Covid-19 Breakthrough Outcomes Among Health Workers in Marondera District, Mashonaland East Province, Zimbabwe 2021

Abstract

Coronavirus disease (COVID-19) was pronounced a global pandemic after it spread across the globe causing a lot of health and economic burden. This pandemic had an impact on health workers as they were on the frontline fighting against the disease. Several vaccines were produced to lessen the burden of COVID-19. However, breakthrough infections among the health workers were recorded. Health workers in Marondera District, Zimbabwe were also affected by these breakthrough infections. Breakthrough infections amongst health workers challenged the efforts towards reducing the burden of the disease in the district. In Marondera District, outcomes for breakthrough infections among health care workers had not been studied before. The aim of the study was to determine the outcomes of COVID-19 breakthrough infections and the factors associated with severe illness amongst health care professionals working in Marondera District. The study used a retrospective cohort design using secondary data set analysis. The study population comprised of the records of all the health workers in Marondera District who tested positive to SARSCoV- 2 between 1 April and 31 December 2021 and total population sampling was used. Three hundred and four (304) records were used for the study. The researcher used the line list of COVID-19 cases in the district together with vaccination and admission records. The data was analysed using Epi Info version 7.2.2. Univariate, bivariate and multivariate analysis of the data was done. The unvaccinated were 144 (47.4%) whilst the vaccinated (breakthrough infections) were 160 (52.6%). Most of the individuals with breakthrough infections (86.9%) and unvaccinated (88.9%) health workers were aged below 50 years. The median age for health workers with breakthrough infections was 38 years. Vaccinated health workers who were involved in clinical work were 68.1% and the unvaccinated who were involved in clinical work were 54.2%. Amongst health workers with breakthrough infections 30.6% had comorbidities while 32.6% of those unvaccinated had comorbidities. Among the breakthrough infections, 26.3% had hypertension and 7.5% had diabetes and among the unvaccinated 23.6% had hypertension and 4.2% had diabetes. 35.0% of the breakthrough infections were asymptomatic while 8.3% of those unvaccinated were asymptomatic. Among health workers with breakthrough infections, 6.2% were hospitalised and 1.9% were admitted in the ICU. All of the breakthrough infections recovered and only one death was recorded amongst the unvaccinated. Factors significantly associated with severe disease were; having comorbidities (RR=4.2; 95% CI: 2.3-7.6; p<0.01), hypertension (RR=2.6; 95% CI: 1.5- 4.5; p<0.01), diabetes (RR=5.1; 95% CI: 3.0- 8.7; p<0.01) and having five more or symptoms at baseline (RR= 50.4; 95% CI: 7.0- 362.2; p<0.01). Being vaccinated was protective against severe disease (RR=0.2; 95% CI: 0.1- 0.5; p<0.01) including being aged below 50 years (RR= 0.26; 95% CI: 0.2- 0.5; p<0.01). From the findings of the study, it can be concluded COVID-19 vaccines were protective against severe illness. The researcher recommends that all health workers should receive a COVID-19 vaccine so as to prevent severe illness after infection.