COVID-19 in Turkish health care workers practicing chest medicine

Sandal, Abdulsamet; Toreyin, Zehra Nur; Salturk, Cuneyt; Arbak, Peri Meram

doi:10.1590/1806-9282.20210667

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Revista da Associação Médica Brasileira

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Original Article • Rev. Assoc. Med. Bras. 67 (10) • Oct 2021 • https://doi.org/10.1590/1806-9282.20210667 copy

COVID-19 in Turkish health care workers practicing chest medicine

Authorship SCIMAGO INSTITUTIONS RANKINGS

SUMMARY

OBJECTIVE:

This study aimed to evaluate the data of Turkish health care workers practicing chest medicine on their coronavirus disease 2019 (COVID-19) status and related parameters.

METHODS:

This descriptive study included online survey data that the Turkish Thoracic Society conducted with its members in two phases starting in June and December 2020. The 33-item survey included demographic data, smoking status, the presence of any chronic diseases, occupation, working status, and non–work-related and work-related COVID-19 exposure characteristics.

RESULTS:

Of 742 responses, 299 (40.3%) reported that they had contracted COVID-19. The second survey detected a higher frequency of health care workers who had contracted COVID-19 (12.1% versus 57.4%, p<0.001) than the first survey. The analysis of the association between study parameters and COVID-19 in health care workers using logistic regression revealed statistical significance with working at the onset of the outbreak (OR 3.76, 95%CI 1.09–12.98, p=0.036), not working at the time of survey (OR 5.69, 95%CI 3.35–9.67, p<0.001), COVID-19 history in colleagues (OR 2.27, 95%CI 1.51–3.41, p<0.001), any non–work-related COVID-19 exposure (OR 4.72, 95%CI 2.74–8.14, p<0.001), COVID-19 exposure at home (OR 6.52, 95%CI 3.52–12.08, p<0.001), and COVID-19 history in family members (OR 8.16, 95%CI 5.52–12.08, p<0.001) after adjusting for age and sex. The study also observed an inverse relationship between the use of aprons and goggles and COVID-19 in health care workers.

CONCLUSION:

Occupational and nonoccupational characteristics are related to COVID-19 in health care workers practicing chest medicine. Therefore, active surveillance to detect health care workers contracting COVID-19 and to document and control occupational and nonoccupational risks should be provided.

KEYWORDS:
COVID-19; Occupational health; Health personnel; Occupational medicine; Occupational diseases

