Publication date: Feb 08, 2025
To protect healthcare workforce during the COVID-19 pandemic, rigorous efforts were made to reduce infection rates among healthcare workers (HCWs), especially prior to vaccine availability. This study aimed to investigate the prevalence of SARS-CoV-2 infections among HCWs and identify potential risk factors associated with transmission. We searched MEDLINE, Embase, and Google Scholar from 1 December 2019 to 5 February 2024. From 498 initial records, 190 articles were reviewed, and 63 studies were eligible. ROBINS-E tool revealed a lower risk of bias in several domains; however, some concerns related to confounding and exposure measurement were identified. Globally, 11% (95% confidence interval (CI) 9-13) of 283,932 HCWs were infected with SARS-CoV-2. Infection rates were associated with a constellation of risk factors and major circulating SARS-CoV-2 variants. Household exposure (odds ratio (OR) 7. 07; 95% CI 3. 93-12. 73), working as a cleaner (OR 2. 72; 95% CI 1. 39-5. 32), occupational exposure (OR 1. 79; 95% CI 1. 49-2. 14), inadequate training on infection prevention and control (OR 1. 46; 95% CI 1. 14-1. 87), insufficient use of personal protective equipment (OR 1. 45; 95% CI 1. 14-1. 84), performing aerosol generating procedures (OR 1. 36; 95% CI 1. 21-1. 52) and inadequate hand hygiene (OR 1. 17; 95% CI 0. 79-1. 73) were associated with an increased SARS-CoV-2 infection. Conversely, history of quarantine (OR 0. 23; 95% CI 0. 08-0. 60) and frequent decontamination of high touch areas (OR 0. 52; 95% CI 0. 42-0. 64) were protective factors against SARS-CoV-2 infection. This study quantifies the substantial global burden of SARS-CoV-2 infection among HCWs. We underscore the urgent need for effective infection prevention and control measures, particularly addressing factors such as household exposure and occupational practices by HCWs, including cleaning staff.