{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T16:03:00Z","timestamp":1784131380224,"version":"3.55.0"},"update-to":[{"DOI":"10.12688\/f1000research.149673.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,11,14]],"date-time":"2024-11-14T00:00:00Z","timestamp":1731542400000}}],"reference-count":15,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2024,11,14]],"date-time":"2024-11-14T00:00:00Z","timestamp":1731542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/3.0\/igo\/"}],"funder":[{"DOI":"10.13039\/100004423","name":"World Health Organization","doi-asserted-by":"publisher","award":["HQTDR2422924-4.1-72863"],"award-info":[{"award-number":["HQTDR2422924-4.1-72863"]}],"id":[{"id":"10.13039\/100004423","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>Background Sustaining a \u2018fit-for-purpose\u2019 health workforce requires a better understanding of the health care worker cadres that are affected during pandemics and their outcomes. In hospitalized health care workers with confirmed COVID-19 between March 2020 and May 2023 in Liberia, we determined the hospitalization and case fatality rates, type of health care worker cadres affected, their demographic and clinical characteristics and hospital exit outcomes. Methods This was a cohort study using routine data extracted from hospitalization forms for health care workers in 24 designated COVID-19 treatment facilities. Results Of the 424 health care workers with COVID-19, hospitalization rates progressively declined between 2020 and 2023, (P&lt;0.001) with the highest rates in 2020 (24\/1,000 health care workers) and 2021 (14\/1,000 health care workers). Case fatality was 2% in both 2020 and 2021 with no deaths thereafter. Among those hospitalized, the highest proportions were nursing cadres with 191(45%), physicians with 63 (15%) and laboratory technicians with 42 (10%). The most frequent reported site for COVID-19 infection was the health facility (326, 89%). COVID-19 vaccination coverage in health care workers was 20%. The majority (91%) of hospitalizations were for mild symptomatic infections. Even in referral centres (n-52), 18 (35%) were for mild infections. Of the 424 who were hospitalized, 412 (97%) recovered, 9 (2%) died and 3 (1%) either left against medical advice or absconded. Of the nine deaths, none were vaccinated, seven had moderate-to-severe disease but were not referred to specialized COVID-19 treatment centers. Conclusions The hospitalized health care workers for COVID-19 were predominantly clinical and laboratory personnel who were mostly unvaccinated, and health facilities were hot-spots for contracting infections. The triage and referral system was weak with unnecessary hospitalization of mild infections. This study provides useful insights for outbreak preparedness including priority vaccination and improving health care worker safety in Liberia.<\/ns3:p>","DOI":"10.12688\/f1000research.149673.2","type":"journal-article","created":{"date-parts":[[2024,11,14]],"date-time":"2024-11-14T12:05:10Z","timestamp":1731585910000},"page":"656","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Health care workers hospitalized for COVID-19 in Liberia: who were they, and what were their outcomes?"],"prefix":"10.12688","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-9894-7409","authenticated-orcid":false,"given":"Darius B.","family":"Lehyen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3269-8509","authenticated-orcid":false,"given":"Louis","family":"Ako-Egbe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2875-4130","authenticated-orcid":false,"given":"Emmanuel","family":"Dwalu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin T.","family":"Vonhm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pruthu","family":"Thekkur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2915-9328","authenticated-orcid":false,"given":"Rony","family":"Zachariah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Bawo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2024,11,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"104211","DOI":"10.1016\/j.ijnurstu.2022.104211","article-title":"COVID-19 pandemic-related mortality, infection, symptoms, complications, comorbidities, and other aspects of physical health among healthcare workers globally: An umbrella review.","volume":"129","author":"M Chutiyami","year":"2022","journal-title":"Int. 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Essential Package for Health Services for Univsersal Health Coverage.","year":"2022"},{"key":"ref8","article-title":"Ministry of Health and NPHIL. National Public Health Institute of Liberia. Interim guidance on clinical care for patients with COVID-19 in Liberia.","year":"2021"},{"key":"ref9","article-title":"Ministry of Health. Interim guidance on clinical care for patients with COVID-19 in Liberia. 2022.clinical-care-for-patients-with-covid-19-in-liberia."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"25-36","DOI":"10.1080\/14760584.2022.2004125","article-title":"COVID-19 vaccine equity: a health systems and policy perspective.","volume":"21","author":"R Van De Pas","year":"2022","journal-title":"Expert Rev. Vaccines."},{"key":"ref11","doi-asserted-by":"crossref","first-page":"1-5","DOI":"10.1080\/21645515.2022.2034457","article-title":"Low coverage of COVID-19 vaccines in Africa: current evidence and the way forward.","volume":"18","author":"L Lawal","year":"2022","journal-title":"Hum. Vaccin. Immunother."