Background
The higher risk of COVID-19 in healthcare workers (HCWs) is well-known. However, the risk within HCWs is not fully understood. The objective was to compare the COVID-19 risk in intensive care unit (ICU) versus non-ICU locations.
Methods
A prospective surveillance study was conducted among HCWs at a large tertiary care facility in Riyadh between March 1st to November 30th, 2020. HCWs included both clinical (provide direct patient care) and non-clinical positions (do not provide direct patient care).
Results
A total 1,594 HCWs with COVID-19 were included; 103 (6.5%) working in ICU and 1491 (93.5%) working in non-ICU locations. Compared with non-ICU locations, ICU had more nurses (54.4% versus 22.1%, p<0.001) and less support staff (2.9% versus 53.1%, p<0.001). COVID-19 infection was similar in ICU and non-ICU locations (9.0% versus 9.8%, p=0.374). However, it was significantly higher in ICU nurses (12.3% versus 6.5%, p<0.001). Support staff had higher risk than other HCWs, irrespective of ICU working status (15.1% versus 7.2%, p<0.001). The crude relative risk (RR) of COVID-19 in ICU versus non-ICU locations was 0.92, 95% confidence interval [CI] was 0.76-1.11 (p=0.374). However, RR adjusted for professional category was significantly increased to 1.23, 95% CI 1.01-1.50 (p=0.036).
Conclusion
ICU had a significantly higher risk of COVID-19 infection only after adjusting for the distribution and risk of different professional categories. The later is probably determined by both exposure level and protection practices. The finding underscores the importance of strict implementation of preventive measures among all HCWs, including those performing non-clinical services.