Seroprevalence of SARS-CoV-2 infection in healthcare workers in a large teaching hospital in the North West of England: a period prevalence survey

ObjectivesSince its emergence in late 2019, SARS-CoV-2 has caused a global pandemic that has significantly challenged healthcare systems. Healthcare workers have previously been shown to have experienced higher rates of infection than the general population. We aimed to assess the extent of infection in staff working in our healthcare setting.DesignA retrospective analysis of antibody results, compared with staff demographic data, and exposure to patients with COVID-19 infection.SettingA large teaching hospital in the North West of England.Participants4474 staff in diverse clinical and non-patient facing roles who volunteered for SARS-CoV-2 antibody testing by the Roche Elecsys assay between 29 May and 4 July 2020.ResultsSeroprevalence was 17.4%. Higher rates were seen in Asian/Asian British (OR 1.61, 95% CI 1.27 to 2.04) and Black/Black British (OR 2.08, 95% CI 1.25 to 3.45) staff. Staff working in any clinical location were more likely to be seropositive (OR 2.68, 95% 2.27 to 3.15). Staff were at an increased risk of seropositivity as the ‘per 100 COVID-19 bed-days change’ increased in the clinical area in which they worked (OR 1.12, 95% 1.10 to 1.14). Staff working in critical care were no more likely to have detectable antibodies than staff working in non-clinical areas. Symptoms compatible with COVID-19 were reported in 41.8% and antibodies were detected in 30.7% of these individuals. In staff who reported no symptoms, antibodies were detected in 7.7%. In all staff who had detectable antibodies, 25.2% reported no symptoms.ConclusionsStaff working in clinical areas where patients with COVID-19 were nursed were more likely to have detectable antibodies. The relationship between seropositivity in healthcare workers and the increase in ‘per 100 COVID-19 bed-days’ of the area in which they worked, although statistically significant, was weak, suggesting other contributing factors to the risk profile. Of staff with detectable antibodies and therefore evidence of prior infection, a quarter self-reported that they had experienced no compatible symptoms. This has implications for potential unrecorded transmission in both staff and patients.

Download Full-text

768 Impact Of COVID-19 And BOAST Standards on Surgical Management of Upper Limb Injuries in A Large Teaching Hospital

British Journal of Surgery ◽

10.1093/bjs/znab259.098 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

T Naylor

Keyword(s):

Teaching Hospital ◽

Upper Limb ◽

Day Case ◽

North West ◽

The North ◽

Large Teaching Hospital ◽

Limb Injuries ◽

Upper Limb Surgery ◽

Limb Fractures

Abstract Aim During the first peak of the COVID-19 pandemic, the BOA recommended that upper limb surgery for trauma should be avoided if possible, or performed as day-case if unavoidable, to reduce the risk of COVID-19 related negative outcomes. This audit assessed compliance with recommendations and impact on proportion of injuries managed conservatively due to COVID-19 risks, inpatient stay duration, COVID-19 infections, and corrective surgical intervention rates. Method Data was collected for all referrals to orthopaedics for upper limb fractures/dislocations at a large NHS teaching hospital in the North West over a 10-week period from April 4th to June 12th. Follow up was performed to 6 months after date of injury. Care was audited against the “British Orthopaedic Association Standard in Trauma: Management of patient with urgent orthopaedic conditions and trauma during the coronavirus pandemic”. Results A total of 112 patients were referred. 76% of patients were discharged from Emergency Department, with surgery indicated in 48%. Of those, 11% (n = 6) were not operated on due to COVID-19 risks and 1 patient from this group (16.7%) has required secondary corrective surgery. Surgery was completed as day-case procedure in 50%. COVID-19 swabs were not taken in 46% of referrals, 50% had a negative test and 4% positive. No patients tested positive after discharge following treatment. Conclusions Few cases were managed conservatively based on COVID-19 risk, and only 1 patient has required secondary surgery. More upper limb injuries may be managed conservatively, as per BOAST standards, with day-case procedures better utilised as an alternative.