Characteristics		First survey			Second survey			Total
Characteristics		HCWs contracted COVID-19 (n=34)	HCWs without COVID-19 history (n=246)	p-value	HCWs contracted COVID-19 (n=265)	HCWs without COVID-19 history (n=197)	p-value	HCWs contracted COVID-19 (n=299)	HCWs without COVID-19 history (n=443)	p-value
Age, median (min–max)^* * The missing values were due to unanswered online survey questions for age in 26, occupation in one, the exposure to secretions from infected patients in 132 responses. The item for any household member older than 60 years of age was only replied by the participants who reported that they did not live single.		44.5 (26–65)	43 (23–73)	0.534^† † Mann–Whitney U test.	42 (22–64)	43 (23–70)	0.253^† † Mann–Whitney U test.	43 (22–65)	43 (23–73)	0.367^† † Mann–Whitney U test.
Sex, n (%)				0.711^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.			0.337^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.			0.949^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
	Female	22 (64.7)	167 (67.9)		169 (63.8)	117 (59.4)		191 (63.9)	284 (64.1)
	Male	12 (35.3)	79 (32.1)		96 (36.2)	80 (40.6)		108 (36.1)	159 (35.9)
Smoking status, n (%)				0.765^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.			0.009^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.			0.002^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
	Never smoker	24 (70.6)	158 (64.2)		190 (71.7)	128 (65.0)		214 (71.6)	286 (64.6)
	Ex-smoker	5 (14.7)	43 (17.5)		54 (20.4)	35 (17.8)		59 (19.7)	78 (17.6)
	Current smoker	5 (14.7)	45 (18.3)		21 (7.9)	34 (17.3)		26 (8.7)	79 (17.8)
Any comorbidity, n (%)		11 (32.4)	75 (30.5)	0.825^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	97 (36.6)	59 (29.9)	0.135^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	108 (36.1)	134 (30.2)	0.094^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
Comorbid hypertension, n (%)		3 (8.8)	29 (11.8)	0.778§	43 (16.2)	24 (12.2)	0.222^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	46 (15.4)	53 (12.0)	0.179^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
Comorbid diabetes mellitus, n (%)		1 (2.9)	12 (4.9)	1.000§	17 (6.4)	13 (6.6)	0.937^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	18 (6.0)	25 (5.6)	0.829^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
Comorbid coronary artery disease, n (%)		0	5 (2.0)	1.000§	9 (3.4)	3 (1.5)	0.211^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	9 (3.0)	8 (1.8)	0.282^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
Comorbid hyperlipidemia, n (%)		1 (2.9)	6 (2.4)	0.600§	12 (4.5)	11 (5.6)	0.606^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	13 (4.3)	17 (3.8)	0.729^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
Comorbid cerebrovascular accident, n (%)		1 (2.9)	3 (1.2)	0.406§	1 (0.4)	3 (1.5)	0.317§	2 (0.7)	6 (1.4)	0.485§
Comorbid cancer, n (%)		2 (5.9)	4 (1.6)	0.157§	4 (1.5)	3 (1.5)	1.000§	6 (2.0)	7 (1.6)	0.664^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
Comorbid COPD, n (%)		0	2 (0.8)	1.000§	2 (0.8)	1 (0.5)	1.000§	2 (0.7)	3 (0.7)	1.000§
Comorbid asthma, n (%)		4 (11.8)	20 (8.1)	0.510§	33 (12.5)	14 (7.1)	0.060^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	37 (12.4)	34 (7.7)	0.033^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
Comorbid thyroid disease, n (%)		1 (2.9)	8 (3.3)	1.000§	12 (4.5)	3 (1.5)	0.071^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	13 (4.3)	11 (2.5)	0.159^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
Comorbid rheumatic disease, n (%)		1 (2.9)	6 (2.4)	0.600§	6 (2.3)	5 (2.5)	1.000§	7 (2.3)	11 (2.5)	0.902^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
Comorbid liver disease, n (%)		0	0	–	2 (0.8)	2 (1.0)	1.000§	2 (0.7)	2 (0.5)	1.000§
Household size, n (%)				0.550§			0.637^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.			0.671^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
	Single	2 (5.9)	25 (10.2)		32 (12.1)	21 (10.7)		34 (11.4)	46 (10.4)
	Family	32 (94.1)	221 (89.8)		233 (87.9)	176 (89.3)		265 (88.6)	397 (89.6)
	Any household member older than 60 years of age, n (%)^* * The missing values were due to unanswered online survey questions for age in 26, occupation in one, the exposure to secretions from infected patients in 132 responses. The item for any household member older than 60 years of age was only replied by the participants who reported that they did not live single.	12 (37.5)	55 (24.9)	0.131^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	48 (20.6)	40 (22.7)	0.604^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	60 (22.6)	95 (23.9)	0.701^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
	Any non–work-related COVID-19 exposure, n (%)	4 (11.8)	5 (2.0)	0.003§	51 (19.2)	15 (7.6)	<0.001^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	55 (18.4)	20 (4.5)	<0.001^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
	Non–work-related COVID-19 exposure at home, n (%)	3 (8.8)	3 (1.2)	0.025§	49 (18.5)	11 (5.6)	<0.001^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	52 (17.4)	14 (3.2)	<0.001^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
	Non–work-related COVID-19 exposure at other settings, n (%)	1 (2.9)	2 (0.8)	0.323§	1 (0.4)	4 (2.0)	0.169§	2 (0.7)	6 (1.4)	0.485§
	COVID-19 history in any household member, n (%)	9 (26.5)	13 (5.3)	<0.001§	134 (50.6)	33 (16.8)	<0.001^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	143 (47.8)	46 (10.4)	<0.001^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
Occupation, n (%)				0.054§			0.821^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.			0.279^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
