Deaths from COVID-19 in healthcare workers in Italy—What can we learn?

Lapolla, Pierfrancesco; Mingoli, Andrea; Lee, Regent

doi:10.1017/ice.2020.241

Cited by 124 publications

(123 citation statements)

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“…Shortages of personal protective equipment (PPE) have been described as a significant contributing risk factor for COVID-19 in HCW worldwide ( Lapolla et al, 2020 , Lai et al, 2020 ). Infection control training and use of PPE have been associated with decreased risk of COVID-19 infection ( Chou et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

“…By early March 2020, more than 3300 HCW had been infected in China alone, with reports of at least 22 HCW deaths ( Zhan et al, 2020 ). In Italy, a country with a high burden of COVID-19, over 20% of responding HCW have been infected, with almost 200 HCW deaths ( Lapolla et al, 2020 , Lancet, 2020 ). The International Council of Nurses (ICN) has reported that more than 600 nurses have died in the COVID-19 pandemic and estimate that over 450,000 HCW had been infected by June 3 rd , 2020 ( International Council Nurses 2020 ).…”

Section: Introductionmentioning

confidence: 99%

“…Shortages of personal protective equipment (PPE) have been described as a contributing risk factor for COVID-19 in HCW worldwide ( Lapolla et al, 2020 , Lai et al, 2020 , Australian Government Department of Health, 2020 ). Initial recommendations from the Centres for Disease Control and Prevention (CDC) were to use respirators, but following a shortage in supply of these, guidelines changed to the use of medical masks, or even cloth masks ( Chughtai et al, 2020 , Center for Disease Control and Prevention 2020 ).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Estimating the burden of COVID-19 on the Australian healthcare workers and health system during the first six months of the pandemic

Quigley¹,

Stone

Nguyen

et al. 2021

International Journal of Nursing Studies

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Introduction There is no publicly available national data on healthcare worker infections in Australia. It has been documented in many countries that healthcare workers are at increased occupational risk of COVID-19. We aimed to estimate the burden of COVID-19 on Australia healthcare workers and the health system by obtaining and organizing data on HCW infections, analyzing national HCW cases in regards to occupational risk and analyzing healthcare outbreak. Methods We searched government reports and websites and media reports to create a comprehensive line listing of Australian healthcare worker infections and nosocomial outbreaks between January 25 th and July 8 th , 2020. A line list of healthcare worker related COVID-19 reported cases was created and enhanced by matching data extracted from media reports of healthcare related COVID-19 relevant outbreaks and reports, using matching criteria. Rates of infections and odds ratios (ORs) for healthcare workers were calculated per state, by comparing overall cases to healthcare worker cases. To investigate the sources of infection amongst healthcare workers, transmission data were collated and graphed to show distribution of sources. Results We identified 36 hospital outbreaks or outbreaks between January 25 th and July 8 th , 2020. According to our estimates, at least 536 healthcare workers in Australia have been infected with COVID-19, comprising 6.03% of all reported infections. The rate of healthcare worker infection was 72/100,000 and of community infection 34/100,000. healthcare workers were 2.76 times more likely to contract COVID-19 (95% CI 2.53 to 3.01; P <0.001). The timing of hospital outbreaks did not always correspond to community peaks. Where data were available, a total of 131 healthcare workers across 21 outbreaks, led to 1656 healthcare workers being furloughed for quarantine. One hospital was closed and had 1200 workers quarantined in one outbreak. Conclusion The study shows that HCWs were at nearly 3 times the risk of infection. Of concern, this nearly tripling of risk occurred during a period of low community prevalence suggesting failures at multiple hazard levels including PPE policies within the work environment. Even in a country with relatively good control of COVID-19, healthcare workers are at greater risk of infection than the general community and nosocomial outbreaks can have substantial effects on workforce capacity by the quarantine of numerous workers during an outbreak. The occurrence of hospital outbreaks even when community incidence was low, highlights the high risk setting that hospitals present. Australia faces a resurgence of COVID-19 since late June 2020, with multiple hospital outbreaks. We recommend formal reporting of healthcare worker infections, testing protocols for nosocomial outbrea...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Estimating the burden of COVID-19 on the Australian healthcare workers and health system during the first six months of the pandemic

Quigley¹,

Stone

Nguyen

et al. 2021

International Journal of Nursing Studies

View full text Add to dashboard Cite

show abstract

“…On April 17 the latest estimate of medical doctor deaths reached 119 in Italy, which is 57.8% of total HCP deaths; followed by nurses at 16.5% (34), nurse aides at 8.3% (17), and dentists at 5.8% (12) [ 21 ]. Factors contributing to the elevated number of fatalities among HCP in Italy may be i) the sheer intensity of the COVID-19 outbreak; ii) the recruitment of elderly retired doctors and iii) shortages of personal protective equipment (PPE), particularly in non-hospital care [ 22 ]. Mortality per institute will definitely be low.…”

Section: Discussionmentioning

confidence: 99%

Clinical Presentation, Management and In-Hospital Outcome of Healthcare Personnel With COVID-19 Disease

