OBJECTIVES: COVID-19 disease, which has caused a global pandemic, poses significant threat to the healthcare system as healthcare workers (HCW) are at an elevated risk of contracting the disease and being temporarily removed from their regular duties. This study analyses and evaluates a cohort of employees at the University Hospital Ostrava (UHO) who applied for the recognition of COVID-19 as an occupational disease. METHODS: The disease characteristics and risk factors for severe cases of COVID-19 were analysed for all 474 claimants who applied for recognition of an occupational disease during the reporting period (March 2020 to November 2022) and were obtained from medical records. Statistical evaluation was performed using Fisher's exact test, Pearson's chi-square test and logistic regression analysis. RESULTS: The largest number of diseases was objectified in the period from September to November 2020. The most frequently reported symptoms were subfebrilia or febrilia (81.4%), olfactory dysfunction (75.1%), and dry cough (74.3%). A severe course of COVID-19 was experienced by 15.4% of the cohort. Additionally, 76.8% reported having at least one chronic disease. The risk of severe course was found to increase with the number of chronic diseases (p = 0.017). Individuals with chronic respiratory disease (CRD) had a 2.75-fold increased risk, and women had an approximately threefold increased risk. Higher risk was also associated with increasing age. CONCLUSIONS: Healthcare workers face a heightened risk of severe COVID-19, particularly among those with CRD, women and older age. Identifying these risk factors underscores the need for targeted preventive measures and early interventions to protect this vulnerable group and reduce the incidence of severe outcomes.

Clinic of Occupational Health and Preventive Medicine University Hospital Ostrava Ostrava Czech Republic

Department of Epidemiology and Public Health Faculty of Medicine University of Ostrava Ostrava Czech Republic

Public Health Institute Ostrava Ostrava Czech Republic

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Guo YR, Cao QD, Hong ZS, Tan YY, Chen SD, Jin HJ, et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak - an update on the status. Mil Med Res. 2020;7(1):11. doi: 10.1186/s40779-020-00240-0. PubMed DOI

Riou J, Althaus CL. Pattern of early human-to-human transmission of Wuhan 2019 novel coronavirus (2019-nCoV), December 2019 to January 2020. Euro Surveill. 2020;25(4):2000058. doi: 10.2807/1560-7917.ES.2020.25.4.2000058. PubMed DOI

Liu Y, Gayle AA, Wilder-Smith A, Rocklöv J. The reproductive number of COVID-19 is higher compared to SARS coronavirus. J Travel Med. 2020;27(2):taaa021. doi: 10.1093/jtm/taaa021. PubMed DOI

Alimohamadi Y, Sepandi M, Taghdir M, Hosamirudsari H. Determine the most common clinical symptoms in COVID-19 patients: a systematic review and meta-analysis. J Prev Med Hyg. 2020;61(3):E304-12.

Chen X, Laurent S, Onur OA, Kleineberg NN, Fink GR, Schweitzer F, et al. A systematic review of neurological symptoms and complications of COVID-19. J Neurol. 2021;268(2):392-402. PubMed DOI

Odriozola-González P, Planchuelo-Gómez Á, Irurtia MJ, de Luis-García R. Psychological symptoms of the outbreak of the COVID-19 confinement in Spain. J Health Psychol. 2022;27(4):825-35. PubMed DOI

Meo SA, Meo AS, Al-Jassir FF, Klonoff DC. Omicron SARS-CoV-2 new variant: global prevalence and biological and clinical characteristics. Eur Rev Med Pharmacol Sci. 2021;25(24):8012-8.

Šanda R, Němečková M. Population change - 1st half of 2023: number of births continued to decline [Internet]. Prague: Czech Statistical Office; 2023 [cited 2023 Oct 27]. Available from: https://csu.gov.cz/rychle-informace/population-change-1st-half-of-2023.

Klimovsky D, Nemec J, Bouckaert G. The COVID-19 Pandemic in the Czech Republic and Slovakia. SpiPap. 2021;29(1):1320. doi: 10.46585/sp29011320. DOI

Komenda M, Panoška P, Bulhart V, Žofka J, Brauner T, Hak J, et al. [COVID-19: overview of the current situation in the Czech Republic] [Internet]. Prague: IHIS CR [cited 2023 Mar 5]. Available from: https://onemocneni-aktualne.mzcr.cz/covid-19. Czech.