	Physician	34 (100.0)	221 (89.8)		210 (79.5)	155 (78.7)		244 (81.9)	376 (84.9)
	Other	0	25 (10.2)		54 (20.5)	42 (21.3)		54 (18.1)	67 (15.1)
Working status at the onset of the outbreak, n (%)				0.372§			0.295§			0.019^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
	Not working	0	12 (4.9)		3 (1.1)	5 (2.5)		3 (1.0)	17 (3.8)
	Working	34 (100.0)	234 (95.1)		262 (98.9)	192 (97.5)		296 (99.0)	426 (96.2)
	Working status at the time of survey, n (%)			0.136§			<0.001^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.			<0.001^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
	Not working	4 (11.8)	13 (5.3)		60 (22.6)	7 (3.6)		64 (21.4)	20 (4.5)
	Working	30 (88.2)	233 (94.7)		205 (77.4)	190 (96.4)		235 (78.6)	423 (95.5)
Any work-related COVID-19 exposure, n (%)		26 (76.5)	160 (65.0)	0.186^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	151 (57.0)	120 (60.9)	0.396^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	177 (59.2)	280 (63.2)	0.271^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
Work-related COVID-19 exposure in outpatient clinics, n (%)		4 (11.8)	42 (17.1)	0.434^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	52 (19.6)	52 (26.4)	0.085^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	56 (18.7)	94 (21.2)	0.434^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
Work-related COVID-19 exposure in wards, n (%)		15 (44.1)	78 (31.7)	0.150^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	70 (26.4)	35 (17.8)	0.028^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	85 (28.4)	113 (25.5)	0.378^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
Work-related COVID-19 exposure in COVID-19 triage area, n (%)		1 (2.9)	19 (7.7)	0.485§	12 (4.5)	10 (5.1)	0.784^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	13 (4.3)	29 (6.5)	0.204^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
Work-related COVID-19 exposure in intensive care unit, n (%)		4 (11.8)	20 (8.1)	0.510§	28 (10.6)	25 (12.7)	0.479^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	32 (10.7)	45 (10.2)	0.812^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
Work-related COVID-19 exposure in emergency department, n (%)		1 (2.9)	12 (4.9)	1.000§	20 (7.5)	14 (7.1)	0.858^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	21 (7.0)	26 (5.9)	0.527^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
Work-related COVID-19 exposure in other departments, n (%)		1 (2.9)	8 (3.3)	1.000§	13 (6.6)	7 (2.6)	0.039^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	8 (2.7)	21 (4.7)	0.155^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
Any exposure to secretions from infected patients, n (%)^* * The missing values were due to unanswered online survey questions for age in 26, occupation in one, the exposure to secretions from infected patients in 132 responses. The item for any household member older than 60 years of age was only replied by the participants who reported that they did not live single.		3 (11.1)	44 (19.6)	0.287^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	57 (28.9)	45 (28.0)	0.837^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	60 (26.8)	89 (23.1)	0.301^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
COVID-19 history in colleagues, n (%)		22 (64.7)	150 (61.0)	0.675^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	239 (90.2)	179 (90.9)	0.807^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	261 (87.3)	329 (74.3)	<0.001^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
Use of any PPE, n (%)		34 (100.0)	242 (98.4)	1.000§	257 (97.0)	184 (93.4)	0.068^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	291 (97.3)	426 (96.2)	0.390^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
Use of disposable gloves, n (%)		30 (88.2)	193 (78.5)	0.184^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	186 (70.2)	126 (64.0)	0.157^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	216 (72.2)	319 (72.0)	0.945^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
Use of gowns, n (%)		30 (88.2)	201 (81.7)	0.348^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	188 (70.9)	122 (61.9)	0.041^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	218 (72.9)	323 (72.9)	0.999^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
Use of aprons, n (%)		14 (41.2)	79 (32.1)	0.293^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	46 (17.4)	45 (22.8)	0.143^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	60 (20.1)	124 (28.0)	0.014^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
Use of surgical masks, n (%)		29 (85.3)	221 (89.8)	0.384§	228 (86.0)	173 (87.8)	0.576^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	257 (86.0)	394 (88.9)	0.224^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
Use of respirators (N95/FFP2/FFP3), n (%)		29 (85.3)	186 (75.6)	0.210^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	200 (75.5)	137 (69.5)	0.156^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	229 (76.6)	323 (72.9)	0.260^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
Use of facial protectors, n (%)		23 (67.6)	177 (72.0)	0.603^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	166 (62.6)	101 (51.3)	0.014^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	189 (63.2)	278 (62.8)	0.899^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.
Use of goggles, n (%)		16 (47.1)	139 (56.5)	0.299^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	88 (33.2)	62 (31.5)	0.694^‡ ‡ Pearson's χ2 test. §Fisher's exact test. COPD: chronic obstructive pulmonary disease; COVID-19: coronavirus disease 2019; HCW: health care worker; min–max: minimum–maximum; PPE: personal protective equipment.	104 (34.8)	201 (45.4)	0.004‡'