Download Full-text

Increased risk of COVID-19 in haemodialysis healthcare workers in a tertiary centre in the North West of England

Journal of Hospital Infection ◽

10.1016/j.jhin.2020.07.030 ◽

2020 ◽

Vol 106 (2) ◽

pp. 390-391

Author(s):

S. Gray ◽

T. Clough ◽

Y. Mcgee ◽

T. Murphy ◽

D. Poulikakos

Keyword(s):

Healthcare Workers ◽

North West ◽

The North ◽

Tertiary Centre ◽

Increased Risk

Download Full-text

Occupational exposure to blood and bodily fluids among healthcare workers in Serbian general hospitals

Archives of Industrial Hygiene and Toxicology ◽

10.2478/aiht-2018-69-3047 ◽

2018 ◽

Vol 69 (1) ◽

pp. 61-68

Author(s):

Bojana Mandić ◽

Stefan Mandić-Rajčević ◽

Ljiljana Marković-Denić ◽

Petar Bulat

Keyword(s):

Occupational Exposure ◽

Healthcare Workers ◽

Cross Sectional Study ◽

Cross Sectional ◽

General Hospitals ◽

North West ◽

The North ◽

Skin Contact ◽

Entire Career ◽

Bloodborne Infections

Abstract The risk of occupational bloodborne infections (HBV, HCV, and HIV) among healthcare workers remains a serious issue in developing countries. The aim of this study was to estimate occupational exposure to bloodborne infections among general hospital workers in Serbia. This cross-sectional study was conducted in the spring of 2013 and included 5,247 healthcare workers from 17 general hospitals. The questionnaire was anonymous, self-completed, and included sociodemographic information with details of blood and bodily fluid exposure over the career and in the previous year (2012). Significant predictors of sharps injuries were determined with multiple logistic regressions. The distribution of accidents in 2012 was equal between the genders (39 %), but in entire career it was more prevalent in women (67 %). The most vulnerable group were nurses. Most medical doctors, nurses, and laboratory technicians reported stabs or skin contact with patients’ blood/other bodily fluid/tissue as their last accident. Healthcare workers from the north/west part of the country reported a significantly lower number of accidents over the entire career than the rest of the country (p<0.001). The south of Serbia stood out as the most accident-prone in 2012 (p=0.042).

Download Full-text

Assessment of Insulin-related Knowledge among Healthcare Professionals in a Large Teaching Hospital in the United Kingdom

Pharmacy ◽

10.3390/pharmacy7010016 ◽

2019 ◽

Vol 7 (1) ◽

pp. 16 ◽

Cited By ~ 2

Author(s):

Amie Bain ◽

Sallianne Kavanagh ◽

Sinead McCarthy ◽

Zaheer-Ud-Din Babar

Keyword(s):

Patient Safety ◽

Teaching Hospital ◽

Healthcare Professionals ◽

Small Scale ◽

Junior Doctors ◽

The North ◽

The United Kingdom ◽

Large Teaching Hospital ◽

Pharmacy Technicians ◽

Insulin Use

Despite numerous strategies introduced to promote the safe use of insulin, insulin-related medication errors persist. Our aim was to examine the knowledge and self-reported confidence of a range of healthcare professionals regarding insulin use in a large teaching hospital in the North of England. A 16-item electronic questionnaire was prepared in light of locally reported insulin-related incidents and distributed electronically to all healthcare professionals at the hospital over a 4-week study period. A range of healthcare professionals, including nurses, pharmacists, pharmacy technicians, junior doctors and consultants, completed the questionnaires (n = 109). Pharmacists achieved the greatest percentage of mean correct answers overall (49%), followed by consultant doctors (38%) and pharmacy technicians (37%), junior doctors (34%) and nurses (32%). Healthcare professionals were mainly “slightly confident” in their knowledge and use of insulin. Confidence level positively correlated to performance, but number of years’ experience did not result in higher confidence or performance. This small-scale study allowed for a broad assessment of insulin-related topics that have been identified both nationally and locally as particularly problematic. Identifying knowledge gaps may help tailor strategies to help improve insulin knowledge and patient safety.

Download Full-text

402 - An audit of Lithium Prescribing Practices in an Old Age PsychiatryService highlighting renal impairment in this cohort

International Psychogeriatrics ◽

10.1017/s1041610221001617 ◽

2021 ◽

Vol 33 (S1) ◽

pp. 29-30

Author(s):

L. Valentine ◽

J. Cannon ◽

S. Marmion ◽

M. Corcoran ◽

M. Cryan ◽

...

Keyword(s):

