Detection of SARS-CoV-2 infection in gargle, spit and sputum specimens

The gold standard for SARS-CoV-2 infection diagnosis is RT-PCR from nasopharyngeal specimen (NPS). Its collection involves a close contact between patients and healthcare workers requiring a significant amount of workforce and putting them at risk of infection. We evaluated self-collection of alternative specimens and compared their sensitivity and Ct values to NPS. We visited acute COVID-19 outpatients to collect concomitant nasopharyngeal and gargle specimens and had patients self-collect a gargle and either sputum or spit specimens on the next morning. We included 40 patients and collected 40 concomitant nasopharyngeal and gargle specimens, as well as 40 gargle, 22 spit and 16 sputum specimens on the next day, as 2 patients could not produce sputum. All specimens were as sensitive as NPS. Gargle specimens had a sensitivity of 0.97 (CI 95% 0.92-1,00), whether collected concomitantly to NPS or on the next morning. Next morning spit and sputum specimens showed a sensitivity of 1.00 CI (95% 1.00-1.00) and 0.94 (CI 95% 0.87-1.00), respectively. The gargle specimens had a significantly higher mean cycle threshold (Ct) values, 29.89 (SD 4.63) (p-value <0.001) and 29.25 (SD 3.99) (p-value <0.001) when collected concomitantly and on the next morning compared to NPS (22.07, SD 4.63). Ct value obtained with spit (23.51, SD 4.57, p-value 0.11) and sputum (25.82, SD 9.21, p-value 0.28) specimens were close to NPS. All alternative specimen collection methods were as sensitive as NPS, but spit collection appeared more promising, with a low Ct value and ease of collection. Our findings warrant further investigation.

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375. High Laboratory-confirmed SARS-CoV-2 Attack Rate in Lima Health Care Personnel During August 2020-March 2021 Suggests Role for Improved Infection Control

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.576 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S289-S290

Author(s):

Matthew Westercamp ◽

Giselle Soto ◽

Rachel Smith ◽

Eduardo Azziz-Baumgartner ◽

Susan Bollinger ◽

...

Keyword(s):

Attack Rate ◽

Healthcare Workers ◽

P Value ◽

Risk Of Infection ◽

Vaccine Introduction ◽

Specimen Collection ◽

Increased Risk ◽

Reduction Strategies ◽

Risk Reduction Strategies

Abstract Background Peru has one of the highest per capita SARS-CoV-2 death rates in Latin America. Healthcare workers (HCW) are a critical workforce during the COVID-19 pandemic but are themselves often at increased risk of infection. We evaluated SARS-CoV-2 attack rate and risk factors among frontline HCWs. Methods We performed a prospective cohort study of HCW serving two acute care hospitals in Lima, Peru from Aug 2020 to Mar 2021. Participants had baseline SARS-CoV-2 serology using the CDC ELISA, active symptom monitoring, and weekly respiratory specimen collection with COVID-19 exposure/risk assessment for 16-weeks regardless of symptoms. Respiratory specimens were tested by real-time reverse transcriptase PCR (rRT-PCR). Results Of 783 eligible, 667 (85%) HCW were enrolled (33% nurse assistants, 29% non-clinical staff, 26% nurses, 7% physicians, and 6% other). At baseline and prior to COVID-19 vaccine introduction, 214 (32.1%; 214/667) were reactive for SARS-CoV-2 antibodies. In total, 72 (10.8%; 72/667) HCWs were found to be rRT-PCR positive during weekly follow-up. Of the rRT-PCR positive HCWs, 37.5% (27/72) did not report symptoms within 1-week of specimen collection. During follow up, HCW without detectable SARS-CoV-2 antibodies at baseline were significantly more likely to be rRT-PCR positive (65/453, 14.3%) compared to those with SARS-CoV-2 antibodies at baseline (4/214, 1.9%) (p-value: < 0.001). Three HCW were both serologically reactive and rRT-PCR positive at baseline. Looking only at HCW without SARS-CoV-2 antibodies, nurse assistants (rRT-PCR positive: 18.6%; 27/141) and non-clinical healthcare workers (16.5%; 21/127) were at greater risk of infection compared to nurses (8.5%; 10/118), physicians (7.9%; 3/38), and other staff (10.3%; 4/29) (RR 1.95;95%CI 1.2,3.3; p-value: 0.01). Conclusion Baseline SARS-CoV-2 prevalence and 16-week cumulative incidence were substantial in this pre-vaccination Peruvian HCW cohort. Almost 40% of new infections occurred in HCW without complaint of symptoms illustrating a limitation of symptom-based HCW screening for COVID-19 prevention. Nurse assistants and non-clinical healthcare workers were at greater risk of infection indicating a role for focused infection prevention and risk reduction strategies for some groups of HCW. Disclosures Fernanda C. Lessa, MD, MPH, Nothing to disclose

