Prevalence and Predisposing Factors Associated with Covid-19 Disease among Anesthesia Healthcare Providers

Document Type : Original Article


1 Department of Anesthesia and Critical Care, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Department of Cardiovascular Surgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Clinical Research Development Unit Imam Reza hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Department of Complementary and Chinese Medicine, School of Persian and complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

5 General Practitioners, Mashhad University of Medical Sciences, Mashhad, Iran.

6 Resident of Anesthesiology, Department of Anesthesia and Critical Care, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

7 Virologist, Antimicrobial Resistance Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

8 Department of Pathology, Mashhad University of Medical Sciences, Mashhad, Iran.

9 MS of Nursery in Intensive and Critical Care, Mashhad University of Medical Sciences, Mashhad, Iran.


Introduction: Covid-19 pandemic has put high pressure on the anesthesia healthcare workforce due to imposing heavy workload as well as high risk of disease transmission. Identifying the risk factors for the disease is the first step to reduce the risk of infection. We aimed to assess the prevalence and the risk factors of COVID-19 among anesthesia healthcare workers.
Materials and Method: Between June and September 2020, 199 members including faculty anesthesiologists working in public teaching hospitals, anesthesia assistants, anesthesia technicians, and nurses working in Covid-19 and non-Covid-19 care units were enrolled in this study. A questionnaire including demographics, medical history, job category, history of presence in areas with Covid-19 epidemic, use of safety tips, current clinical manifestations and the results of COVID-19 tests was sent by email to the healthcare workers. Evidence of COVID-19 disease according to WHO diagnostic recommendations, was assessed in all participants.
Results: Of 199 participants in our study, 43.7% were Covid-19 positive and 56.3% had no evidence of Covid-19 disease. Comparison of the two groups of personnel with and without Covid-19 disease showed no differences in demographics and blood groups. While, physicians were more infected than nurses and presence of infected cases in COVID zone was much longer. Regarding observance of safety points, there was no difference between the personnel with and without Covid-19 but using filtered N95 masks was significantly more prevalent in infected cases (p = 0.019). During follow-up, 38.0% of infected cases showed some evidence of end organ damages including cardiac complications in 4.3% and renal dysfunction in 4.3%.
Conclusion:  Our study showed a high rate of Covid-19 infection in anesthesia personnel involving in the care centers of patients with Covid-19. Using filtered N95 masks could not effectively protect the personnel against Covid-19 infection. History of presence in epidemic areas and working in Covid-19 patients’ wards were identified as the main risk factor for Covid-19 infection among personnel.


