Nursing workforce plays a significant role in reducing COVID-19 deaths worldwide : a cross-sectional analysis of data from 178 countries

Worldwide, the role of nursing workforce in reducing COVID-19 case fatality ratio (CFR) is analyzed with scatter plots, Pearson's r and nonparametric, partial correlation and multiple linear regression models. The potential confounders, median age, health expenditure, physician density, and urbanization were incorporated for calculating the independent role of nursing workforce in protecting against COVID-19 CFR. The study findings suggested that (1) the nursing workforce inversely and significantly correlates with COVID-19 CFR; (2) this relationship remained independent of the confounding effects of each individual confounder or their combination; (3) Nursing workforce was the only variable identified as a significant contributor for reducing COVID-19 CFR, when it was incorporated into stepwise regression model with health expenditure, median age, physician density, and urbanization for analyzing their individual predicting effects on COVID-19 CFR. A strong message for the health authorities is that, although in shortage, nursing workforce showed their significant role in reducing COVID-19 deaths worldwide. This study highlights that the role of nursing workforce should be incorporated into population health research.