Renal Function ◽

Renal Impairment ◽

Old Age ◽

Best Practice ◽

Bipolar Affective Disorder ◽

Prescribing Practices ◽

Lithium Level ◽

North West ◽

The North ◽

Increased Risk

AbstractAims:To compare Lithium prescribing practices in a Psychiatry of Old Age (POA) Service in the North-West ofIreland among adults aged 65 years and over with best practice guidelines.Methods:Review of the literature informed development of audit standards for Lithium prescribing. These included National Institute for Clinical Excellent (NICE) 2014 guidelines, The British National Formulary(2019) and Maudsley Prescribing Guidelines (2018). Data was collected retrospectively, using an audit-specific data collection tool, from clinical files of POA team caseload, aged 65 years or more and prescribed Lithium over the past year.Results:At the time of audit in February 2020, 18 patients were prescribed lithium, 67% female, average age 74.6 years. Of those prescribed Lithium; 50% (n=9) had depression, 44% (n=8) had bipolar affective disorder (BPAD) and 6% (n=1) schizoaffective disorder.78% (n= 14) of patients met the NICE standard of 3-monthly lithium level. Lithium levels were checkedon average 4.5 times in past year, average lithium level was 0.61mmol/L across the group and 39% (n=7) had lithium level within recommended therapeutic range (0.6-0.8mmol/L).83% of patients (n=15) met the NICE standards of 3 monthly renal tests. Taking into consideration mostrecent blood test results, 100% (n=18) had abnormal renal function.Half (n=9) were initiated on lithium by POA service and of these, 56% (n=5) had documented renal impairment prior to initiation. Of patients on long term lithium at time of referral (n=9), almost half (n=4) had a documented history of lithium toxicity.Conclusions:The results of this audit highlight room for improvement in lithium monitoring of older adults attending POA service. Furthermore, all patients prescribed lithium had impaired renal function. This is an important finding given the associations between those admitted to hospital with COVID-19 and co- morbid kidney disease and increased risk of inpatient death.Our findings highlight the need for three monthly renal function monitoring in elderly prescribed lithiumgiven the additive adverse effects of increasing age and lithium on the kidney. Close working with specialised renal services to provide timely advice on renal management for those with renal impairment prescribed lithium is important to minimise adverse patient outcomes.

Download Full-text

High prevalence of SARS-CoV-2 infection among symptomatic healthcare workers in a large university tertiary hospital in São Paulo, Brazil

10.21203/rs.3.rs-42898/v2 ◽

2020 ◽

Author(s):

Carolina Palamin Buonafine ◽

Beatriz Nobre Monteiro Paiatto ◽

Fabyano Leal ◽

Samantha Matos ◽

Camila Ohomoto Moraes ◽

...

Keyword(s):

Latin America ◽

Healthcare Workers ◽

Clinical Characteristics ◽

Medical Condition ◽

Demographic Data ◽

Sao Paulo ◽

University Hospital ◽

São Paulo ◽

Ocular Pain ◽

Increased Risk

Abstract Background: Latin America became the epicenter of the COVID-19 pandemic in May 2020, mostly driven by Brazil's situation. Healthcare workers are at increased risk of SARS-CoV-2 infection, experiencing a significant burden from COVID-19. Identifying and understanding the clinical characteristics and risk factors associated with infection are of paramount importance to inform screening strategies and infection control practices in this scenario. The aims of this study were to investigate the prevalence and clinical characteristics of healthcare workers with COVID-19 symptoms. Methods: Between March 21 st and May 22 nd , 2020 a cross-sectional study was performed in a tertiary university hospital in São Paulo. Prevalence of SARS-CoV-2 infection among health care workers with COVID-19 symptoms was determined by RT-PCR testing on nasopharyngeal and oropharyngeal samples. Participants were asked to complete an electronic structured questionnaire including clinical and demographic data. Results: Overall, 125 (42.37%) of 295 symptomatic healthcare workers tested positive for SARS-CoV-2. Over the 10-week study period, positivity rates varied from 22.2% (CI 95% 15.9% - 60.3%) in the second week to 55.9% (CI 95% 43.2% - 68.6%) in the sixth week, reaching a plateau (38% - 46%) thereafter. Median (SD) age was 34.2 (9.9) years and 205 (69.5%) were female. We did not find significant differences in the prevalence of the most commonly reported underlying medical condition among healthcare workers that tested positive or negative for SARS-CoV-2 infection. After multivariate analysis, using logistic regression, anosmia (OR 4.4 95% C.I. 2.21 - 8.74) and ocular pain (OR 1.95 C.I. 95% 1.14 - 3.33) were the only symptoms independently associated with positivity for SARS-CoV-2 infection. Follow-up information on clinical outcomes showed that 9 (7.2%) healthcare workers were hospitalized (seven were male) and 2 (1.6%) died. Conclusions: The findings of this study confirmed the high burden of SARS-CoV-2 infection among healthcare workers in the hardest hit city by the pandemic in Latin America. Anosmia and ocular pain were symptoms independently associated with COVID-19 diagnosis. In low and middle-income countries, where limited availability of tests is frequent, these findings may contribute to optimize a targeted symptom-oriented screening strategy.

