European Journal of Cardiovascular Medicine

Objectives:To analyze the spread rate and the cumulative risk of COVID-19 infection among healthcare workers (HCWs) over the first year of the pandemic. Method: An online, cross-sectional study involved HCWs who were in-service during the first year of COVID-19 crisis, including all healthcare institutions of Jeddah. History and date of COVID-19 infection were collected to estimate the COVID-19-free time, by reference to 03 March 2020, when the first case in Saudi Arabia was identified. Kaplan-Meier survival and Cox regression methods were used to analyze the cumulative risk of COVID-19 infection and the associated factors. Results: There were three peaks of COVID-19 incidence among HCWs; the highest (7.2%) was in September 2020. The cumulative hazard reached 0.10 by the first trimester, then escalated exponentially during the 3rd trimester to reach a plateau at 0.35. The hazard ratio was independently associated with the HCW’s nationality, department affiliation, and receipt of influenza vaccine, as well as the facility type and bed capacity. Receipt of the BCG vaccine in the last year was associated with 40% reduction of the cumulative hazard. Conclusion: The identified risk factors and high-exposure clusters constitute a weak link in the national management strategy of COVID-19 crisis and highlight the urgent need to reinforce the in-hospital protective measures. Findings from the present study have strong implication for the viability and resilience of the healthcare system during major health crises.