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The Significance of Duration of Exposure and Circulation of Fresh Air in SARS-CoV-2 Transmission Among Healthcare Workers

Frontiers in Medicine ◽

10.3389/fmed.2021.664297 ◽

2021 ◽

Vol 8 ◽

Author(s):

Vasiliki Vlacha ◽

Gavriela Feketea ◽

Athanasia Petropoulou ◽

Sebastian Daniel Trancá

Keyword(s):

Healthcare Workers ◽

Preventive Measures ◽

Healthcare Setting ◽

Descriptive Study ◽

Risk Of Infection ◽

Rt Pcr ◽

Antibody Testing ◽

Regional Health ◽

Additional Information ◽

Index Cases

Background: The true risk of infection after exposure to SARS-CoV-2 of healthcare workers (HCWs) in the workplace has not yet been established. This descriptive study analyzes the exposure characteristics of HCWs to SARS-CoV-2.Methods: In March 2020, at the beginning of the pandemic, a total of 58 HCWs in a regional hospital in Greece were exposed to three patients with symptomatic SARS-CoV-2 infection. These three index cases had taken part in an 8-day religious tour, during which 52 travelers spent 10 h every day in a tour bus. A study was made of the circumstances of the hospital exposure.Results: Of the 52 travelers in the bus, 48 contracted SARS-CoV2. None of the 58 HCW contacts developed symptoms related to COVID-19, although, 43% were exposed to a SARS-CoV-2 infected patient for more than 15 min, and 74% were within a distance of <1 m, and half of the contacts were not wearing a surgical mask. Additional information was that 63% of the contacts were exposed in a room sized more than 15 m2, and in more than 80% of cases, the window or the door to the room was open during their exposure. In about one-third of the exposure events, the HCW contacts were not wearing a mask and were at a distance of <1 m, and just under half of them were exposed for more than 15 min. One-fourth of the contacts underwent RT-PCR testing, and 11% IgG/IgM antibody testing for SARS-CoV-2, all of which were negative. All observed quarantine at home for 14 days.Conclusion: This observational study was made before the extent of the SARS-CoV-2 became apparent, and before routine preventive measures were observed by all HCWs. Comparing the conditions of exposure in the two different settings (bus vs. regional health facility), it is apparent that the duration of exposure and the small, enclosed nature of the bus are the distinguishing factors. In the healthcare setting, the elimination of both factors and the implementation of additional measures protected the exposed HCWs from contracting SARS-CoV-2 infection.

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Self-collected gargle specimen as a patient-friendly sample collection method for COVID-19 diagnosis in a population context

10.21203/rs.3.rs-764442/v3 ◽

2021 ◽

Author(s):

Revata Utama ◽

Rebriarina Hapsari ◽

Iva Puspitasari ◽

Desvita Sari ◽

Meita Hendrianingtyas ◽

...

Keyword(s):

Healthcare Workers ◽

Room Temperature ◽

Rna Extraction ◽

User Preference ◽

Sample Collection ◽

Rt Pcr ◽

Collection Method ◽

Qrt Pcr ◽

Alternative Specimen ◽

Temperature Storage

Abstract Scaling up SARS-CoV-2 testing and tracing continues to be plagued with the limitation of the sample collection method, which requires trained healthcare workers to perform and causes discomfort to the patients. In response, we assessed the performance and user preference of gargle specimens for qRT-PCR-based detection of SARS-CoV-2 in Indonesia. Inpatients who had recently been diagnosed with COVID-19 and outpatients who were about to perform qRT-PCR testing were asked to provide nasopharyngeal and oropharyngeal (NPOP) swabs and self-collected gargle specimens. We demonstrated that self-collected gargle specimens can be an alternative specimen to detect SARS-CoV-2 and the viral RNA remained stable for 31 days at room temperature storage. The developed method was validated for use on multiple RNA extraction kits and commercially available COVID-19 RT-PCR kits. Our developed method achieved a sensitivity of 91.38% when compared to paired NPOP swab specimens (Ct < 35), with 97.10% of patients preferring the self-collected gargle method.

