Fatores associados à infecção e hospitalização pela Covid-19 em trabalhadoras em enfermagem

Abstract

The new coronavirus pandemic has revealed the importance of nursing workers in providing care to people suspected of being infected with SARS-CoV-2, highlighting their greater exposure to infection and hospitalization. To investigate the association between sociodemographic and occupational variables and SARS-CoV-2 infection, as well as between sociodemographic, clinical and occupational variables and hospitalization for COVID-19 among nursing workers. This is a retrospective cohort of 15,936 nursing workers from the Bahia State Health Department who underwent diagnostic tests for the infection. The department's secondary database was used, built with variables collected in the process of monitoring workers during the pandemic, from March to October 2020. The data was analyzed in terms of absolute and relative frequencies, means and standard deviation. Pearson's chi-square test or Fisher's exact test were used in the bivariate analyses, and variables with a p-value ≤0.20 were subjected to multiple analysis using the Robust Poisson Regression and Logistic Regression models. Statistical significance of 5% was adopted at this stage. The backward procedure was used and Akaike Information Criterion was applied to choose the best model, the one with the lowest value. The research was approved by two Research Ethics Committees. Of the 15,936 workers, there was a predominance of females (87.3%), 31-59 year olds (80.3%), brown race/color (63.4%), nursing technicians and/or assistants (69.6%), jobs in the care area (95.1%), outsourced jobs (70.1%) and single jobs (78.2%). Previous contact with people with COVID-19 was reported by 37.3% and 25.5% had their infection confirmed. A total of 48 workers (1.4%) were hospitalized. In the bivariate analyses, the following variables were associated with the infection outcome: male gender (p= 0.131), age group 18 to 30 years (p= 0.001), black race (p= 0.030), contact with people with COVID-19 (p= 0.016) and more than one employment relationship (p= ≤ 0.001). In the multivariate analysis, the 31-59 age group (RR=1.33), black race/color (RR=1.15), more than one employment relationship (RR=1.23) and contact with a confirmed case (RR=1.11) increased the risk of infection. The outcome hospitalization, in the bivariate analyses, was associated with age group greater than or equal to 60 years (p= ≤ 0.001), type of employment status (p= 0.003), systemic arterial hypertension (p= ≤ 0.001), diabetes mellitus (p= 0.014), obesity (p= 0.010), cardiovascular disease (p= 0.077), kidney failure (p= 0.068), fever (p= 0.026), cough (p= 0.003), loss of taste (p= 0.012) and shortness of breath (p= ≤ 0.001). In the multiple analysis, kidney failure (OR=24.60), obesity (OR=4.43), difficulty breathing (OR=6.39), age group between 31 and 59 years (OR=8.38) and 60 years or older increased the chances of hospitalization. The incidence of infection was high and the risk higher for adult and older workers who were black, had more than one job and had contact with infected people. There was a greater chance of hospitalization for those who were older, had comorbidities and difficulty breathing. Measures to reduce exposure in the workplace and actions to prevent and control risk factors for illness and mitigate occupational and psycho- emotional stressors are essential.