Risk of COVID-19 in different groups of healthcare professionals between February 2020 and June 2021 in Finland: a register-based cohort study

Background

During the Coronavirus Disease 2019 (COVID-19) pandemic, healthcare workers (HCWs) have been a risk group for COVID-19.

Aim

To assess the cumulative incidence in different groups of HCWs and the risk factors and outcomes of COVID-19 in HCWs between February 2020 and June 2021 in Finland.

Methods

We linked two national registers, National Infectious Diseases Register (NIDR) and Register of Social Welfare and Healthcare Professionals (Terhikki), using national identity codes. COVID-19 cases were identified from NIDR notifications made by laboratories and physicians, and their healthcare professions from Terhikki. We categorized healthcare professions into seven groups and calculated cumulative incidences using Kaplan-Meier estimate during three periods (1/2/2020−30/6/2020, 1/7/2020−31/12/2020, 1/1/2021−30/6/2021). We identified risk factors in a multivariable model using Cox's regression.

Findings

We identified 8,009 COVID-19-cases among HCWs, with cumulative incidence of 1.79%; 83% were female, median age was 40.9 years (interquartile range, 31.2−51.6). Most COVID-19-cases occurred in nursing assistants (53%) and nurses (17%), with the highest cumulative incidences 2.07% (95%CI, 2.01−2.13%) and 1.82% (95%CI, 1.73−1.91%), respectively. Risk factors were male sex (hazard ratio (HR) 1.2; 95%CI, 1.1−1.3), foreign native language (HR 2.5; 95%CI, 2.2−2.9) and foreign country of birth (HR 1.2; 95%CI, 1.1−1.4). Physician notification data was available for 6,113/8,009 cases (76.3%); 244/6,113 (4.0%) were hospitalized and 37/6,113 (0.6%) in intensive care.

Conclusion

Nurses and nursing assistant, especially men and professionals with foreign background, were at higher risk of COVID-19. This should be specifically addressed during training and implementing infection control measures to protect themselves and patients.