Incidence and the Factors Associated with Severe COVID-19 among Healthcare Workers in Kannur District of Kerala: A Longitudinal Study

  • Ameena Subair Raheela Assistant Surgeon, Department of Health Services, Government of Kerala.
  • Preetha Muduvana District Surveillance Officer, Department of Health Services, Government of Kerala.
Keywords: Healthcare Workers, Kerala, Severe COVID-19

Abstract

Background: COVID-19 remains a challenge to healthcare workers (HCWs) all over the world since its emergence in the form of a pandemic. Keeping in view the vulnerability of HCWs to multiple exposures because of the nature of the service they are providing, the Government of India launched COVID-19 vaccination initially for the HCWs. The study intended to estimate the incidence of severe COVID-19, the factors associated with as well as the predictors of severe COVID-19 among the HCWs declared positive for Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) in Kannur, a northern district of Kerala.

Methods: The study design used was a prospective observational, where the study population was HCWs declared positive for SARS-CoV-2 from January to July 2021 in Kannur district. Out of the total declared, 3014 HCWs were followed up for two months from their date of declaring positive for COVID-19, over the telephone as part of the district-level monitoring process under COVID-19 surveillance.

Results: Out of the total 3014 HCWs, 2604 (86%) reported at least one kind of symptom. Twenty cases belonged to severe COVID-19 and the severity of COVID-19 was found associated with factors like place of isolation, transmission of COVID-19 infection to the family members, history of COVID-19 vaccination, presence of more than one co-morbidity, having diabetes mellitus, having hypertension, presence of symptoms such as fatigue, vomiting and dyspnoea. 65 cases were COVID-19 re-infections and none of them were having severe COVID-19. On regression, the significant predictors obtained were the presence of vomiting, dyspnoea, diabetes mellitus, and a history of transmission of COVID-19 infection to the family members.

Conclusion: The disease severity can be predicted by the presence of co-morbidities, disease transmission, and certain clinical features.

How to cite this article:
Raheela AS, Muduvana P. Incidence and the Factors Associated with Severe COVID-19 among Healthcare Workers in Kannur District of Kerala: A Longitudinal Study. XIV Annual Conference of Indian Society for Malaria & Other Communicable Diseases (ISMOCD). 2023;40-48.

DOI: https://doi.org/10.24321/0019.5138.202335

References

Wu YC, Chen CS, Chan YJ. The outbreak of COVID-19: an overview. J Chin Med Assoc [Internet]. 2020 Mar [cited 2023 Mar 14];83(3):217-20. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7153464/ [PubMed] [Google Scholar]

World Health Organization [Internet]. Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV); [cited 2020 Aug 21]. Available from: https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-coronavirus-(2019-ncov)

Health & Family Welfare Department, Govt of Kerala [Internet]. Kerala epidemic diseases, COVID-19 regulations, 2020; [cited 2020 Aug 21]. Available from: https://dhs.kerala.gov.in/wp-content/uploads/2020/06/Daily-Bulletin-HFWD-English-June-12.pdf

John TJ, Seshadri MS [Internet]. Imperatives after India’s September virus peak. The Hindu; 2020 Sep 29 [cited 2021 Mar 3]. Available from: https://www.thehindu.com/opinion/lead/imperatives-after-indias-september-virus-peak/article32719000.ece

Sahu AK, Amrithanand VT, Mathew R, Aggarwal P, Nayer J, Bhoi S. COVID-19 in health care workers – a systematic review and meta-analysis. Am J Emerg Med [Internet]. 2020 Sep [cited 2023 Mar 14];38(9):1727-31. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7837172/ [PubMed] [Google Scholar]

Zhang J, Shoucai W, Lingzhong X. Asymptomatic carriers of COVID-19 as a concern for disease prevention and control: more testing, more follow-up. Biosci Trends [Internet]. 2020 Jul 17 [cited 2023 Mar 16];14(3):206-8. Available from: https://pubmed.ncbi.nlm.nih.gov/32321904/ [PubMed] [Google Scholar]

Li X, Zhong X, Wang Y, Zeng X, Luo T, Liu Q. Clinical determinants of the severity of COVID-19: a systematic review and meta-analysis. PLoS One [Internet]. 2021 May 3 [cited 2023 Mar 16];16(5):e0250602. Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0250602 [PubMed] [Google Scholar]

Wang F, Kream RM, Stefano GB. Long-term respiratory and neurological sequelae of COVID-19. Med Sci Monit [Internet]. 2020 [cited 2023 Mar 14];26:e928996. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7643287/ [PubMed] [Google Scholar]

Ministry of Health & Family Welfare, Government of India [Internet]. Revised guidelines for implementation of National COVID Vaccination Program; [cited 2023 Mar 14]. Available from: https://www.mohfw.gov.in/pdf/RevisedVaccinationGuidelines.pdf

Huang YZ, Kuan CC. Vaccination to reduce severe COVID-19 and mortality in COVID-19 patients: a systematic review and meta-analysis. Eur Rev Med Pharmacol Sci [Internet]. 2022 [cited 2023 Mar 14];26(5):1770-6. Available from: https://www.europeanreview.org/article/28248 [PubMed] [Google Scholar]