Malik¹,

Ishraquzzaman²,

Kalimuddin³

et al. 2020

Cureus

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Objective Healthcare personnel (HCP) are undoubtedly one of the major frontline fighters in the coronavirus disease 2019 (COVID-19) pandemic. Therefore, it comes as no surprise that many HCP have become infected by COVID-19 globally. The infection of HCP has received great attention in social media and is frequently reported from different parts of the world. However, there are few scientific reports addressing this aspect of the COVID-19 pandemic. The aim of this study was to evaluate the characteristics of clinical presentation, treatment, and outcome of COVID-19 infection among the HCP of our setting. Methods This cross-sectional study was performed in the National Heart Foundation Hospital & Research Institute of Bangladesh from April 29 to July 20, 2020. HCP employed in this hospital who experienced fever or respiratory symptoms or came in close contact with COVID-19 patients at home or their workplace were included in this study. The presence of COVID-19 disease was confirmed by real-time reverse transcriptase-polymerase chain reaction on nasopharyngeal samples. A total of 394 HCP were sampled and 139 had a positive corona test. Structured interviews were conducted to document symptoms for all HCP with confirmed COVID-19. Data analysis was performed in July 2020. Results Out of 1,409 HCP, 139 subjects tested positive for COVID-19. Among the HCP, infection rate was 9.86%. The mean age of the study population was 34.08±11.11 years (range: 20-69 yrs), of whom 82 (59%) were female. Most of this cohort were nurses (56 [40.3%]) and physicians (25 [18%]), and the remaining 58 (41.7%) were other staff. The mean duration of onset of symptoms to test was 2.89±2.07 days. The most common symptoms were fever (84.2%), fatigue (56.1%), cough (54%), body ache (39.6%), headache, and anosmia (38.8%). Most subjects had mild disease (125 [93%]), three (2.1%) of the HCP had moderate disease and one (0.7%) had severe disease. Ten of the HCP (7.2%) were asymptomatic. Most of them were treated either by ivermectin plus azithromycin or ivermectin plus doxycycline. Only 20 (14.4%) of the HCP were hospitalized, while others were treated either in home isolation (59.7%) or in institutional isolation (25.9%). Recovery was almost uneventful except one healthcare worker who died. Conclusion Most HCP had mild symptoms and a few of them were asymptomatic also. HCP with mild COVID-19 symptoms may be treated in home or institutional isolation. As they are a vulnerable group for infection, providing adequate protection to HCP is absolutely mandatory to safeguard them from this pandemic.

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“…It is estimated to be up to 38.9% (23.7% in an intramural survey including 4968 health professionals of our hospital, data not published) [9][10][11] , while it is up to 5.7% in the general population 12 . This higher prevalence among HCW is closely related to risk factors such as exposure to aerosol-generating procedures, suboptimal handwashing after patient contact, longer work hours, and suboptimal protective personal equipment use [13][14] .…”

mentioning

confidence: 99%

SARS-CoV-2 cellular immune response in uninfected health care workers with prolonged and close exposure to COVID-19 patients

Vallejo¹,

Vizcarra²,

Quereda³

et al. 2020

Preprint

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Health care workers (HCW) are at an increased risk since they are directly exposed to SARS-CoV-2 infected patients, nevertheless, some remained without the development of anti-SARS-CoV-2 antibodies, suggesting lesser susceptibility to infection1-5. This study aimed to ascertain a potential specific cellular immune response to SARS-CoV-2 in these largely exposed HCWs.In this cross-sectional, case-control study, we analyzed 39 exposed uninfected HCWs and 17 convalescent HCWs. Cellular immune response was evaluated after SARS-CoV-2 stimulation with peptide pools (proteins S, M, and N), using bead-based multiplex assay (12 cytokines).Overall, 94.8% of uninfected HCWs had some degree of specific cellular response to SARS-CoV-2 structural proteins that could be classified, according to the number of cytokine production, as strong (61.5%), partial (33.3%), and weak/no response (5.1%). Strong responders showed a higher anti-inflammatory cytokine production (IL5 and IL10, p<0.001 and 0.002, respectively), and similar (IFN-γ and TNF-α, p=0.435 and 0.532, respectively) or higher (IL12, p=0.021) pro-inflammatory production compared to convalescents, resulted in a predominantly Th2 response. This study demonstrated a consistent and polyfunctional immune cellular response after stimulation with SARS-CoV-2 peptides in extensively exposed individuals that should be considered to establish the infection susceptibility, the impact in herd immunity, and the risk of relapses.

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Deaths from COVID-19 in healthcare workers in Italy—What can we learn?

Cited by 124 publications

References 1 publication

Estimating the burden of COVID-19 on the Australian healthcare workers and health system during the first six months of the pandemic

Estimating the burden of COVID-19 on the Australian healthcare workers and health system during the first six months of the pandemic

Clinical Presentation, Management and In-Hospital Outcome of Healthcare Personnel With COVID-19 Disease

SARS-CoV-2 cellular immune response in uninfected health care workers with prolonged and close exposure to COVID-19 patients

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