Download Full-text

18 Socio-Demographic Associations of COVID Antibody in Multi-Ethnic Healthcare Workers

Age and Ageing ◽

10.1093/ageing/afab028.18 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

pp. i1-i6

Author(s):

M Patel ◽

M Nair ◽

E Pirozzoli ◽

M C Cienfuegos ◽

E Aitken

Keyword(s):

Healthcare Workers ◽

Demographic Data ◽

Antibody Test ◽

Prevalence Rates ◽

Antibody Testing ◽

Cross Sectional ◽

Staff Members ◽

Healthcare Settings ◽

General Populations ◽

General Wards

Abstract Introduction Healthcare workers are particularly susceptible to developing COVID-19 owing to close and frequent contact with COVID-19 patients. This study aimed to describe prevalence of SARS-COV-2 antibodies amongst healthcare workers within a hospital trust and examine factors associated with increased prevalence of this antibody. Methods Data was obtained over a 4-week period in 2020 from a cross-sectional prospective survey of healthcare workers serving a multi-ethnic inner-city population who had IgG SARS-COV-2 antibody. Multiple, overlapping sources of notification were implemented to promote the availability of the test. Anonymised socio-demographic data about staff members were cross referenced with data of the antibody tests. Results Of 7,013,6,212 (89%) staff undertook the antibody test during the study period. The overall detection rate of IgG SARS COV-2 antibody was 26%(1584/6212). Univariate analyses reveal that there were no differences in the prevalence rates in terms of gender or age. Compared to white staff members (18%), prevalence of the antibody was significantly greater in Black(38%) and Asian(27%) staff members. The combined prevalence for all BAME staff members was 32%. The prevalence rates of staff in general wards (43%) were significantly higher other areas of the trust. For staff in emergency medicine, intensive care and anaesthetics, prevalence was 23%, whereas for other clinical teams it was 21%. In terms of professional groups, prevalence rates were highest amongst nursing and allied clinical services (28%), followed by doctors (23%), whereas, it was lower for non-clinical staff(19%). Discussion This large multi-ethnic hospital-based study has described the prevalence of recent exposure to SARS-COV-2 infection amongst healthcare workers and determined socio-demographic associations of this prevalence including ethnicity, professional healthcare groups, and geographical areas of work in healthcare settings. The study provides information that may be useful in future COVID studies examining the role of antibody testing both in general populations as well as in healthcare settings.

Download Full-text

981 Management of Epistaxis During The COVID-19 Pandemic Our Experience

British Journal of Surgery ◽

10.1093/bjs/znab134.105 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

M Eastwood ◽

C Metcalfe ◽

A Lovett ◽

M Isles

Keyword(s):

Teaching Hospital ◽

Management Strategies ◽

Upper Airway ◽

Risk Of Infection ◽

Prospective Audit ◽

Large Teaching Hospital ◽

Increased Risk ◽

Current Guidance

Abstract Introduction Epistaxis is a frequently encountered emergency by ENT services. With the COVID-19 outbreak, examination and procedures on the upper airway may put otolaryngologists at increased risk of infection. ENT UK released new guidance for the management of epistaxis during COVID-19 pandemic to safely manage epistaxis and reduce admissions. We report our experience in managing epistaxis using a locally approved protocol using this guidance. Method Prospective audit of management and outcomes of patients presenting to acute ENT services at a large teaching hospital with epistaxis over a 3-month period. Results 58 patients attended with epistaxis. Various management strategies were used with 50% managed with non-absorbable packing. 15 cases required admission only 8 solely due to epistaxis. Only 5 cases (8.6%) reported re-bleeding within 30 days with one case (1.7%) requiring readmission. Conclusions The current guidance appears to be a safe and effective method for managing epistaxis and minimising the number of admissions which may lead to a permanent shift in epistaxis management.

Download Full-text

Dentists deployed: an insider’s perspective of life on the NHS front line

Primary Dental Journal ◽

10.1177/20501684211034013 ◽

2021 ◽

Vol 10 (3) ◽

pp. 21-29

Author(s):

Harriet E. Powell

Keyword(s):

Emergency Department ◽

Secondary Care ◽

Healthcare Workers ◽

Major Trauma ◽

Healthcare Services ◽

Front Line ◽

North West ◽

National Crisis ◽

The North ◽

The Uk

The COVID-19 pandemic has stretched and overburdened healthcare services within the UK. This national crisis has led to the widespread redeployment of healthcare workers and reorganization of services throughout the NHS in the UK. The flexible and altruistic nature of healthcare workers has been inspiring, and central in the UK’s response to the COVID-19 pandemic. This article describes the ‘first-hand’ experience of a secondary care dentist, highlighting the redeployment journey to the emergency department (ED) of a major trauma hospital in the North-West of England during the first wave of the COVID-19 pandemic.

Download Full-text