Tejan Yusuf Sheku, Ashubwe Jacklyne, Beglaryan Mher, Hassan Shermarke, Kenneh Sartie, Moses Francis, Jalloh Abdulai Tejan, Grovogui Fassou Mathias, Kaba Ibrahima, Tengbe Sia Morenike, Kabba Mustapha, Kamara Mamud Idriss, Sesay Santigie, Kamara Jonta, Mbasha Jerry-Jonas, Relan Pryanka, Nuwagira Innocent, Kamara Ibrahim Franklyn
Ministry of Health, 4th Floor, Youyi Building, Freetown, Sierra Leone.
Medwise Solutions Consultancy, Nairobi, P.O. Box 2356 00202, Kenya.
F1000Res. 2025 Jun 11;13:624. doi: 10.12688/f1000research.150838.2. eCollection 2024.
BACKGROUND: Due to occupational exposure, healthcare workers (HCWs) have a higher risk of Coronavirus Disease 2019(COVID-19) infection than the general population. Non-communicable diseases (NCDs) may increase the risk of COVID-19-related morbidity and mortality among HCWs, potentially reducing the available health workforce. We examined the association between NCDs and COVID-19 disease severity and mortality among infected HCWs. METHODS: This cohort study used data from the International Severe Acute Respiratory and Emerging Infections Consortium (ISARIC) database. HCWs hospitalized between January 2020 and January 2023 due to clinically suspected or laboratory-confirmed COVID-19 were eligible for inclusion. Variables collected included demographic data, comorbidities, and hospitalization outcomes. Descriptive statistics were reported using mean/standard deviation (SD), median/interquartile range (IQR), or frequencies and proportions. For each NCD, the relative risk of death, adjusted for age and sex, was calculated using log-binomial regression as well as the population-attributable fraction. RESULTS: There were 17,502 HCWs, 95.7% of whom had a confirmed COVID-19 diagnosis. The majority were female (66.5%) and the mean age (SD) was 49.8 (14.3) years. Roughly, half (51.42%) of HCWs had no comorbidities, 29.28% had one comorbidity, 14.68% had 2 comorbidities and <5% had ≥3 comorbidities. The most common comorbidities were diabetes mellitus (49.40%) and cardiovascular disease (36.90%). Approximately one-fifth of the HCWs had severe COVID-19 (16.95%) and 10.68% of the HCWs with COVID-19 died. Being ≥45 years old, male gender, smoking, obesity, and certain NCDs increased the risk of COVID-19 severity and mortality. Obesity and diabetes mellitus were the leading risk factors in terms of the population-attributable risk for COVID-19 severity (6.89%) and mortality (36.00%) respectively. CONCLUSIONS: Many HCWs with COVID-19 had one or more NCDs. Obesity and diabetes mellitus increased COVID-19 severity and mortality risk. Reducing the prevalence of obesity and diabetes mellitus would yield the biggest reduction in COVID-19-related morbidity and mortality among HCWs.
背景：由于职业暴露，医护人员感染2019冠状病毒病（COVID-19）的风险高于普通人群。非传染性疾病（NCDs）可能会增加医护人员中与COVID-19相关的发病和死亡风险，从而可能减少可用的卫生人力。我们研究了非传染性疾病与感染的医护人员中COVID-19疾病严重程度和死亡率之间的关联。 方法：这项队列研究使用了国际严重急性呼吸道和新发感染联盟（ISARIC）数据库中的数据。2020年1月至2023年1月期间因临床疑似或实验室确诊的COVID-19住院的医护人员符合纳入条件。收集的变量包括人口统计学数据、合并症和住院结局。使用均值/标准差（SD）、中位数/四分位间距（IQR）或频率和比例报告描述性统计数据。对于每种非传染性疾病，使用对数二项回归以及人群归因分数计算调整年龄和性别的死亡相对风险。 结果：共有17502名医护人员，其中95.7%确诊感染COVID-19。大多数为女性（66.5%），平均年龄（SD）为49.8（14.3）岁。大致上，一半（51.42%）的医护人员无合并症，29.28%有1种合并症，14.68%有2种合并症，<5%有≥3种合并症。最常见的合并症是糖尿病（49.40%）和心血管疾病（3,6.90%）。约五分之一的医护人员患有重症COVID-19（16.95%），感染COVID-19的医护人员中有10.68%死亡。年龄≥45岁、男性、吸烟、肥胖和某些非传染性疾病会增加COVID-19严重程度和死亡风险。就COVID-19严重程度（6.89%）和死亡率（36.00%）的人群归因风险而言，肥胖和糖尿病是主要危险因素。 结论：许多感染COVID-19的医护人员患有一种或多种非传染性疾病。肥胖和糖尿病增加了COVID-19的严重程度和死亡风险。降低肥胖和糖尿病的患病率将最大程度降低医护人员中与COVID-19相关的发病和死亡。
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