Hospitalization, death, and probable reinfection in Peruvian healthcare workers infected with SARS-CoV-2: a national retrospective cohort study

Abstract

Background Peru has some of the worst outcomes worldwide as a result of the SARS-CoV-2 pandemic; it is presumed that this has also affected healthcare workers. This study aimed to establish whether occupation and other non-occupational variables were risk factors for possible reinfection, hospitalization, and mortality from COVID-19 in cohorts of Peruvian healthcare workers infected with SARS-CoV-2. Methods Retrospective cohort study. Healthcare workers who presented SARS-CoV-2 infection between March 1, 2020, and August 6, 2021, were included. Occupational cohorts were reconstructed from the following sources of information: National Epidemiological Surveillance System, molecular tests (NETLAB), results of serology and antigen tests (SICOVID-19), National Registry of Health Personnel (INFORHUS), and National Information System of Deaths (SINADEF). The incidence of probable reinfection, hospitalization, and death from COVID-19 was obtained in the cohorts of technicians and health assistants, nursing staff, midwives, dentists, doctors, and other healthcare workers. We evaluated whether the occupation and other non-occupational variables were risk factors for probable reinfection, hospitalization, and death from COVID-19 using log-binomial and probit binomial models, obtaining the adjusted relative risk (RRAJ). Results 90,398 healthcare workers were included in the study. Most cases were seen in technicians and health assistants (38.6%), and nursing staff (25.6%). 8.1% required hospitalization, 1.7% died from COVID-19, and 1.8% had probable reinfection. A similar incidence of probable reinfection was found in the six cohorts (1.7–1.9%). Doctors had a higher incidence of hospitalization (13.2%) and death (2.6%); however, they were also those who presented greater susceptibility linked to non-occupational variables (age and comorbidities). The multivariate analysis found that doctors (RRAJ = 1.720; CI 95: 1.569–1.886) had a higher risk of hospitalization and that the occupation of technician and health assistant was the only one that constituted a risk factor for mortality from COVID-19 (RRAJ = 1.256; 95% CI: 1.043–1.512). Conclusions Peruvian technicians and health assistants would have a higher risk of death from COVID-19 than other healthcare workers, while doctors have a higher incidence of death probably linked to the high frequency of non-occupational risk factors. Doctors present a higher risk of hospitalization independent of comorbidities and age; likewise, all occupations show a similar risk of probable reinfection.

COVID-19 Reinfection in Healthcare Workers: An Original Comprehensive Longitudinal Study

“…Our investigation revealed a COVID-19 recurrence rate of 15%, signifying a substantial rate of recurrence in Iran. In comparison, prior studies have reported varying reinfection rates among HCWs, ranging from 5.94-20.57%, with notable differences potentially arising from variations in diagnostic certainty and the inclusion of probable cases (11)(12)(13)(14)(15). The criteria used to de ne recurrence or reinfection based on the time interval between positive SARS-CoV-2 tests may also contribute to these disparities.…”

“…However, Ramos W. et al reported a higher risk of reinfection among those with direct contact with COVID-19 cases in their work environment. They also found that physicians and nurses had a higher risk of hospitalization compared to other HCWs(15). In addition, physicians and nurses, in the second degree, were at higher risk of hospitalization than other HCWs(15).…”

“…They also found that physicians and nurses had a higher risk of hospitalization compared to other HCWs(15). In addition, physicians and nurses, in the second degree, were at higher risk of hospitalization than other HCWs(15). Studies by Pople D. et al and Costa LGVD.…”

Epidemiological and clinical characteristics of COVID-19 reinfection during the epidemic period in Yangzhou city, Jiangsu province

“…For example, France conducted three reinfection surveys at different periods, with reinfection incidences of 0.08% (June 2020 to February 2021), 0.4% (March 2020 to August 2021), and 3.1% (March 2021 to February 2022), respectively ( 17 – 19 ). 1.8% of Peruvian healthcare workers might have been reinfected with SARS-CoV-2 between March 2020 and August 2021 ( 20 ). The overall SARS-CoV-2 reinfection incidence was found to be 28.3% (95% CI: 23.7%–33.2%) in Guangdong Province between December 2022 and January 2023 ( 12 ).…”

Predictors of Recurrent Laboratory-Confirmed Symptomatic SARS-CoV-2 Infections in a Cohort of Healthcare Workers

“…The evidence derived from observational studies shows that patients who have recovered from coronavirus disease 2019 (COVID-19) by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) can develop natural immunity [ 3 , 4 ]. However, high variability in antibody titers has been documented and healthcare workers seem to be at a high reinfection risk [ 5 , 6 ]. The reinfection risk in these specific population segments seemed to be higher during the dominance of the Omicron variant [ 7 ].…”