prediction.

Conclusion: Associated chronic diseases and management at home were the main independent variables predicting severity of SARS-COV-2 infection among HCWs. So, HCWs with chronic diseases should not work in COVID-19 designated hospitals, and there should be a screening strategy for their infection with SARS-COV-2. HCWs must not be negligent in adhering to strict precautions of infection control. HCWs infected with SARS-COV-2 must be managed in hospital not at home.

Keywords: COVID-19; SARS-CoV-2; delivery of health care; health care providers; infection control introduction.

Grants and funding

This study was not funded.