TY - JOUR
T1 - Risk of hospital admission with coronavirus disease 2019 in healthcare workers and their households
T2 - nationwide linkage cohort study
AU - Shah, Anoop S V
AU - Wood, Rachael
AU - Gribben, Ciara
AU - Caldwell, David
AU - Bishop, Jennifer
AU - Weir, Amanda
AU - Kennedy, Sharon
AU - Reid, Martin
AU - Smith-Palmer, Alison
AU - Goldberg, David
AU - McMenamin, Jim
AU - Fischbacher, Colin
AU - Robertson, Chris
AU - Hutchinson, Sharon
AU - McKeigue, Paul
AU - Colhoun, Helen
AU - McAllister, David A
PY - 2020/10/28
Y1 - 2020/10/28
N2 - Objective To assess the risk of hospital admission for coronavirus disease 2019 (covid-19) among patient facing and non-patient facing healthcare workers and their household members. Design Nationwide linkage cohort study. Setting Scotland, UK, 1 March to 6 June 2020. Participants Healthcare workers aged 18-65 years, their households, and other members of the general population. Main outcome measure Admission to hospital with covid-19. Results The cohort comprised 158 445 healthcare workers, most of them (90 733; 57.3%) being patient facing, and 229 905 household members. Of all hospital admissions for covid-19 in the working age population (18-65 year olds), 17.2% (360/2097) were in healthcare workers or their households. After adjustment for age, sex, ethnicity, socioeconomic deprivation, and comorbidity, the risk of admission due to covid-19 in non-patient facing healthcare workers and their households was similar to the risk in the general population (hazard ratio 0.81 (95% confidence interval 0.52 to 1.26) and 0.86 (0.49 to 1.51), respectively). In models adjusting for the same covariates, however, patient facing healthcare workers, compared with non-patient facing healthcare workers, were at higher risk (hazard ratio 3.30, 2.13 to 5.13), as were household members of patient facing healthcare workers (1.79, 1.10 to 2.91). After sub-division of patient facing healthcare workers into those who worked in "front door,"intensive care, and non-intensive care aerosol generating settings and other, those in front door roles were at higher risk (hazard ratio 2.09, 1.49 to 2.94). For most patient facing healthcare workers and their households, the estimated absolute risk of hospital admission with covid-19 was less than 0.5%, but it was 1% and above in older men with comorbidity. Conclusions Healthcare workers and their households contributed a sixth of covid-19 cases admitted to hospital. Although the absolute risk of admission was low overall, patient facing healthcare workers and their household members had threefold and twofold increased risks of admission with covid-19.
AB - Objective To assess the risk of hospital admission for coronavirus disease 2019 (covid-19) among patient facing and non-patient facing healthcare workers and their household members. Design Nationwide linkage cohort study. Setting Scotland, UK, 1 March to 6 June 2020. Participants Healthcare workers aged 18-65 years, their households, and other members of the general population. Main outcome measure Admission to hospital with covid-19. Results The cohort comprised 158 445 healthcare workers, most of them (90 733; 57.3%) being patient facing, and 229 905 household members. Of all hospital admissions for covid-19 in the working age population (18-65 year olds), 17.2% (360/2097) were in healthcare workers or their households. After adjustment for age, sex, ethnicity, socioeconomic deprivation, and comorbidity, the risk of admission due to covid-19 in non-patient facing healthcare workers and their households was similar to the risk in the general population (hazard ratio 0.81 (95% confidence interval 0.52 to 1.26) and 0.86 (0.49 to 1.51), respectively). In models adjusting for the same covariates, however, patient facing healthcare workers, compared with non-patient facing healthcare workers, were at higher risk (hazard ratio 3.30, 2.13 to 5.13), as were household members of patient facing healthcare workers (1.79, 1.10 to 2.91). After sub-division of patient facing healthcare workers into those who worked in "front door,"intensive care, and non-intensive care aerosol generating settings and other, those in front door roles were at higher risk (hazard ratio 2.09, 1.49 to 2.94). For most patient facing healthcare workers and their households, the estimated absolute risk of hospital admission with covid-19 was less than 0.5%, but it was 1% and above in older men with comorbidity. Conclusions Healthcare workers and their households contributed a sixth of covid-19 cases admitted to hospital. Although the absolute risk of admission was low overall, patient facing healthcare workers and their household members had threefold and twofold increased risks of admission with covid-19.
KW - hospital admission
KW - coronavirus
KW - covid-19
KW - healthcare workers
UR - http://www.scopus.com/inward/record.url?scp=85094806817&partnerID=8YFLogxK
U2 - 10.1136/bmj.m3582
DO - 10.1136/bmj.m3582
M3 - Article
C2 - 33115726
AN - SCOPUS:85094806817
SN - 0959-8146
VL - 371
JO - The BMJ
JF - The BMJ
M1 - m3582
ER -