New coronavirus infection as an occupational disease: complex expert cases

Introduction. The professional activity of medical workers (MW) is in close contact with daily contact with various factors of the production environment: physical, chemical, biological, and labor processes.

Until 2020, tuberculosis and viral hepatitis prevailed in the structure of occupational diseases (OD) of the medical workers in the Russian Federation. 

According to the State report "On the state of sanitary and epidemiological welfare of the population in the Russian Federation in 2020," the first ranking the second place in the structure of occupational diseases, depending on the impact of harmful production factor took the illnesses associated with the action of biological factors — 20,19%, while the main reason for the growth in the incidence of healthcare workers in coronavirus infection COVID-19 (further COVID-19).

The study aims were to identify problematic aspects in the establishment of the COVID-19 work from MW.

Materials and methods. We have given descriptions of clinical cases, as well as a retrospective analysis of issues of OD according to the patient registers of the following medical institutions: the Center of Occupational Pathology of Sechenov University, the Republican Center of Occupational Pathology of the Ministry of Health, Republic of Tatarstan, the Regional Center of Occupational Pathology of the Samara Region.

Results. In 2020, COVID-19 was the most common OD with fatal outcomes and complications in healthcare workers.

Today, difficulties in determining the connection of COVID-19 with the profession arise when assessing the epidemiological history, the consequences after a coronavirus infection, and the formulation of the diagnosis.

Conclusions. For a qualitative examination of the connection of COVID-19 with the profession, it is necessary to develop a list of clinical conditions with the definition of the timing of complications.

1. Nienhaus А., Kesavachandran К., Wendeler D., Dulon М. Infectious diseases in healthcare workers — an analysis of the standardised data set of a German compensation board. J Occup Med Toxicol. 2012; 7(1): 8. https://doi.org/10.1186/1745-6673-7-8

2. Kersten J.F., Nienhaus А., Schneider S., Schablon А. Tuberculosis among health workers — a secondary data analysis of German social accident insurance data from 2002–2017. Int J. Environ. Res. Public Health. 2020; 17(5): 1564. https://doi.org/10.3390/ijerph17051564

3. Garipova R.V., Berheeva Z.M. Occupational pathology of respiratory organs in health care workers: issues of timely diagnosis. Med. truda i prom. ekol. 2020; 60(2). https://doi.org/10.31089/1026-9428-2020-60-2-89-92 (in Russian).

4. Wu Y.C., Chen C.S., Chan Y.J. The outbreak of COVID-19: an overview. J. Chin. Med. Assoc. 2020; 83(3): 217–20. https://doi.org/10.1097/JCMA.0000000000000270

5. Garipova R.V., Strizhakov L.A., Umbetova K.T., Safina K.R. Occupational diseases of health care workers from exposure to infectious agents: the current state of the problem. Med. truda i prom. ekol. 2020; 60(2): 13–17. https://doi.org/10.31089/1026-9428-2020-60-2-89-92 (in Russian)

6. Suslin S.A., Sirotko M.L., Bochkareva M.N., Babanov S.A. Incidence of COVID-19 in outpatient healthcare workers. Med. truda i prom. ekol. 2021; 61(8): 540–545. (In Russ.) https://doi.org/10.31089/1026-9428-2021-61-8-540-545

7. Wang J., Zhou M., Liu F. Reasons for healthcare workers becoming infected with novel coronavirus disease 2019 (COVID-19) in China. J Hosp Infect. 2020; 105(1): 100–1. https://doi.org/10.1016/j.jhin.2020.03.002

8. Schwartz J., King C.-C., Yen М.-Y. Protecting healthcare workers during the coronavirus disease 2019 (COVID-19) outbreak: lessons from Taiwan's severe acute respiratory syndrome response. Clin Infect Dis (2020). Infection Control & Hospital Epidemiology. 2020; 41(6): 745–6. https://doi.org/10.1017/ice.2020.60

9. Ran L., Chen X., Wang Y., Wu W., Zhang L., Tan X. Risk factors of healthcare workers with corona virus disease 2019: a retrospective cohort study in a designated hospital of Wuhan in China. Clin Infect Dis. 2020; 19; 71(16): 2218–21. https://doi.org/10.1093/cid/ciaa287

10. Mutambudzi M., Niedzwiedz C.L., Macdonald E.B., Leyland A.H. et al. Occupation and risk of severe COVID-19: prospective cohort study of 120,075 UK Biobank participants. medRxiv. 2020.05.22.20109892. https://doi.org/10.1101/2020.05.22.20109892

11. COVID-19 should be recognized as an occupational disease worldwide. Bente E Moen 01 June 2020. The Author(s) 2020. Published by Oxford University Press on behalf of the Society of Occupational Medicine. https://ww1.issa.int/news/can-covid-19-be-considered-occupational-disease

12. Mhango M., Dzobo M., Chitungo I., Dzinamarira T. COVID-19 Risk Factors Among Health Workers: A Rapid Review. Safety and Health at Work. 2020. https://doi.org/10.1016/j.shaw.2020.06.001

13. Jordan R.E., Adata P., Cheng K.K. Covid-19: risk factors for severe disease and death. BMJ. 2020; Mar 26; 368: m1198. https://doi.org/10.1136/bmj.m1198

14. Jayadevan R. A hundred lives lost: doctor deaths in India during the times of COVID-19. Preprints. 2020; 2020070346. https://doi.org/10.20944/preprints202007.0346.v1

15. Ing E.B., Xu Q.A., Salimi A., Torun N. Physician deaths from corona virus (COVID-19) disease [published online ahead of print, 2020 May 15]. Occup Med (Lond). 2020. https://doi.org/10.1093/occmed/kqaa088

16. On the state of sanitary and epidemiological well-being of the population in the Russian Federation in 2020: State report. Moscow: Federal Service for Surveillance on Consumer Rights Protection and Human Welfare, 2021. https://www.rospotrebnadzor.ru/upload/iblock/5fa/gd-seb_02.06-_s-podpisyu_.pdf

17. Huang L., Zhao P., Tang D. et al. Cardiac involvement in patients recovered from COVID-2019 identified using magnetic resonance imaging. JACC Cardio vasc Imaging. 2020; 13(11): 2330–9. https://doi.org/10.1016/j.jcmg.2020.05.0048

18. Parpas A., Yudd M., Dreisbach A.W., Michaud J. Post COVID-19 multisystem inflammatory syndrome in an older adult. Ren Fail. 2021; 43(1): 530–2. https://doi.org/10.1080/0886022X.2021.1895839

19. Chern A., Famuyide A.O., Moonis G., Lalwani A.K. Bilateral sudden sensorineural hearing loss and intralabyrinthine hemorrhage in a patient with COVID-19. Otol Neurotol. 2021; 42(1): 10–14. https://doi.org/10.1097/MAO.0000000000002860

20. Kumar M.A., Krishnaswamy M., Arul J.N. Post COVID-19 sequelae: venous thromboembolism complicated by lower GI bleed. BMJ Case Reports CP. 2021; 14(1): 241059. https://doi.org/10.1136/bcr-2020-241059

21. New coronavirus infection COVID-19: professional aspects of maintaining the health and safety of medical workers: guidelines. Edited by I.V. Bukhtiyarov, Yu.Yu. Gorblyansky. M; 2021 (in Russian).