Large cohort study measures risk of COVID-19 infection among front-line healthcare workers

Aug. 11, 2020
Health care professional in PPE

Due to their close contact with COVID-19 patients, front-line healthcare workers are at increased risk of infection with the virus. Researchers estimate that healthcare workers could account for 10–20 percent of all diagnoses, with some early evidence that people from Black, Asian, and minority ethnic backgrounds are at higher risk.

Although addressing the needs of these healthcare workers during the COVID-19 pandemic is a high priority, data to inform such efforts are scarce, especially among Black, Asian, and minority ethnic communities.

Distinguished Professor Denis Nash

Distinguished Professor Denis Nash

To investigate the risk of testing positive for COVID-19, the risk of developing symptoms associated with SARS-CoV-2 infection, or both, among a cohort of over two million individuals in the UK and the USA, the Coronavirus Pandemic Epidemiology Consortium, including CUNY SPH Distinguished Professor Denis Nash, conducted a prospective population-based study using data from a smartphone-based application. The results were published in The Lancet.

Participants provided information on demographic factors including age, sex, race or ethnic background, height and weight, and occupation and medical history, and subsequently reported any COVID-19 symptoms.

The study found that, compared with the general community, front-line healthcare workers were at increased risk for reporting a positive COVID-19 test. To account for differences in testing frequency between healthcare workers and the general community and possible selection bias, an inverse probability-weighted model was used to adjust for the likelihood of receiving a COVID-19 test. Secondary and post-hoc analyses suggested adequacy of PPE, clinical setting, and ethnic background were also important factors.

“These findings highlight the pervasiveness of COVID-19 health disparities,” Nash says. “Even within the health care system, there are major disparities in the risk of acquiring SARS-CoV-2 infection by race/ethnicity. We need answers as to why this has happened so that we can prevent and mitigate them going forward. Is it because health care workers of color tend to work in settings and neighborhoods that see a greater number of Coronavirus patients? Is it because they are working in settings that are less safe than the settings where their white counterparts are working in terms of infection control capacity and PPE availability?”

Additional follow up of these findings is needed, the researchers note.

Nguyen, Long H et al. “Risk of COVID-19 among frontline healthcare workers and the general community: a prospective cohort study.” medRxiv : the preprint server for health sciences 2020.04.29.20084111. 25 May. 2020, doi:10.1101/2020.04.29.20084111. Preprint.