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SALIVA - A PROSPECTIVE DIAGNOSTIC TOOL FOR SARS CoV-2

10.36106/ijsr/7610242 ◽

2020 ◽

pp. 1-2

Author(s):

Tarunya Vishwanath ◽

Shalini Arumugam ◽

Sathish. R ◽

Anitha Logaranjini ◽

Prashanthi Prashanthi

Keyword(s):

Severe Acute Respiratory Syndrome ◽

Diagnostic Tool ◽

Healthcare Workers ◽

Standard Technique ◽

Hubei Province ◽

Rt Pcr ◽

Wuhan City ◽

Non Invasive ◽

Specimen Collection

Coronavirus disease 2019 (COVID-19) now called the severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) was first identified in Wuhan city, Hubei province, China. Currently RT-PCR using nasopharyngeal and Oropharyngeal swabs is supposed to be the most efficacious and standard technique for COVID testing, but are invasive and have a few drawbacks due to which, saliva as a diagnostic specimen is proposed. Salivary specimen collection is non-invasive and can be self-collected at any time and repeatedly and greatly minimises the exposure of. healthcare workers to COVID-19.

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Knowledge and practice of infection prevention and control among healthcare workers: a COVID-19 pandemic experience

Anaesthesia, Pain & Intensive Care ◽

10.35975/apic.v24i6.1408 ◽

2020 ◽

Vol 24 (6) ◽

pp. 596-602

Author(s):

Rifat Yasmin ◽

Huma Hussain ◽

Syeda Turab Fatima Abidi ◽

Syed Asim Ali Shah ◽

Tazaeen Hina Kazmi ◽

...

Keyword(s):

Prevention And Control ◽

Healthcare Workers ◽

Infection Prevention ◽

Virus Disease ◽

Close Contact ◽

Infection Prevention And Control ◽

P Value ◽

Corona Virus ◽

Knowledge And Practice ◽

And Control

Background: Coronavirus disease (COVID-19) is a global outbreak caused by novel SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). Study aims to evaluate knowledge and practices of healthcare workers (HCW) regarding infection prevention and control of corona virus disease Material and methods: A cross sectional validation study was conducted. Study was conducted at department of Medicine, Pakistan Ordinance Factory Hospital, Wah Cantt. Study duration was 2 months (May 2020-June2020)A sample size of 217 HCW was calculated using WHO calculator. HCW were selected through non probability sampling (consecutive). Ethical permission was taken and research consent was signed by each participant. SPSS version 24 was used for analysis purpose. Post stratification fissure exact and chi-square test was applied. We found p value ≤0.05 as statistically significant. Results: Total 217 HCW were included in our study. Out of them, 85 (39.2%) were male and 132 (60.8%) were female in our study. Mean age of HCW was 34.5±2.4SD. In knowledge assessment majority of HCW had fair knowledge (46.5%), followed by good (30%) and poor knowledge (23.5%) regarding corona virus associated infection control and prevention. In practice assessment, among all those, 38.2% HCW showed better practices while 61.8% showed poor practices. Knowledge is significantly associated with virus transmission mode (p = 0.00), close contact (p = 0.000), protection from COVID-19 in triage area (p = 0.000), wearing PPE (p = 0.000) etc. Conclusion: Corona virus disease is a major challenge in resource limited countries. Healthcare workers showed relatively improved knowledge and practices regarding infection prevention and control in this COVID-19 Pandemic. Key words: Corona virus disease, Healthcare workers, Infection Prevention and Control, Knowledge, Practices Citation: Yasmin R, Hussain H, Abidi STF, Shah SAA, Kazmi TH, Hussain H. Knowledge and practice of infection prevention and control among healthcare workers: a COVID-19 pandemic experience. Anaesth pain intensive care 2020;24 (6):597-602 Received: 8 November 2020, Reviewed: 17 November 2020, Accepted: 19 November 2020

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COVID-19 Knowledge among Healthcare Professionals in Gombe, Northeast, Nigeria: A Quick Online Cross-Sectional Survey

