Indian Journal of Critical Care Medicine

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 26 , ISSUE 1 ( January, 2022 ) > List of Articles

Original Article

Assessment of Risk Factors for Coronavirus Disease-2019 in Healthcare Workers: A Case–Control Study

Sukhyanti Kerai, Rahil Singh, Suraj D Desai

Keywords : COVID-19, Healthcare workers, Risk factors

Citation Information : Kerai S, Singh R, Desai SD. Assessment of Risk Factors for Coronavirus Disease-2019 in Healthcare Workers: A Case–Control Study. Indian J Crit Care Med 2022; 26 (1):76-84.

DOI: 10.5005/jp-journals-10071-24071

License: CC BY-NC 4.0

Published Online: 17-01-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Background and aims: With the rise of coronavirus disease-2019 (COVID-19) cases globally, the infection among frontline healthcare workers (HCWs) escalates many folds. There is, however, limited literature from low middle-income countries regarding risk factors for COVID-19 infection in HCWs. We conducted a case–control study to evaluate the risk factors of COVID-19 infection to HCWs. Materials and methods: This case–control study was conducted in a designated COVID-19 hospital. Eighty-one HCWs involved in direct care of COVID-19 patients, identified as cases, and 266 were recruited as controls. Telephonic interviews with participants were conducted, and information regarding demographic variables, chemoprophylaxis, exposure to infected patients, and adherence to infection prevention and control (IPC) measures was collected. Results: We observed a statistically significant difference in the number of times training session for IPC measures attended by HCWs (p = 0.02), performance of aerosol-generating medical procedures (AGMPs) (p <0.001), practices of donning and doffing of personal protective equipment (PPE) (p <0.001), hand hygiene (p <0.001), and decontamination of highly touched surfaces (p <0.001). Logistic regression analysis revealed if the decontamination of highly touched surfaces is decreased by one unit, the odds of getting COVID-19 infection is multiplied by a factor of 0.41 and AGMPs decrease the risk of being a case by 0.76. Conclusion: This study highlighted that inadequate observation of IPC methods increases the risk of COVID-19 infection to frontline HCWs, whereas performance of AGMPs does not enhance the risk. In this study, HCWs undertaking an AGMP, because of concern of acquiring infection, were more diligent during procedures and hence had lesser infection.