Fenclová Z, Havlová D, Voříšková M, Urban P, Pelclová D, Žofka J. [Occupational diseases in the Czech Republic 2016-2022] [Internet]. Prague: NIPH; 2016-2022 [cited 2023 Oct 27]. Available from: https://szu.cz/publikace-szu/data/registr-nemoci-z-povolani/nemoci-z-povolani-v-ceske-republice/. Czech.

Tuček M. [The statement of the committee of the Society of Occupational Medicine of the Czech Society of Occupational Medicine on the conditions for recognition of COVID-19 as an occupational disease within the meaning of Government Regulation No. 290/1995 Coll. as of 25 March 2020] [Internet]. Prague: Society of Occupational Medicine of the Czech Medical Association of Jan Evangelista Purkyne; 2020 [cited 2023 Oct 27]. Available from: https://www.pracovni-lekarstvi.cz/files/CoVID-19_jako_NzP_25.3.2020.pdf. Czech.

Tuček M. [The statement of the committee of the Society of Occupational Medicine of the Czech Republic of the Czech Medical Association of Jan Evangelista on the conditions for recognizing the disease COVID-19 as an occupational disease within the meaning of Government Regulation No. 290/1995 Coll. as of 23.2.2021 (1st updated version)] [Internet]. Prague: Society of Occupational Medicine of the Czech Medical Association of Jan Evangelista Purkyne; 2021 [cited 2023 Oct 27]. Available from: https://www.pracovni-lekarstvi.cz/files/CoVID-19_jako_NzP_25.3.2020_rev_23.2.2021.pdf. Czech.

Tuček M. [The statement of the committee of the Society of Occupational Medicine of the Czech Republic of the Czech Medical Association of Jan Evangelista on the conditions for recognizing the disease COVID-19 as an occupational disease within the meaning of Government Regulation No. 290/1995 Coll. as of 17.11.2023 (2nd updated version)] [Internet]. Prague: Society of Occupational Medicine of the Czech Medical Association of Jan Evangelista Purkyne; 2023 [cited 2023 Oct 27]. Available from: https://www.pracovni-lekarstvi.cz/files/CoVID-19_jako_NzP_rev%2017-11-23.pdf. Czech.

Khan AH, Tirth V, Fawzy M, Mahmoud AED, Khan NA, Ahmed S, et al. COVID-19 transmission, vulnerability, persistence and nanotherapy: a review. Environ Chem Lett. 2021;19(4):2773-87. PubMed DOI

Alshamrani MM, El-Saed A, Al Zunitan M, Almulhem R, Almohrij S. Risk of COVID-19 morbidity and mortality among healthcare workers working in a Large Tertiary Care Hospital. Int J Infect Dis. 2021;109:238-43. PubMed DOI

Dlouhý P, Štefan M, Chrdle A. [COVID-19: diagnosis, treatment and prevention]. Prague: Maxdorf; [2022]. Czech.

Tuček M, Vaněček V. COVID-19 in the Czech Republic 2020 and 2021: comparative analysis of probable work-related transmission of the coronavirus SARS-CoV-2. Cent Eur J Public Health. 2022;30(3):201-4. PubMed DOI

Brožová J, Daňková Š, Chudobová M, Kamberská Z, Lexová P. [Women and men in health statistics] [Internet]. Prague: IHIS CR; 2003 [cited 2023 Oct 27]. Available from: https://www.uzis.cz/sites/default/files/knihovna/zeny_muzi_cisl_zdr_stat.pdf. Czech.

De Maria L, Sponselli S, Caputi A, Pipoli A, Giannelli G, Delvecchio G, et al. Comparison of three different waves in healthcare workers during the COVID-19 pandemic: a retrospective observational study in an Italian university hospital. J Clin Med. 2022;11(11):3074. doi: 10.3390/jcm11113074. PubMed DOI

Al Maskari Z, Al Blushi A, Khamis F, Al Tai A, Al Salmi I, Al Harthi H, et al. Characteristics of healthcare workers infected with COVID-19: A cross-sectional observational study. Int J Infect Dis. 2021;102:32-6. PubMed DOI

Drobnik J, Susło R, Pobrotyn P, Fabich E, Magiera V, Diakowska D, et al. COVID-19 among Healthcare Workers in the University Clinical Hospital in Wroclaw, Poland. Int J Environ Res Public Health. 2021;18(11):5600. doi: 10.3390/ijerph18115600. PubMed DOI

Bhargava A, Fukushima EA, Levine M, Zhao W, Tanveer F, Szpunar SM, et al. Predictors for Severe COVID-19 Infection. Clin Infect Dis. 2020;71(8):1962-8. PubMed DOI

Puebla Neira D, Watts A, Seashore J, Polychronopoulou E, Kuo YF, Sharma G. Smoking and risk of COVID-19 hospitalization. Respir Med. 2021;182:106414. doi: 10.1016/j.rmed.2021.106414. PubMed DOI

Berlin I, Thomas D, Le Faou AL, Cornuz J. COVID-19 and Smoking. Nicotine Tob Res. 2020;22(9):1650-2. PubMed DOI

Eurostat. Overweight and obesity - BMI statistics [Internet]. Luxembourg: Eurostat; 2024 [cited 2024 Mar 3]. Available from: https://ec.europa.eu/eurostat/statistics-explained/index.php?title=Overweight_and_obesity_-_BMI_statistics.

