scholarly journals Antibodies Against SARS-CoV-2 among High-Risk Groups: Findings from Serosurveys in 6 Urban Areas of Odisha, India

Author(s):  
Srikanta Kanungo ◽  
Sidhartha Giri ◽  
Debdutta Bhattacharya ◽  
Jaya Singh Kshatri ◽  
Subrata Kumar Palo ◽  
...  

Abstract Background: Personnel involved in essential services or residing in high risk areas during the COVID-19 pandemic are at increased risk of getting infected, and higher infection rates among such personnel can paralyze these services due to shortage of staff. Evaluating the proportion of personnel infected can be done using seroprevalence studies or serosurveys.Methods: During July to November, 2020, individuals from multiple high risk groups in 6 urban centres in the state of Odisha, India, which included health care workers, police personnel, municipality/ sanitation staff, residents of urban slums, vendors, press staff, and prisoners, were recruited into the study after obtaining written informed consent. Blood samples collected from the study participants were tested for IgG antibodies against COVID-19 in Roche Cobas e441. Information on socio-demographic variables, association with a confirmed or suspected case, symptoms profile of individuals within 30 days, travel and history of testing for COVID-19 were collected. All the statistical analyses were performed using STATA 16.0 (Stata corp., Texas). A P value ≤ 0.05 was considered statistically significant. Results: Of the 5434 individuals included in the final analysis, the overall COVID-19 seroprevalence was found to be 34.9% (95% CI 33.6-36.2). The seroprevalence varied from 21.8% (95% CI 19.6-24.1) in Rourkela to 54.9% (95% CI 51.5-58.2) in Bhubaneswar. Seropositivity was maximum among prisoners (47.7%, 138/289), followed by municipality/ sanitation staff (43.5%, 330/758), other office going staff (40.8%, 183/448), slum residents and vendors (39.8%, 252/633), police personnel (38.3%, 354/922), health care workers (27.1%, 536/1977), press staff (27.2%, 18/66) and residents of containment zones (25.2%, 86/341). On multivariate logistic regression, participants aged 18-29 years, 30-44 years, residents of slums and vending zone, municipality staffs, prisoners, residents of urban sites Malkangiri, Cuttack, Paralakhemundi and Bhubaneswar and those with previous history of confirmed COVID-19 were found to be independent co-relates of seropositivity.Conclusions: Risk of COVID-19 infection varied among the various high risk groups of Odisha. Periodic seroprevalence studies in future is essential to protect personnel involved in frontline activities during the ongoing pandemic.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nami Mohammadian Khonsari ◽  
Gita Shafiee ◽  
Atefeh Zandifar ◽  
Sahar Mohammad Poornami ◽  
Hanieh-Sadat Ejtahed ◽  
...  

Abstract Background Studies have shown that health care workers (HCWs), as front liners of the coronavirus (COVID-19) pandemic, are at high risk for psychological symptoms, but few studies have compared these symptoms in infected and non-infected HCWs. This study compares psychological symptoms among these two groups. Methods In this cross-sectional study, 938 HCWs from various medical fields working in the leading general hospitals of Alborz province, Iran, were selected using a multistage sampling method. The participants had contact with COVID-19 patients. Post-traumatic stress disorder-8 (PTSD-8) is a validated questionnaire that we used to evaluate PTSD symptoms along with its subscales, including intrusion, avoidance, and hypervigilance. Also, the Depression, Anxiety, and Stress Scale-21 questionnaire was used to assess the severity of the aforementioned conditions in HCWs. Multivariate logistic regression was used to compare psychological symptoms in infected and non-infected HCWs. Results Among 938 included HCWs, 55 had a history of confirmed COVID-19 infection. Prevalence of stress, anxiety, depression, intrusion, hypervigilance, and avoidance among infected HCWs were significantly higher in comparison to non-infected HCWs. In the multivariate logistic model, history of COVID-19 infection among HCWs was associated with a significantly increased risk of anxiety, depression, stress, intrusion, hyper-vigilance, and avoidance. Conclusion The present study showed that the HCWs with COVID-19 infection were at a high risk of displaying psychological symptoms. Therefore, it is also necessary to develop psychological support and interventions for HCWs, especially those who got infected with the virus.