Joo LK, Sazali MF, Goroh M, Zefong AC, Maluda MC, Avoi R, Gantul VJ. Predictors of severe COVID-19 among healthcare workers in Sabah, Malaysia. BMC Health Serv Res [Internet]. 2022 Dec 17 [cited 2023 Mar 29];22(1):1541. Available from: https://doi.org/10.1186/s12913-022-08920-4 [PubMed] [Google Scholar]

Nienhaus A, Hod R. COVID-19 among health workers in Germany and Malaysia. Int J Environ Res Public Health [Internet]. 2020 Jul [cited 2023 Mar 15];17(13):4881. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7369938/ [PubMed] [Google Scholar]

Bandyopadhyay S, Baticulon RE, Kadhum M, Alser M, Ojuka DK, Badereddin Y, Kamath A, Parepalli SA, Brown G, Iharchane S, Gandino S, Markovic-Obiago Z, Scott S, Manirambona E, Machhada A, Aggarwal A, Benazaize L, Ibrahim M, Kim D, Tol I, Taylor EH, Knighton A, Bbaale D, Jasim D, Alghoul H, Reddy H, Abuelgasim H, Saini K, Sigler A, Abuelgasim L, Moran-Romero M, Kumarendran M, Jamie NA, Ali O, Sudarshan R, Dean R, Kissyova R, Kelzang S, Roche S, Ahsan T, Mohamed Y, Dube AM, Gwini GP, Gwokyala R, Brown R, Papon MR, Li Z, Ruzats SS, Charuvila S, Peter N, Khalidy K, Moyo N, Alser O, Solano A, Robles-Perez E, Tariq A, Gaddah M, Kolovos S, Muchemwa FC, Saleh A, Gosman A, Pinedo-Villanueva R, Jani A, Khundkar R. Infection and mortality of healthcare workers worldwide from COVID-19: a systematic review. BMJ Glob Health [Internet]. 2020 Dec [cited 2023 Mar 29];5(12):e003097. Available from: https://gh.bmj.com/content/5/12/e003097 [PubMed] [Google Scholar]

Raheela AS, Chandran S, Rajan D, Muduvana P. Quadmester-wise comparison of disease transmission dynamics of COVID-19 among health care workers in Kannur district, Kerala. Int J Community Med Public Health [Internet]. 2021 Apr 27 [cited 2023 Mar 14];8(5):2481-5. Available from: https://www.ijcmph.com/index.php/ijcmph/article/view/7980

Sharma J, Rajput R, Bhatia M, Arora P, Sood V. Clinical predictors of COVID-19 severity and mortality: a perspective. Front Cell Infect Microbiol [Internet]. 2021 [cited 2023 Mar 29];11:674277. Available from: https://www.frontiersin.org/articles/10.3389/fcimb.2021.674277 [PubMed] [Google Scholar]

Stoecklin SB, Rolland P, Silue Y, Mailles A, Campese C, Simondon A, Mechain M, Meurice L, Nguyen M, Bassi C, Yamani E, Behillil S, Ismael S, Nguyen D, Malvy D, Lescure FX, Georges S, Lazarus C, Tabaï A, Stempfelet M, Enouf V, Coignard B, Levy-Bruhl D; Investigation Team. First cases of coronavirus disease 2019 (COVID-19) in France: surveillance, investigations and control measures, January 2020. Euro Surveill [Internet]. 2020 Feb [cited 2020 Nov 8];25(6):2000094. Available from: https://www.eurosurveillance.org/docserver/fulltext/eurosurveillance/25/6/eurosurv-25-6-4.pdf?expires=1604843633&id=id&accname=guest&checksum=E1CF112AC2CC7E1E2ED7CE19522A49BC [PubMed] [Google Scholar]

Ge E, Li Y, Wu S, Candido E, Wei X. Association of pre-existing comorbidities with mortality and disease severity among 167,500 individuals with COVID-19 in Canada: a population-based cohort study. PLoS One [Internet]. 2021 Oct 5 [cited 2023 Mar 29];16(10):e0258154. Available from: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0258154 [PubMed] [Google Scholar]

Ganguli S, Howlader S, Dey K, Barua S, Islam MN, Aquib TI, Partho PB, Chakraborty RR, Barua B, Hawlader MD, Biswas PK. Association of comorbidities with the COVID-19 severity and hospitalization: a study among the recovered individuals in Bangladesh. Int J Health Sci (Qassim) [Internet]. 2022 [cited 2023 Apr 3];16(4):30-45. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9288138/ [PubMed] [Google Scholar]

Madhi SA, Nel J. Epidemiology of severe COVID-19 from South Africa. Lancet HIV [Internet]. 2021 Sep [cited 2023 Mar 16];8(9):e524-6. Available from: https://linkinghub.elsevier.com/retrieve/pii/S2352301821001831 [PubMed] [Google Scholar]

Ferioli M, Cisternino C, Leo V, Pisani L, Palange P, Nava S. Protecting healthcare workers from SARS-CoV-2 infection: practical indications. Eur Respir Rev [Internet]. 2020 Apr [cited 2023 Mar 20];29(155):200068. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7134482/ [PubMed] [Google Scholar]

Published
2023-10-21