UCLA

Objective/Purpose: More than 16 months after its first detection, the COVID-19 pandemic has resulted in over 159 million cases and 3.3 million deaths worldwide.1 The purpose of this study is to describe the potential associations between being a healthcare worker and two outcomes of COVID-19 infection: hospitalization and death.

Methods: We conducted detailed descriptive analyses of all incident COVID-19 cases ascertained as part of the passive surveillance system instituted by the CDC from the 50 United States, Puerto Rico, and the US Virgin Islands between 2/1/2020 and 2/28/2021. We modeled the associations between healthcare worker status and two clinical outcomes of COVID-19 infection by individual U.S. state using multivariable multinomial logistic regressions, adjusting for sex, race/ethnicity, age group, and presence of pre-existing conditions.

Results: After adjustment, we observed that healthcare workers in Colorado, Louisiana, Massachusetts, and Ohio had lower odds of both hospitalization and death compared to those who were not healthcare workers. In addition, we noticed a pattern of higher odds of both hospitalization and death in people with unknown healthcare worker status compared to non-healthcare workers in all 12 states/territories assessed. Those with unknown healthcare worker status had the highest odds of hospitalization in the state of Utah (odds ratio, OR 11.73; 95% CI 9.51-14.46) and death in the state of Colorado (OR 13.99; 95% CI 3.12-62.68). The hospitalization ORs for healthcare workers and those with unknown healthcare worker status ranged from 0.27 to 11.73, while the death ORs ranged from 0.19 to 13.99.

Conclusions: The study results demonstrated that being a healthcare worker in the US was associated with less hospitalization and death from COVID-19 infection while having unknown healthcare worker status is associated with greater hospitalization and death. This study underscores the necessity for additional analyses of COVID-19 infection outcomes among both non-healthcare and healthcare workers, as well as the importance of complete data collection for disease surveillance systems.