		Crude analysis			Adjusted analysis
		n	OR (95%CI)	p-value	OR (95%CI)	p-value
Smoking status		716
	Never smoker		1.00 (ref)		1.00 (ref)
	Ex-smoker		0.99 (0.67–1.45)	0.947	1.04 (0.69–1.55)	0.868
	Current smoker		0.38 (0.23–0.63)	<0.001	0.38 (0.23–0.63)	<0.001
Asthma		716	1.62 (0.98–2.69)	0.060	1.66 (1.00–2.75)	0.050
Working at the onset of the outbreak		716	3.88 (1.13–13.37)	0.032	3.76 (1.09–12.98)	0.036
Any work-related COVID-19 exposure		716	0.84 (0.62–1.15)	0.276	0.84 (0.62–1.14)	0.258
Any exposure to secretions from infected patients		588	1.14 (0.77–1.68)	0.522	1.11 (0.75–1.65)	0.607
Not working at the time of survey		716	5.67 (3.34–9.64)	<0.001	5.69 (3.35–9.67)	<0.001
COVID-19 history in colleagues		716	2.29 (1.52–3.44)	<0.001	2.27 (1.51–3.41)	<0.001
Non-work-related COVID-19 exposure		716	4.66 (2.72–7.99)	<0.001	4.72 (2.74–8.14)	<0.001
COVID-19 exposure at home		716	6.45 (3.50–11.90)	<0.001	6.52 (3.52–12.08)	<0.001
COVID-19 history in any household member		716	7.98 (5.42–11.74)	<0.001	8.16 (5.52–12.08)	<0.001
Use of disposable gloves		716	1.03 (0.74–1.44)	0.853	1.00 (0.71–1.40)	0.976
Use of gowns		716	0.96 (0.69–1.35)	0.823	0.96 (0.68–1.34)	0.796
Use of aprons		716	0.64 (0.45–0.92)	0.017	0.62 (0.43–0.90)	0.011
Use of surgical masks		716	0.80 (0.51–1.26)	0.340	0.80 (0.51–1.27)	0.341
Use of respirators (N95/FFP2/FFP3)		716	1.19 (0.84–1.68)	0.323	1.17 (0.82–1.65)	0.388
Use of facial protectors		716	1.07 (0.78–1.46)	0.676	1.06 (0.78–1.44)	0.725
Use of goggles		716	0.64 (0.47–0.88)	0.005	0.64 (0.47–0.87)	0.005

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[1] *Corresponding author: asandal@hotmail.com.tr