  1. Zhang HF, Bo L, Lin Y, Li FX, Sun S, Lin HB, et al. Response of Chinese anesthesiologists to the COVID-19 outbreak. Anesthesiology. 2020 Apr 8.
  2. Sommerstein R, Fux CA, Vuichard-Gysin D, Abbas M, Marschall J, Balmelli C, et al. Risk of SARS-CoV-2 transmission by aerosols, the rational use of masks, and protection of healthcare workers from COVID-19. Antimicrobial Resistance & Infection Control. 2020 Dec;9(1):1-8.
  3. Peng PW, Ho PL, Hota SS. Outbreak of a new coronavirus: what anaesthetists should know. British journal of anaesthesia. 2020 May 1;124(5):497-501.
  4. Tang SW, Romano MR, Wong DH, Montericcio A, Yip NK, Montalbano C, et al. The use of personal protective equipment in clinical ophthalmology during corona virus disease-2019: a review of international guidelines and literature. Current opinion in ophthalmology. 2020 Sep 1;31(5):435-46.
  5. Khokhar M, Roy D, Purohit P, Goyal M, Setia P. Viricidal treatments for prevention of coronavirus infection. Pathogens and global health. 2020 Oct 2;114(7):349-59.
  6. Nicolle L. SARS safety and science. Canadian Journal of Anesthesia. 2003 Dec 1;50(10):983.
  7. Loeb M, McGeer A, Henry B, Ofner M, Rose D, Hlywka T, et al. SARS among critical care nurses, Toronto. Emerging infectious diseases. 2004 Feb;10(2):251.
  8. Chou R, Dana T, Buckley DI, Selph S, Fu R, Totten AM. Epidemiology of and risk factors for coronavirus infection in health care workers: a living rapid review. Annals of internal medicine. 2020 Jul 21;173(2):120-36.
  10. Zhang M, Zhou M, Tang F, Wang Y, Nie H, Zhang L, et al. Knowledge, attitude, and practice regarding COVID-19 among healthcare workers in Henan, China. Journal of Hospital Infection. 2020 Jun 1;105(2):183-7.
  11. Kalra A, Michos ED, Chinnaiyan KM. COVID-19 and the healthcare workers. European heart journal. 2020 Aug 14.
  12. Houlihan CF, McGowan CR, Dicks S, Baguelin M, Moore DA, Mabey D, et al. Ebola exposure, illness experience, and Ebola antibody prevalence in international responders to the West African Ebola epidemic 2014–2016: A cross-sectional study. PLoS medicine. 2017 May 16;14(5):e1002300.
  13. Lau JT, Fung KS, Wong TW, Kim JH, Wong E, Chung S, et al. SARS transmission among hospital workers in Hong Kong. Emerging infectious diseases. 2004 Feb;10(2):280.
  14. Chen MI, Lee VJ, Barr I, Lin C, Goh R, Lee C, et al. Risk factors for pandemic (H1N1) 2009 virus seroconversion among hospital staff, Singapore. Emerging infectious diseases. 2010 Oct;16(10):1554.
  15. Nguyen LH, Drew DA, Graham MS, Joshi AD, Guo CG, Ma W, et al. Risk of COVID-19 among front-line health-care workers and the general community: a prospective cohort study. The Lancet Public Health. 2020 Sep 1;5(9):e475-83.
  16. Peng X, Xu X, Li Y, Cheng L, Zhou X, Ren B. Transmission routes of 2019-nCoV and controls in dental practice. International journal of oral science. 2020 Mar 3;12(1):1-6.
  17. Seidelman JL, Lewis SS, Advani SD, Akinboyo IC, Epling C, Case M, et al. Universal masking is an effective strategy to flatten the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) healthcare worker epidemiologic curve. Infection Control & Hospital Epidemiology. 2020 Dec;41(12):1466-7.
  18. Meng L, Hua F, Bian Z. Coronavirus disease 2019 (COVID-19): emerging and future challenges for dental and oral medicine. Journal of dental research. 2020 May;99(5):481-7.
  19. Jordan RE, Adab P, Cheng K. Covid-19: risk factors for severe disease and death. 368:m1198
  20. Covid CD, Team R, COVID C, Team R, COVID C, Team R, et al. Severe outcomes among patients with coronavirus disease 2019 (COVID-19)—United States, February 12–March 16, 2020. Morbidity and mortality weekly report. 2020 Mar 27;69(12):343..
  21. Cuellar NG, Aquino E, Dawson MA, Garcia-Dia MJ, Im EO, Jurado LF, et al. Culturally congruent health care of COVID-19 in minorities in the United States: A clinical practice paper from the National Coalition of Ethnic Minority Nurse Associations. Journal of Transcultural Nursing. 2020 Sep;31(5):434-43.
  22. Dunn M, Sheehan M, Hordern J, Turnham HL, Wilkinson D. ‘Your country needs you’: the ethics of allocating staff to high-risk clinical roles in the management of patients with COVID-19. Journal of Medical Ethics. 2020 Jul 1;46(7):436-40.
  23. Zhang X, Jiang Z, Yuan X, Wang Y, Huang D, Hu R, et al. Nurses reports of actual work hours and preferred work hours per shift among frontline nurses during coronavirus disease 2019 (COVID-19) epidemic: a cross-sectional survey. International journal of nursing studies advances. 2021 Nov 1;3:100026.
  24. Hassanian-Moghaddam H, Zamani N, Kolahi AA. COVID-19 pandemic, healthcare providers’ contamination and death: an international view. Critical Care. 2020 Dec;24(1):1-2.
  25. Obara S. Anesthesiologist behavior and anesthesia machine use in the operating room during the COVID-19 pandemic: awareness and changes to cope with the risk of infection transmission. Journal of anesthesia. 2021 Jun;35(3):351-5.