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Analysis of the infection status of the health care workers in Wuhan during the COVID-19 outbreak: A cross-sectional study

Our take —

In this descriptive study, health care workers (HCW) had higher rates of infection but a lower case fatality rate than the general population. HCW in general hospitals had a higher infection rate than those at specialty or community hospitals. Results of the study were likely influenced by selection bias because HCW are more likely to receive testing for COVID-19 and more likely to be exposed during early stages of the epidemic with limited access to PPE.

Study design

Retrospective Cohort

Study population and setting

This retrospective cohort study includes 2457 health care workers from 145 hospitals in Wuhan, who had laboratory-confirmed COVID-19 and received assistance from the Red Cross Humanitarian Aid Fund between January 26 and March 26, 2020. Statistics on the total population of Wuhan were gathered from the Wuhan Statistics Bureau. Case infection rate was estimated as the number of laboratory-confirmed COVID-19 cases divided by the total population of interest (i.e. health care workers or non-health care workers).

Summary of Main Findings

Among the estimated 117,100 health care workers in Wuhan, 2,457 were diagnosed with COVID-19 and received assistance from the Humanitarian Aid Fund, corresponding to a case infection rate of 2.1%. During the same period, the general (non-health care worker) population of Wuhan was close to 11 million people with 47,549 cases of COVID-19, corresponding to a case infection rate of 0.43%. The case fatality rate among health care workers was 0.69%, and among non-health care workers was 5.3%. Among health care workers, those working in general hospitals had the highest case infection rate (2.93%), whereas 0.8% and 0.5% of health care workers in specialized and community hospitals, respectively, were infected. Additionally, nurses had a slightly higher case infection rate than doctors (2.22% vs 1.92%).

Study Strengths

This was a very large and multi-site study of health care workers in Wuhan, which is an understudied area.


The analyses were descriptive with no adjustment for potential confounding factors. The authors do not provide any details on the clinical characteristics (symptoms, comorbidities) of included patients. The authors do not address selection bias, which is likely given that health care workers are more likely to get screened for COVID-19 than the general population. In the early stages of the epidemic, access to personal protective equipment was limited, but it is unclear how this influenced the rates of infection.

Value added

This is a large study that compares COVID-19 infection rates between health care workers and the general population.

This review was posted on: 17 June 2020