10 The extent of risk modification with PPE remains unclear. In contrast, a screening study of HCW in England showed no significant difference in positive results between clinical and nonclinical staff with implementation of isolation and PPE protocols perhaps suggesting predominant community rather than nosocomial transmission patterns. 6 Reported experiences in China, 7 Italy, 8 and Solano County, CA, without initial use of PPE, 9 showed higher percentages of HCW testing positive for COVID-19. 5 Based upon data from the 2018 National Health Interview Survey, it was estimated that 26.6% of patient-facing HCW were at increased risk for poor outcomes from COVID-19 infection because of their comorbidities or age. The presence of specific symptoms in HCW (China, USA) 2, 3 and symptoms predicting SARS-CoV-2 test positivity in HCW (Netherlands) 4 has been reported as well as characteristics associated with HCW deaths (China).
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Prediction of risk can inform how to protect HCW such as recommendations on use of personal protective equipment (PPE) at work or in the community. Understanding the risks associated with the COVID-19 pandemic 1 on healthcare workers (HCW), including the risk of acquisition at work vs. 5.5), but no statistically significant increase in hospitalization (OR 0.88, CI 0.20–3.66, proportions 10.2 vs. Those HCW identified as patient facing compared to not had increased odds of a positive SARS-CoV-2 test (OR 1.60, CI 1.08–2.39, proportions 8.6 vs. non-HCW with OR of 0.42 (CI 0.26–0.66) and for ICU admission: 2.2 vs.
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Among those testing positive, weighted proportions for hospitalization were 7.4 vs.
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non-HCW having a positive test with weighted odds ratio (OR) 1.17, 95% confidence interval (CI) 0.99–1.38. However, the overlap propensity score weighted proportions were 8.9 vs. 57.5, p < 0.001) with more females (proportion of males 21.5 vs. The HCW were younger than the non-HCW (median age 39.7 vs.