Risk to health from COVID‐19 for anaesthetists and intensivists – a narrative review

Cook, T.M.

Healthcare workers are at increased risk of infection, harm and death from COVID‐19. Close and prolonged exposure to individuals infectious with SARS‐CoV‐2 leads to infection. A person’s individual characteristics (age, sex, ethnic and comorbidities) then influence the subsequent risk of COVID‐19 leading to hospitalisation or critical care admission or death. While relative risk is often reported as a measure of individual danger, absolute risk is more important and dynamic, particularly in a healthcare setting. Individual risk interacts with exposure and environmental risk factors and the extent of mitigation to determine overall risk. Hospitals create a unique environment in which there is significantly increased risk of infection for all healthcare workers. Anaesthetists and intensivists are at particularly high risk of exposure to SARS‐CoV‐2 infected patients due to their working environments and exposure to certain patient groups. However, the available evidence suggests that the risk for this group of individuals is not currently increased. The review examines factors associated with increased risk of infection with SARS‐CoV‐2, increasing severity of COVID‐19 and death. A risk tool is proposed that includes personal, environmental and mitigating factors, and enables an individualised dynamic ‘point of time’ risk assessment.