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i430839 ◽

2021 ◽

pp. 105-114

Author(s):

Rabiu Ibrahim ◽

Abdulsalam Yakubu ◽

Ahmed Iya Girei ◽

Danladi Muhammed Umar

Keyword(s):

Infection Control ◽

Healthcare Workers ◽

Healthcare Professionals ◽

Close Contact ◽

Healthcare Setting ◽

Control Measures ◽

P Value ◽

Cross Sectional Survey ◽

Online Questionnaire ◽

Cross Sectional

Aims: Despite control measures adopted to check the rapid spread of the COVID-19 pandemic in Nigeria, healthcare workers still face a serious threat to infection due to SARS-CoV-2 virus. Adherence to control measures by healthcare workers depends on their knowledge. This study aimed to determine the knowledge of COVID-19 and related infection control practices among healthcare professionals in Gombe State. Mythology: A cross sectional study was conducted among healthcare professionals in Gombe. Relying on our network with the healthcare professionals, 500 participants were recruited into the study using simple random sampling method. The data were collected using online questionnaire consisting of socio-demographic questions and 17questions based on knowledge and infection control practices related to COVID-19 disease in the healthcare setting adapted from a study in India. The data were analyzed using SPSS version 23 at uni-variate and bivariate levels with p value at < 0.05. Results: Close to three-fourth (72.1%) of the participants reported correct answer about knowledge of COVID-19, thus overall knowledge was found to be adequate for all subgroups. About four-fifth (78.9%) of doctors’ responses were correct. and the lowest (65.5%) was from CHOs, Laboratory assistants and health recorders. 43.7% of the participants could correctly define “close contact.” More than three-fourths of the participants knew the various infection control measures like rapid triage, respiratory hygiene, and cough etiquette and having a separate, well ventilated waiting area for suspected COVID-19 patients. However, less than half (47.8) of the participants were aware of the correct sequence for the application of a mask/respirator, and 62.2% of them knew the preferred hand hygiene method for visibly soiled hands. Conclusion: Regular health educational programs aimed at improving COVID-19 knowledge and infection control are needed.

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Self-collected gargle specimen as a patient-friendly sample collection method for COVID-19 diagnosis in a population context

10.21203/rs.3.rs-764442/v2 ◽

2021 ◽

Author(s):

Revata Utama ◽

Rebriarina Hapsari ◽

Iva Puspitasari ◽

Desvita Sari ◽

Meita Hendrianingtyas ◽

...

Keyword(s):

Healthcare Workers ◽

Room Temperature ◽

Rna Extraction ◽

User Preference ◽

Sample Collection ◽

Rt Pcr ◽

Collection Method ◽

Qrt Pcr ◽

Alternative Specimen ◽

Temperature Storage

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Self-collected gargle as a patient-friendly sample collection method for COVID-19 diagnosis in population context

10.21203/rs.3.rs-764442/v1 ◽

2021 ◽

Author(s):

Revata Utama ◽

Rebriarina Hapsari ◽

Iva Puspitasari ◽

Desvita Sari ◽

Meita Hendrianingtyas ◽

...

Keyword(s):

Healthcare Workers ◽

Room Temperature ◽

Rna Extraction ◽

User Preference ◽

Sample Collection ◽

Rt Pcr ◽

Collection Method ◽

Qrt Pcr ◽

Alternative Specimen ◽

Temperature Storage

Abstract Scaling up SARS-CoV-2 testing and tracing continues to be plagued with limitation of sample collection method that requires trained healthcare workers to perform and cause discomfort to the patients. In response, we assessed the performance and user preference of gargle specimens for qRT-PCR based detection of SARS-CoV-2 in Indonesia. Inpatients who had recently been diagnosed with COVID-19 and outpatients who were about to perform qRT-PCR testing were asked to provide nasopharyngeal and oropharyngeal (NPOP) swabs and self-collected gargle specimens. We demonstrated that self-collected gargle specimens can be an alternative specimen to detect SARS-CoV-2 and the viral RNA remained stable for 31 days on room temperature storage. The developed method was validated for use on multiple RNA extraction kit and commercially available COVID-19 RT-PCR kits. Our developed method achieved sensitivity of 91.38% when compared to paired NPOP swab specimens (Ct < 35) with 95.16% of patients prefer the self-collected gargle method.

