J C Crosby, R A Lee, G McGwin, S L Heath, G A Burkholder, R M Gravett, E T Overton, G Locks, M E Fleece, R Franco, S Nafziger
{"title":"A COVID-19 monitoring process for healthcare workers utilizing occupational health.","authors":"J C Crosby, R A Lee, G McGwin, S L Heath, G A Burkholder, R M Gravett, E T Overton, G Locks, M E Fleece, R Franco, S Nafziger","doi":"10.1093/occmed/kqad114","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Hospital-based occupational health (HBOH) is uniquely positioned to not only prevent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission, but to care for healthcare workers (HCWs) sick with coronavirus disease 2019 (COVID-19).</p><p><strong>Aims: </strong>The primary objective of this study is to describe a system where HBOH services were adapted to provide a monitoring programme whereby HCWs with SARS-CoV-2 received daily evaluations and treatment options in order to improve access to care, and to report the clinical outcomes and predictors of hospitalization in HCWs enrolled in the programme. A secondary objective is to compare clinical outcomes to data on national HCWs with COVID-19.</p><p><strong>Methods: </strong>This retrospective cohort study used survey data collected on HCWs at a university health system with COVID-19 from 1 March 2020 through 1 December 2021. A firth regression model was used to examine the unadjusted and adjusted association between clinical factors and hospitalization.</p><p><strong>Results: </strong>The study cohort included 4814 HCWs with COVID-19. Overall hospitalizations were 119 (2%), and there were six deaths (0.12%). Predictors of hospitalization include several co-morbidities and symptoms. A total of 1835 HCWs monitored before vaccine or monoclonal antibody availability were compared with data on U.S. HCWs in a similar time period. The monitored HCWs had a lower rate of co-morbidities (19% versus 44%, P < 0.001), a lower hospitalization rate (3% versus 8% P < 0.001) and case-fatality rate (0.11% versus 0.95% P < 0.001).</p><p><strong>Conclusions: </strong>This monitoring strategy for COVID-19 may be feasible for HBOH systems to implement and improve access to care, but more data are needed to determine if it improves outcomes.</p>","PeriodicalId":54696,"journal":{"name":"Occupational Medicine-Oxford","volume":" ","pages":"71-77"},"PeriodicalIF":2.4000,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10875928/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Occupational Medicine-Oxford","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/occmed/kqad114","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Hospital-based occupational health (HBOH) is uniquely positioned to not only prevent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission, but to care for healthcare workers (HCWs) sick with coronavirus disease 2019 (COVID-19).
Aims: The primary objective of this study is to describe a system where HBOH services were adapted to provide a monitoring programme whereby HCWs with SARS-CoV-2 received daily evaluations and treatment options in order to improve access to care, and to report the clinical outcomes and predictors of hospitalization in HCWs enrolled in the programme. A secondary objective is to compare clinical outcomes to data on national HCWs with COVID-19.
Methods: This retrospective cohort study used survey data collected on HCWs at a university health system with COVID-19 from 1 March 2020 through 1 December 2021. A firth regression model was used to examine the unadjusted and adjusted association between clinical factors and hospitalization.
Results: The study cohort included 4814 HCWs with COVID-19. Overall hospitalizations were 119 (2%), and there were six deaths (0.12%). Predictors of hospitalization include several co-morbidities and symptoms. A total of 1835 HCWs monitored before vaccine or monoclonal antibody availability were compared with data on U.S. HCWs in a similar time period. The monitored HCWs had a lower rate of co-morbidities (19% versus 44%, P < 0.001), a lower hospitalization rate (3% versus 8% P < 0.001) and case-fatality rate (0.11% versus 0.95% P < 0.001).
Conclusions: This monitoring strategy for COVID-19 may be feasible for HBOH systems to implement and improve access to care, but more data are needed to determine if it improves outcomes.
期刊介绍：
Occupational Medicine is an international peer-reviewed journal which provides vital information for the promotion of workplace health and safety. The key strategic aims of the journal are to improve the practice of occupational health professionals through continuing education and to raise the profile of occupational health with key stakeholders including policy makers and representatives of employers and employees.
Topics covered include work-related injury and illness, accident and illness prevention, health promotion, occupational disease, health education, the establishment and implementation of health and safety standards, monitoring of the work environment, and the management of recognized hazards. Contributions are welcomed from practising occupational health professionals and research workers in related fields.
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