Table 3.

Results of included studies table (Direct evidences on COVID-19 for primary outcome of Incident cases).

SN	Study ID country	Study design and setting	Outcomes (as reported in studies)	Outcomes (interpretation)	Conclusion
1.	Ran et al. (25) China	Retrospective study Hospital-based setting (Tertiary hospital single-center)	Qualified hand-washing (n = 22): infected: n = 04 Unqualified hand-washing (n = 50): infected: n = 24, RR (95% CI) = 2.64 (1.04–6.71), P ≤ 0.05 Qualified hand-washing v/s unqualified hand-washing: RR (95% CI): 0.38 (0.15–0.96), P = 0.04 Optimal hand hygiene before contact patients (n = 33): Infected: n = 06 Optimal hand hygiene after contact patients (n = 44): Infected: n = 11 Suboptimal hand hygiene before contact patients (n = 39): Infected: n = 22, RR (95% CI): 3.10 (1.43–6.73), P < 0.01 Suboptimal hand hygiene after contact patients (n = 28): Infected: n = 17, RR (95% CI): 2.43 (1.34–4.39), P < 0.01 Optimal handwash v/s Suboptimal handwash (after contact with patients): RR (95% CI) = 0.41 (0.23–0.74), P = 0.003	Optimal handwashing practices in HCWs reduces the risk of developing COVID-19 by 59% (P = 0.003) as compared to those with suboptimal handwash	HCWs working with suboptimal hand hygiene after contacting patients had a higher risk of COVID-19.
2.	Xu et al. (26) China	Prospective hospital-based study	Hand washing: 84 out of 206 (40.78%) complied to hand washing Disinfection: disinfection rate of environmental and medical supplies was 100% Cases of COVID-19: Nil	Though the compliance rate for hand hygiene was only 40.78%, no cases of COVID-19 were found	Refined management strategies for the prevention and control of nosocomial infections in HCWs.