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High-risk exposure without personal protective equipment and infection with SARS-CoV-2 in healthcare workers: results of the CoV-CONTACT prospective cohort

10.1101/2020.09.17.20194860 ◽

2020 ◽

Author(s):

Sarah Tubiana ◽

Charles Burdet ◽

Nadhira Houhou ◽

Michael Thy ◽

Pauline Manchon ◽

...

Keyword(s):

High Risk ◽

Personal Protective Equipment ◽

Prospective Cohort ◽

Healthcare Workers ◽

Risk Exposure ◽

Protective Equipment ◽

Risk Of Infection ◽

Rt Pcr ◽

Specific Symptom ◽

Increased Risk

Objective: We aimed to estimate the risk of infection in Healthcare workers (HCWs) following a high-risk exposure without personal protective equipment (PPE). Methods: We conducted a prospective cohort in HCWs who had a high-risk exposure to SARS-CoV-2-infected subject without PPE. Daily symptoms were self-reported for 30 days, nasopharyngeal swabs for SARS-CoV-2 RT-PCR were performed at inclusion and at days 3, 5, 7 and 12, SARS-CoV-2 serology was assessed at inclusion and at day 30. Confirmed infection was defined by positive RT-PCR or seroconversion, and possible infection by one general and one specific symptom for two consecutive days. Results: Between February 5th and May 30th, 2020, 154 HCWs were enrolled within 14 days following one high-risk exposure to either a hospital patient (70/154; 46.1%) and/or a colleague (95/154; 62.5%). At day 30, 25.0% had a confirmed infection (37/148; 95%CI, 18.4%; 32.9%), and 43.9% (65/148; 95%CI, 35.9%; 52.3%) had a confirmed or possible infection. Factors independently associated with confirmed or possible SARS-CoV-2 infection were being a pharmacist or administrative assistant rather than being from medical staff (adjusted OR (aOR)=3.8, CI95%=1.3;11.2, p=0.01), and exposure to a SARS-CoV-2-infected patient rather than exposure to a SARS-CoV-2-infected colleague (aOR=2.6, CI95%=1.2;5.9, p=0.02). Among the 26 HCWs with a SARS-CoV-2-positive nasopharyngeal swab, 7 (26.9%) had no symptom at the time of the RT-PCR positivity. Conclusions: The proportion of HCWs with confirmed or possible SARS-CoV-2 infection was high. There were less occurrences of high-risk exposure with patients than with colleagues, but those were associated with an increased risk of infection.

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Evaluating Healthcare Workers Needs and Empowering Them During Pandemics.

Open Science Journal ◽

10.23954/osj.v5i3.2507 ◽

2020 ◽

Vol 5 (3) ◽

Author(s):

Ikeoluwa Ayomiposi Akintujoye

Keyword(s):

Healthcare Workers ◽

Health Workers ◽

Close Contact ◽

Critical Role ◽

The United States ◽

Disease Outbreak ◽

Collateral Damage ◽

Risk Of Infection ◽

Increased Risk ◽

The Government

Healthcare workers play an essential and critical role in mitigating the effect of COVID-19 pandemic on the population. In the United States, estimated confirmed cases are over 3million as of July 8, 2020. Healthcare workers have increased risk of infection and, likewise, their close contact. Healthcare workers are the frontline heroes in this battle with their families as collateral damage. During the outbreak, healthcare workers have taken drastic steps to reduce the risk of infecting their family members. Some have moved out of their homes, staying in hotels, in makeshift tents in their garage, or staying with fellow healthcare workers while having decided to stay home not just because they want to get infected but mainly because they do not want to infect their loved ones and families. This paper explains how to encourage health workers to work during a disease outbreak, such as the current coronavirus called COVID-19. It is an eye-opener to what the Government can do to keep health workers encouraged to continue to render services by providing the necessary medical equipment, disposable and non-disposable gears, continuous education on proper hand hygiene, and regular check on the stockpile. The suggestion is for health workers to shower and change into a different cloth when going back home at the end of every shift, and the clothes wore at work will be recycled at the disinfecting unit within the hospital. The hospital should provide scrub that can be recycled. It will reduce the rate at which infection spread out of the hospital.Keywords: Coronavirus, COVID-19, disinfecting, and recycling work outfit, healthcare workers.

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