Mortality of medical workers from COVID-19 during the pandemic 2020–2022

Introduction. COVID-19 has had a particular impact on the health of medical workers who are in the most intense contact with infected people. This is confirmed by foreign studies. There have been no epidemiological studies on the mortality of medical workers from COVID-19 in Russia. The study aims to conduct a comparative analysis of mortality from COVID-19 in professional groups of staff of a large medical network and the Russian population. Materials and methods. Based on depersonalized information from the network of healthcare institutions of Russian Railways-Medicine JSC on the gender and age composition of staff and those who died during the three years of the pandemic and Rosstat data on the sex and age of the population and the number of deaths for 2020-2022 (form C-51), a cohort epidemiological study of mortality from COVID-19 of medical workers compared with the Russian population was performed. The researchers formed two groups — male and female. Both groups included medical (doctors, middle and junior medical staff) and non-medical workers. During the period from 01.01.2020 to 31.12.2022, the number of person-years of follow-up was 25,099 in the male cohort and 134,208 in the female cohort. 40 men and 73 women died. The second stage of the study was an in-depth analysis of mortality in individual years of the pandemic based on age-standardized mortality rates for each of the occupational groups. Standardization was carried out using the direct method. Results. In the male cohort, the risk of dying from COVID-19 was significantly higher than the population risk (SIR=1.86; 95% CI 1.05–3.31). The indicator was formed due to the high risk in the professional group of doctors (SIR=1.96; 95% CI 1.06-3.62). Female doctors had a SIR=1.37, but the differences were unreliable (95% CI 0.77–2.44). In the remaining professional groups of the female cohort, the death rate was significantly lower than the population level. An analysis of standardized mortality rates in individual years of the pandemic showed that mortality from COVID-19 was particularly high in the first year. Male doctors had a 3.97-fold higher mortality rate than the population and 3.6-fold higher mortality rate for women. There was also a tendency to an increased mortality rate among men in the group of secondary medical personnel. In the remaining occupational groups of both sexes, mortality rates were significantly lower than in the population. In 2021 and 2022, the indicators for non-medical and medical workers were significantly lower than in the population, or no differences were found. Limitations. Lack of data on the specific place of work of medical personnel (hospital, polyclinic, etc.). Conclusion. It was found that in Russia's largest medical network during the COVID-19 pandemic, a high risk of death compared to the Russian population was registered among doctors of both sexes and male nursing staff in the first year of the pandemic (2020). This deserves further study and points to the need to adapt the healthcare system to possible new challenges. Ethics. The conducted research did not require the conclusion of the Ethics Committee.