COVID-19 hospital admissions and mortality among healthcare workers in South Africa, 2020-2021

Nonhlanhla Tlotleng; Cheryl Cohen; Felix Made; Tahira Kootbodien; Maureen Masha; Nisha Naicker; Lucille Blumberg; Waasila Jassat

doi:10.1016/j.ijregi.2022.08.014

COVID-19 hospital admissions and mortality among healthcare workers in South Africa, 2020-2021

IJID Reg. 2022 Dec:5:54-61. doi: 10.1016/j.ijregi.2022.08.014. Epub 2022 Sep 1.

Authors

Nonhlanhla Tlotleng^{1

2

3}, Cheryl Cohen^{4

5}, Felix Made¹, Tahira Kootbodien¹, Maureen Masha^{6

7}, Nisha Naicker², Lucille Blumberg^{6

7}, Waasila Jassat^{6

7}

Affiliations

¹ Epidemiology and Surveillance Section, National Institute for Occupational Health, National Health Laboratory Service, Braamfontein, Johannesburg 2001, South Africa.
² Environmental Health Department, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2028, South Africa.
³ School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Arcadia 0007, South Africa.
⁴ School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Witwatersrand 2193, South Africa.
⁵ Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa.
⁶ Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, Johannesburg, South Africa.
⁷ Right to Care, Johannesburg, South Africa.

Abstract

Objectives: This study describes the characteristics of admitted HCWs reported to the DATCOV surveillance system, and the factors associated with in-hospital mortality in South African HCWs.

Methods: Data from March 5, 2020 to April 30, 2021 were obtained from DATCOV, a national hospital surveillance system monitoring COVID-19 admissions in South Africa. Characteristics of HCWs were compared with those of non-HCWs. Furthermore, a logistic regression model was used to assess factors associated with in-hospital mortality among HCWs.

Results: In total, there were 169 678 confirmed COVID-19 admissions, of which 6364 (3.8%) were HCWs. More of these HCW admissions were accounted for in wave 1 (48.6%; n = 3095) than in wave 2 (32.0%; n = 2036). Admitted HCWs were less likely to be male (28.2%; n = 1791) (aOR 0.3; 95% CI 0.3-0.4), in the 50-59 age group (33.1%; n = 2103) (aOR 1.4; 95% CI 1.1-1.8), or accessing the private health sector (63.3%; n = 4030) (aOR 1.3; 95% CI 1.1-1.5). Age, comorbidities, race, wave, province, and sector were significant risk factors for COVID-19-related mortality.

Conclusion: The trends in cases showed a decline in HCW admissions in wave 2 compared with wave 1. Acquired SARS-COV-2 immunity from prior infection may have been a reason for reduced admissions and mortality of HCWs despite the more transmissible and more severe beta variant in wave 2.

Keywords: SARS-CoV-2; healthcare workers; hospital admissions; hospital surveillance; in-hospital mortality.