Singh R, Rathore SS, Khan H, Karale S, Chawla Y, Iqbal K, et al. Association of obesity with COVID-19 severity and mortality: an updated systemic review, meta-analysis, and meta-regression. Front Endocrinol (Lausanne). 2022;13:780872. doi: 10.3389/fendo.2022.780872. PubMed DOI

Petráš M, Králová Lesná I, Večeřová L, Nyčová E, Malinová J, Klézl P, et al. The effectiveness of post-vaccination and post-infection protection in the hospital staff of three Prague hospitals: a cohort study of 8-month follow-up from the start of the COVID-19 Vaccination Campaign (COVANESS). Vaccines (Basel). 2021;10(1):9. doi: 10.3390/vaccines10010009. PubMed DOI

Tenforde MW, Patel MM, Ginde AA, Douin DJ, Talbot HK, Casey JD, et al. Effectiveness of SARS-CoV-2 mRNA vaccines for preventing covid-19 hospitalizations in the United States. medRxiv [Preprint]. 2021 Jul 8:2021.07.08.21259776. doi: 10.1101/2021.07.08.21259776. PubMed DOI

Puranik A, Lenehan PJ, Silvert E, Niesen MJM, Corchado-Garcia J, O'Horo JC, et al. Comparison of two highly-effective mRNA vaccines for COVID-19 during periods of Alpha and Delta variant prevalence. medRxiv [Preprint]. 2021 Aug 21:2021.08.06.21261707. doi: 10.1101/2021.08.06.21261707. PubMed DOI

Angioni R, Sasset L, Cioccarelli C, Sánchez-Rodríguez R, Bertoldi N, Putaggio CC, et al. COVID-19 Vaccination Limits Systemic Danger Signals in SARS-CoV-2 Infected Patients. Viruses. 2022;14(3):565. doi: 10.3390/v14030565. PubMed DOI

Gibson DM, Greene J. Risk for severe COVID-19 illness among health care workers who work directly with patients. J Gen Intern Med. 2020;35(9):2804-6. DOI

da Rosa Mesquita R, Francelino Silva Junior LC, Santos Santana FM, Farias de Oliveira T, Campos Alcântara R, Monteiro Arnozo G, et al. Clinical manifestations of COVID-19 in the general population: systematic review. Wien Klin Wochenschr 2021;133(7-8):377-82. PubMed DOI

Schneider A, Kirsten H, Lordick F, Lordick F, Lübbert C, von Braun A, et al. Covid-19 in outpatients-Is fever a useful indicator for SARS-CoV-2 infection? PLoS One. 2021;16(2):e0246312. doi: 10.1371/journal.pone.0246312. PubMed DOI

Buttenschøn HN, Lynggaard V, Sandbøl SG, Glassou EN, Haagerup A. Comparison of the clinical presentation across two waves of COVID-19: a retrospective cohort study. BMC Infect Dis. 2022;22(1):423. doi: 10.1186/s12879-022-07413-3. PubMed DOI

Aveyard P, Gao M, Lindson N, Hartmann-Boyce J, Watkinson P, Young D, et al. Association between pre-existing respiratory disease and its treatment, and severe COVID-19: a population cohort study. Lancet Respir Med. 2021;9(8):909-23. PubMed DOI

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(10229):1054-62. PubMed DOI

Gallo G, Calvez V, Savoia C. Hypertension and COVID-19: current evidence and perspectives. High Blood Press Cardiovasc Prev. 2022;29(2):115-23. PubMed DOI

Tadic M, Cuspidi C, Grassi G, Mancia G. COVID-19 and arterial hypertension: Hypothesis or evidence? J Clin Hypertens. 2020;22(7):1120-6. PubMed DOI

Government Regulation No. 276 on compensation for pain and hardship of social employment caused by occupational Injury or occupational disease. Sbírka zákonů ČR. 2015;Pt 113:3506-3559. Czech.