2021 ◽  
Author(s):  
Jessy S J ◽  
Shamha Beegum ◽  
Genga Gopakumar ◽  
Bindu G ◽  
Chntha S ◽  
...  

Back ground and objectives- This study was undertaken to estimate the prevalence of SARS-CoV-2 infection among Health care workers [HCWs] of a hybrid COVID treatment hospital in Kerala. Methods- The study was conducted during 3rd week of January 2021. Among 3550 HCWs, 979 subjects were selected by stratified random sampling and grouped into high risk and low risk category based on job setting. Demographic details and clinical information regarding previous history of COVID 19 were collected at the time of SARS-CoV-2 IgG testing. Results: From 979 subjects, the data with respect to 940 health care workers were analysed. SARS-CoV-2 IgG was detected in 19.1% of HCWs. Seroprevalence among high risk group was 20.3% and that in low risk group was 7.4% [p=0.005]. In high-risk group, seropositivity was noted in 30.54 % of nurses, 19% hospital attenders, 18.9% resident doctors and 6.4% consultant doctors. In those with past history of SARS-CoV-2 infection, seropositivity was 75.4%. In those who were COVID positive during July2020, 33.3% were still IgG reactive. Interpretation and conclusion- The study reported 19.1% SARS CoV-2 IgG reactivity among health care workers in our hospital. Seropositivity was significantly higher in high risk group compared to low risk group. Antibody decay kinetics in our study is comparable to that in published literature. Infection control challenges in hybrid hospitals account for higher seropositivity in this study compared to overall seroprevalence among HCWs in Kerala.


Author(s):  
W David Strain ◽  
Janusz Jankowski ◽  
Angharad Davies ◽  
Peter MB English ◽  
Ellis Friedman ◽  
...  

SummaryHealthcare workers have a greater exposure to individuals with confirmed SARS-novel coronavirus 2, and thus a higher probability of contracting coronavirus disease (CoViD)-19, than the general population. Employers have a duty of care to minimise the risk for their employees. Several bodies including the Faculty of Occupational Medicine, NHS Employers, and Public Health England have published a requirement to perform risk assessments for all health care workers, however, with the absence of an objective risk stratification tool, comparing assessments between individuals is difficult if not impossible. Using published data, we explored the predictive role of basic demographics such as age, sex, ethnicity and comorbidities in order to establish an objective risk stratification tool that could help risk allocate duties to health care workers. We developed an objective risk stratification tool using a Caucasian female <50years of age with no comorbidities as a reference. Each point allocated to risk factors was associated with an approximate doubling in risk. This tool was then validated against the primary care-based analysis. This tool provides objective support for employers when determining which healthcare workers should be allocated to high-risk vs. lower risk patient facing clinical duties or to remote supportive roles.Strengths and limitations of this studyThere is an increased risk of mortality in the clinical workforce due to the effects of CoViD-19.This manuscript outlines a simple risk stratification tool that helps to quantify an individual’s biological riskThis will assist team leaders when allocating roles within clinical departments.This tool does not incorporate other external factors, such as high-risk household members or those at higher risk of mental health issues, that may require additional consideration when allocating clinical duties in an appropriate clinical domain.This population-based analysis did not explain for the very high risk observed in BAME healthcare workers suggesting there are other issues at play that require addressing. BAME healthcare workers suggesting there are other issues at play that require addressing.


