COVID-19 in healthcare workers in the state of Espírito Santo, Brazil: clinical and sociodemographic characteristics associated with death and hospitalization

Corona, Rodolfo Antonio; Cunha, Arthur Arantes da

doi:10.31744/einstein_journal/2022AO6241

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ORIGINAL ARTICLE • Einstein (São Paulo) 20 • 2022 • https://doi.org/10.31744/einstein_journal/2022AO6241 copy

COVID-19 in healthcare workers in the state of Espírito Santo, Brazil: clinical and sociodemographic characteristics associated with death and hospitalization

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

To analyze clinical and sociodemographic characteristics associated with death and hospitalization of healthcare workers due to COVID-19, in addition to calculating the incidence rates per profession.

Methods

A cross-sectional observational study using secondary open data from the State Health Department of Espírito Santo (ES), Brazil. The cases of COVID-19 in healthcare workers were recorded between February 27 and August 17, 2020, in Espírito Santo, excluding cases with missing information.

Results

Of the confirmed cases, 75.6% (n=9,191) were female. The overall case fatality rate was 0.27% and the general hospitalization rate was 0.99%. The clinical outcome of death and the occurrence of hospitalization were associated with male sex, age ≥50 years, higher education, fever, difficulty breathing, cough, cardiac comorbidity, diabetes and obesity (p<0.05). Only the occurrence of hospitalization was associated with case reported in the metropolitan region of Vitória, runny nose, sore throat, headache and renal comorbidity (p<0.05). The profession with the highest incidence rate was nurse (16,053.2 cases/100,000 nurses).

Conclusion

The study demonstrated high frequency of cases among women, low overall case fatality rate, and high incidence in nurses.

Health personnel; Epidemiology; Occupational health; Coronavirus infections; COVID-19; SARS-CoV-2; Brazil

Clinical outcomes

All cases (n=12,164)			Death (n=33)			Cure (n=12,131)			p value^†

Mean	SD	Median	Mean	SD	Median	Mean	SD	Median
38.67	±10.54	38.00	55.36	±14.07	58.00	38.62	±10.49	38.00	<0.01^*
Hospitalizations

All cases (n=8,666)			Hospitalized (n=86)			Non hospitalized (n=8,580)

Mean	SD	Median	Mean	SD	Median	Mean	SD	Median
38.70	±10.59	38.00	50.10	±13.77	49.00	38.59	±10.49	38.00	<0.01^*

Variable	Outcome		Total	Case fatality rate %	p value^†

	Death	Cure
Total (n=12,164)	33 (100)	12,131 (100)	12,164 (100)	0.27
Sex (n=12,163), n (%)
Male	17 (51.5)	2,955 (24.4)	2,972 (24.4)	0.57	<0.01^*
Female	16 (48.5)	9,175 (75.6)	9,191 (75.6)	0.17	<0.01^*
Age range, years (n=12,164), n (%)
<50	12 (36.4)	10,177 (83.9)	10,189 (83.8)	0.12	<0.01^*
50 or older	21 (63.6)	1,954 (16.1)	1,975 (16.2)	1.06	<0.01^*
Race/skin color (n=10,294), n (%)
White	17 (54.8)	4,684 (45.6)	4,701 (45.7)	0.36	0.717
Brown	11 (35.5)	4,160 (40.5)	4,171 (40.5)	0.26
Black	1 (3.2)	810 (7.9)	811 (7.9)	0.12
Others	2 (6.5)	609 (5.9)	611 (5.9)	0.33
Location (n=12,164), n (%)
Metropolitan Region of Greater Vitória	15 (45.5)	7,423 (61.2)	7,438 (61.1)	0.20	0.064
Other locations	18 (54.5)	4,708 (38.8)	4,726 (38.9)	0.38	0.064
Education (n=10,134), n (%)
2No higher education	10 (38.5)	5,979 (59.2)	5,989 (59.1)	0.17	0.032^*
Higher education	16 (61.5)	4,129 (40.8)	4,145 (40.9)	0.39	0.032^*
Symptoms
Fever (n=12,142)	27	5,621	5,648	0.48	<0.01^*
Respiratory distress (12,142)	19	2,269	2,288	0.83	<0.01^*
Cough (n=12,141)	25	7,009	7,034	0.36	0.038^*
Runny nose (n=12,143)	11	5,639	5,650	0.19	0.128
2Sore throat (n=12,142)	7	4,246	4,253	0.16	0.096
Diarrhea (n=12,143)	4	2,035	2,039	0.20	0.472
Headache (n=12,140)	20	7,307	7,327	0.27	0.976
Comorbidity^‡/risk factor
Pulmonary comorbidity (n=12,127)	2	410	412	0.49	0.309
Cardiovascular comorbidity (n=12,130)	17	1,381	1,398	1.22	<0.01*
Renal comorbidity (n=12,128)	0	29	29	0.00	0.924
2Diabetes (n=12,127)	7	416	423	1.65	<0.01*
2Smoking (n=12,127)	0	149	149	0.00	0.665
2Obesity (n=12,090)	6	526	532	1.13	<0.01*