  1. Nguyen LH, Drew DA, Graham MS, Joshi AD, Guo CG, Ma W, et al. Risk of COVID-19 among frontline healthcare workers and the general community: a prospective cohort study. Lancet Public Health 2020;5(9):e475–e483. DOI: 10.1016/S2468-2667(20)30164-X.
  2. Chatterjee P, Anand T, Singh KJ, Rasaily R, Singh R, Das S, et al. Health care workers and SARS-COV-2 infection in India: a case control investigation in the time of COVID-19. Indian J Med Res 2020;151(5):459–467. DOI: 10.4103/ijmr.IJMR_2234_20.
  3. Jha S, Soni A, Siddiqui S, Batra N, Goel N, Dey S, et al. Prevalence of flu-like symptoms and COVID-19 in healthcare workers from India. J Assoc Physicians India 2020;68(7):27–29. PMID: 32602677.
  4. Bandopadhyay S, Baticulon RE, Kadhum M, Asler M, Ojuka DK, Badereddin Y, et al. Infection and mortality of healthcare workers worldwide from COVID-19: a systematic review. BMJ Glob Health 2020;5(12):e003097. DOI: 10.1136/bmjgh-2020-003097.
  5. [internet]. World Health Organization: WHO Coronavirus Disease (COVID-19) dashboard. 2020. Available from:
  6. Tourangeau R, Yan T. Sensitive questions in surveys. Psychol Bull 2007;133(5):859–883. DOI: 10.1037/0033-2909.133.5.859.
  7. Contzen N, Pasquale SD, Mosler HJ. Over-reporting in handwashing self-reports: potential factors and alternative measurements. PLoS One 2015;10:e0136445. DOI: 10.1371/journal.pone.0136445.
  8. Huslage K, Rutala WA, Sickbert-Bennett E, Weber DJ. A quantitative approach to defining highly -touch surfaces in hospitals. Infect Control Hosp Epidemiol 2010;31(8):850–853. DOI: 10.1086/655016.
  9. [internet]. New Delhi: Indian council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, Government of India. 2020. Available from:
  10. Ran L, Chen X, Wang Y, Wu W, Zhang L, Tan X, et al. Risk factors of healthcare workers with corona virus disease 2019: a retrospective cohort study in a designated hospital of Wuhan in China. Clin Infect Dis 2020;71(16):2218–2221. DOI: 10.1093/cid/ciaa287.
  11. Chou R, Dana T, Buckley DI, Selph S, Fu R, Totten AM. Epidemiology of and risk factors for coronavirus infection in healthcare workers: a living rapid review. Ann Intern Med 2020;173(2):120–136. DOI: 10.7326/M20-1632.
  12. Van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, et al. Aerosol and surface stability of SARS-CoV-2 as compared to SARS-CoV-1. N Engl J Med 2020;382(16):1564–1567. DOI: 10.1056/NEJMc2004973.
  13. Ge T, Lu Ye, Zheng S, Zhou L, Yu L, Ni Z, et al. Evaluation of disinfection procedure in a designated hospital for COVID-19. Am J Infect Control 2021;49(4):447–451. DOI: 10.1016/j.ajic.2020.08.028.
  14. Zhang S, Wang C, Lin M, Deng Q, Ye Y, Li Z, et al. Analysis of the virus contamination and disinfection effect in isolation ward of patients with COVID-19. Front Public Health 2020;8:486. DOI: 10.3389/fpubh.2020.00486.
  15. Wang J, Zhou M, Liu F. Reasons for healthcare workers becoming infected with novel coronavirus disease 2019 (COVID-19) in China. J Hosp Infect 2020;105(1):100–101. DOI: 10.1016/j.jhin.2020.03.002.
  16. Houghton C, Meskell P, Delaney H, Smalle M, Glenton C, Booth A, et al. Barrier and facilitators to healthcare worker's adherence with infection prevention and control (IPC) guidelines for respiratory infectious disease: a rapid qualitative evidence synthesis. Cochrane Database Syst Rev 2020;4:CD013582. DOI: 10.1002/14651858.CD013582.
  17. Dyson J, Madeo M. Investigating the use of an electronic hand hygiene monitoring and prompt device: influence and acceptability. J Infect Prev 2017;18(6):278–287. DOI: 10.1177/1757177417714045.
  18. Boyce JM. Measuring healthcare worker hand hygiene activity: current practices and emerging technologies. Infect Control Hosp Epidemiol 2011;32(10):1016–1028. DOI: 10.1086/662015.
  19. Singh A, Naik NB, Lal SS, Puri GD. Real-time remote surveillance of doffing during COVID-19 pandemic: enhancing safety of health care workers. Anaesth Analg 2020;131(2):e112–e113. DOI: 10.1213/ANE.0000000000004940.
  20. Krusumovic E, Lennane S, Cook TM. Deaths in healthcare workers due to COVID-19: the need for robust data and analysis. Anaesthesia 2020;75(8):989–992. DOI: 10.1111/anae.15116.
  21. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan. JAMA 2020;323(11):1061–1069. DOI: 10.1001/jama.2020.1585.
  22. Albella BS, Jolkovsky EL, Biney BT, Uspal JE, Hyman MC, Frank I, et al. Efficacy and safety of hydroxychloroquine Vs placebo for pre-exposure SARS CoV2 prophylaxis among health care workers. JAMA Intern Med 2020;e206319. DOI: 10.1001/jamainternmed.2020.6319.
  23. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020;395:1054–1062. DOI: 10.1016/S0140-6736(20)30566-3.
  24. Tran K, Cimon K, Severn M, Pessoa-Silva CL, Conly J. Aerosol-generating procedures and risk of transmission of acute respiratory infections: a systematic review. CADTH Technol Overv 2013;3(1):e3101. PMCID: PMC3579388.
  25. Brown J, Gregson FKA, Shrimpton A, Cook TM, Bzdek BR, Reid JP, et al. A quantitative evaluation of aerosol generation during tracheal intubation and extubation. Anaesthesia 2020. DOI: 10.1111/anae.15292.
  26. Yao W, Wang T, Jiang B, Gao F, Wang Li, Zheng H, et al. Emergency tracheal intubations in 202 patients with COVID-19 in Wuhan, China: lessons learnt and international expert recommendations. Br J Anaesth 2020;125(1):e28–e37. DOI: 10.1016/j.bja.2020.03.026.
  27. Wilson NM, Nortan A, Young FP, Collins DW. Airborne transmission of severe acute respiratory syndrome coronavirus-2 to health care workers: a narrative review. Anaesthesia 2020;75(8):1086–1095. DOI: 10.1111/anae.15093.
  28. Haas JP, Larson EL. Measurement of compliance with hand hygiene. J Hosp Infect 2007;66(1):6–14. DOI: 10.1016/j.jhin.2006.11.013.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.