Health Care Workers Hospitalized With COVID-19, Spring 2020: Nurses Most Affected

Health care personnel can catch SARS-CoV-2 at work and outside it. Using the COVID-19–Associated Hospitalization Surveillance Network (COVID-NET), CDC looked at those who ended up in the hospital from March 1 to May 31, 2020, in 98 counties in 13 states: California, Colorado, Connecticut, Georgia, Maryland, Michigan, Minnesota, New Mexico, New York, Ohio, Oregon, Tennessee and Utah.

"Health care personnel" meant anyone working in health care settings, home health care, or health jobs elsewhere (a school nurse, for example) with potential exposure to patients or infectious materials.

How many

COVID-NET received reports of 28,972 hospitalized adults; 8,515 were sampled for full chart review. Of 6,760 whose health care worker status was recorded, 438 were health care personnel — a weighted 5.9%.

How cases were selected, COVID-NET, 13 states, March 1–May 31, 2020. CDC

Who they were

Types of health care personnel hospitalized with COVID-19 (438), COVID-NET, 13 states, March 1–May 31, 2020. CDC

Their health

• 89.8% had at least one underlying condition — most often obesity (72.5%), then high blood pressure (40.6%) and diabetes (30.9%).
• Workers without direct patient contact had more obesity (80.9% vs 68.3%) and more cardiovascular disease other than high blood pressure (23.5% vs 8.4%) than those with it.
• 9.6% of women aged 18–49 were pregnant.
• 96.6% had symptoms on admission, most often shortness of breath (79.0%), cough (76.6%) and fever or chills (73.9%).

How sick they got

These severe outcomes were similar to those of all hospitalized adults aged 18–64.

What it means

• Nurses stand out, as in a study of health care workers in China. COVID-NET doesn't record exposures, but nurses' frequent, close patient contact may add up to long total exposure. Registered nurses alone were about a third of U.S. health care practitioners in 2019 — so their illness threatens the system's ability to cope with surges.
• Older and more often Black than earlier counts of infected health care workers — likely reflecting how age raises the risk of severe illness, and COVID-19's disproportionate toll on Black communities.
• Obesity is a strong risk factor for hospitalization, intensive care and death; the report calls for clinical care and workplace policies that support healthy lifestyles for health care workers.

What CDC recommends

• Face masks (medical masks) at all times in health care facilities — patient areas, staff rooms and anywhere colleagues gather.
• Eye protection for all patient care where community transmission is moderate to substantial.
• An N95-equivalent or better respirator for aerosol-generating and certain surgical procedures.
• Every worker, patient contact or not, following infection-control guidance: protective equipment, hand hygiene and physical distancing — plus community prevention, since exposure may happen outside work.

Limits

About 14% of sampled charts were still being reviewed, so the share of health care workers could be over- or underestimated; some estimates rest on small numbers; patient contact was inferred from job titles; exposures weren't recorded; and testing depended on clinicians and hospital policies, so hospitalizations may be undercounted.

Sources

Based on Kambhampati AK, O'Halloran AC, Whitaker M, et al., "COVID-19–Associated Hospitalizations Among Health Care Personnel — COVID-NET, 13 States, March 1–May 31, 2020," MMWR volume 69, number 43, Centers for Disease Control and Prevention, as corrected by its erratum; a work of the United States government in the public domain.