},{"key":"ref13","doi-asserted-by":"crossref","first-page":"1-8","DOI":"10.1186\/s12879-023-08830-8","article-title":"Analysing the implementation of infection prevention and control measures in health care facilities during the COVID-19 pandemic in the African Region.","volume":"23","author":"L Kabego","year":"2023","journal-title":"BMC Infect. Dis."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"133-134","DOI":"10.1111\/j.1365-3156.2011.02892.x","article-title":"Publishing operational research from \u201creal life\u201d programme data: A better form of accountability.","volume":"17","author":"J Rujumba","year":"2012","journal-title":"Trop. Med. Int. Heal."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1140-1151","DOI":"10.1093\/heapol\/czab064","article-title":"Disruptions in maternal and child health service utilization during COVID-19: Analysis from eight sub-Saharan African countries.","volume":"36","author":"G Shapira","year":"2021","journal-title":"Health Policy Plan."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1-13","DOI":"10.3390\/tropicalmed6020097","article-title":"Real-time operational research: Case studies from the field of tuberculosis and lessons learnt.","volume":"6","author":"A Harries","year":"2021","journal-title":"Trop Med Infect Dis."},{"key":"ref18","first-page":"1211","article-title":"Assessing the Impact of COVID-19 on TB and HIV. Trop Med.","author":"P Thekkur","year":"2021; January 2020","journal-title":"Infect. Dis."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"867-872","DOI":"10.2471\/BLT.07.045120","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for reporting observational studies.","volume":"85","author":"E Von Elm","year":"2007","journal-title":"Bull. World Health Organ."}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/13-656\/v2\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/13-656\/v2\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/13-656\/v2\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,19]],"date-time":"2024-11-19T04:45:17Z","timestamp":1731991517000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/13-656\/v2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,14]]},"references-count":15,"URL":"https:\/\/doi.org\/10.12688\/f1000research.149673.2","relation":{"has-version":[{"id-type":"doi","id":"10.12688\/f1000research.149673.1","asserted-by":"subject"}],"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.174181.r340612","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.174181.r340612","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,14]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/13-656\/v2#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.164163.r316429, Kenneth Nugent, Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, 26 Aug 2024, version 1, 1 approved, 1 approved with reservations","URL":"https:\/\/f1000research.com\/articles\/13-656\/v1#referee-response-316429","order":0,"name":"referee-response-316429","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Darius B. Lehyen<\/b>; \n<i>Posted: 26 Aug 2024<\/i>; Thanks so kindly to the reviewer for highlighting the following key points on my submission  1. That the work was clearly and accurately presented and cited the current literature. 2. That the study design was appropriate and the work is technically sound. 3. That there are sufficient details of methods and analysis provided to allow replication by others. 4. That the statistical analysis and its interpretation is appropriate. 5. That all the source data underlying the results are available to ensure full reproducibility and&nbsp; 6. That the conclusions drawn are adequately supported by the results  \n<b>I authorize that I have read the reviewer response to my submission and I believe that he has a suitable level of expertise to confirm that my article is of an acceptable scientific standard.<\/b>","URL":"https:\/\/f1000research.com\/articles\/13-656\/v2#referee-comment-12305","order":1,"name":"referee-comment-12305","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.174181.r340612, Helena C Maltezou, National Public Health Organization, Athens, 18 Nov 2024, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/13-656\/v2#referee-response-340612","order":2,"name":"referee-response-340612","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Darius B. Lehyen<\/b>; \n<i>Posted: 18 Nov 2024<\/i>; Thanks so kindly for confirming that you have read this submission and believe that it is of an acceptable scientific standard. I do appreciate your efforts used to go through this submission.","URL":"https:\/\/f1000research.com\/articles\/13-656\/v2#referee-comment-12841","order":3,"name":"referee-comment-12841","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This SORT IT Programme was funded by the Special Programme for Research and Training in Tropical Diseases (TDR), Geneva, Switzerland (Grant Number HQTDR 2422924-4.1-72863. The APC was also funded by TDR. TDR is able to conduct its work thanks to the commitment and support from a variety of funders. \nA full list of TDR donors is available at: https:\/\/tdr.who.int\/about-us\/our-donors. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":4,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution IGO Licence.","order":0,"name":"copyright-info","label":"Copyright"}]}}