Variable	Hospitalization		Total	Hospitalization rate %	p value^†

	Yes	No
Total (8,666)	86 (100)	8,580 (100)	8,666 (100)	0.99
Sex (n=8,655), n (%)					<0.01*
Male	36 (41.9)	2,019 (23.6)	2,055 (23.7)	1.75
2Female	50 (58.1)	6,550 (76.4)	6,600 (76.3)	0.76
Age range, years (n=8,613), n (%)					<0.01*
<50	44 (51.2)	7,152 (83.9)	7,196 (83.5)	0.61
50 or older	42 (48.8)	1,375 (16.1)	1,417 (16.5)	2.96
Race/skin color (n=7,382), n (%)					0.573
White	30 (48.4)	3,271 (44.7)	3,301 (44.7)	0.91
Brown	21 (33.9)	3,013 (41.2)	3,034 (41.1)	0.69
Black	7 (11.3)	609 (8.3)	616 (8.3)	1.14
Others	4 (6.5)	427 (5.8)	431 (5.8)	0.93
Location (n=8,666), n (%)					0.028*
Metropolitan Region of Greater Vitória	64 (74.4)	5,398 (62.9)	5,462 (63.0)	1.17
Other locations	22 (25.6)	3,182 (37.1)	3,204 (37.0)	0.69
Education (n=7,459), n (%)					<0.01*
No higher education	29 (42.0)	4,378 (59.2)	4,407 (59.1)	0.66
Higher education	40 (58.0)	3,012 (40.8)	3,052 (40.9)	1.31
Symptoms
Fever (n=8,666)	59	4,028	4,087	1.44	<0.01*
Respiratory distress (n=8,661)	43	1,579	1,622	2.65	<0.01*
Cough (n=8,661)	60	5,028	5,088	1.18	0.025*
Runny nose (n=8,662)	22	4,110	4,132	0.53	<0.01*
Sore throat (n=8,661)	20	3,026	3,046	0.66	0.024*
Diarrhea (n=8,661)	8	1,457	1,465	0.55	0.064
Headache (n=8,662)	40	5,253	5,293	0.76	<0.01*
Comorbidity^‡/risk factor
Pulmonary comorbidity (n=8,649)	4	297	301	1.33	0.351
Cardiovascular comorbidity (n=8,652)	32	1,056	1,088	2.94	<0.01*
Renal comorbidity (n=8,651)	2	17	19	10.53	0.015*
Diabetes (n=8,650)	19	308	327	5.81	<0.01*
Smoking (n=8,650)	1	121	122	0.82	0.657
Obesity (n=8,617)	13	401	414	3.14	<0.01*

Profession	Number	Healthcare workers registered in the state of Espírito Santo	Incidence rate
Nurse technician/Licensed practical nurse	4,330	33,539	12,910.3
Nurse	1,496	9,319	16,053.2
Physician	1,148	11,382	10,086.1
Community Health Worker	501	4,917	10,189.1

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[1] Corresponding author: Rodolfo Antonio Corona Rodovia Juscelino Kubitschek, 3.200, Condomínio Parque Felicitá – Universidade Zip code: 68903-913 – Macapá, AP, Brazil Phone: (55 27) 99809-8812 E-mail: rodolfocorona_00@hotmail.com