Author(s):  
Ada Ávila Assunção ◽  
Emanuella Gomes Maia ◽  
Renata Jardim ◽  
Tânia Maria de Araújo

Health care workers (HCWs) are at an increased risk of being exposed to COVID-19. This study aimed to characterize flu-like syndrome cases (FS) in HCWs notified in Brazil and compare them with FS cases in the general community (GC). In the Brazilian protocol, FS corresponds to a suspected case of COVID-19. The manuscript analyzed cases of FS in five Brazilian states, estimating the incidence rates of cases of FS and clinical and epidemiological characteristics. Registered cases (March to June 2020) totaled about 1,100,000 cases of FS. HCWs represented 17% of the registers, whose incidence was 20.41/100 vs. 2.15/100 in the GC. FS cases in HCWs concentrated the highest percentages in the age group of 30 to 49 years (65.15%) and among the nursing staff (46.86%). This study was the first interstate evaluation in Brazil to estimate suspected cases of FS by COVID-19 in HCWs. In order to control the spread of viral respiratory infections in HCWs, including COVID-19, it is necessary to review the management of health information to identify who they are, how many they are, and to what situations these workers are most frequently exposed, as well as in what professions they have. This information can guide specific, practical, and far-reaching actions.


2020 ◽  
Vol 163 (1) ◽  
pp. 98-103 ◽  
Author(s):  
Brittany E. Howard

The correct selection and utilization of respiratory personal protective equipment is of the utmost importance in the current COVID-19 pandemic. This is especially true for health care workers exposed to high-risk aerosol-generating procedures, including otolaryngologists, ophthalmologists, neurosurgeons, maxillofacial surgeons, and laparoscopic surgeons. This communication provides a review of approved forms of respiratory protection and compares their characteristics, including surgical masks, N95 respirator, elastomeric respirators, powered air-purifying respirators, and controlled air-purifying respirators. For standard airborne precautions, N95 respirator are appropriate for respiratory protection. However, high-risk aerosol-generating procedures may create aerosolization of high viral loads that represent increased risk to health care workers. In these situations, enhanced respiratory protection with filters certified as 99, 100, or HEPA (high-efficiency particulate air) may be appropriate.


2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1042-1047
Author(s):  
Khushbu Balsara ◽  
Deepankar Shukla

In a very short period of time, “COVID-19” has seized the consciousness globally by making remarkable changes in our day to day living and has superintended as a public health emergency globally. It has high radar of transmission, affecting an individual at work to frontline workers. The measures and planning for a response plays a key role from drawing up an emergency committee and this follows an equation which broadly deals with epidemiological to clinical history of the patient, management steps from isolation, screening, diagnostic assays for identification and treatment. The application of an organized plan with secure structure aids in better performance, increases efficacy of management and saves time. Also saves time for a health care worker to g through routine levels of channels of administration if already a familiar way of operation is known for such situations. Thus, planning and developing a ‘blueprint of approach’ towards management of patient while facing such situation is a must. This review provides an insight to the measures for detection, response and preparedness of the hospital and health care workers should largely be inclusive of; also highlights the measures to be taken at every step after coming in contact with a positive case of “COVID-19”.


Author(s):  
Nitin Shetty ◽  
Nivedita Chakrabarty ◽  
Amit Joshi ◽  
Amar Patil ◽  
Suyash Kulkarni ◽  
...  

Background: Theoretically, health care workers (HCW) are at increased risk of getting infected with COVID-19 compared to the general population. Limited data exists regarding the actual incidence of COVID-19 infection amongst the high risk and low risk HCW of the same hospital. We present an audit from our tertiary cancer care centre comparing the COVID-19 infection rate between the high risk and low risk HCW, all of whom had been provided with adequate protective measures and health education.Methods: This is a retrospective observational study from 01 April 2020 to 30 September 2020, in which all the 970 HCW of Advanced Centre for Treatment, Research and Education in Cancer were divided into high risk and low risk groups. High risk HCW included all the medical and non-medical staff directly involved with the care of COVID-19 patients, and rest were low risk HCW. Adequate protective measures and classes for infection prevention were provided to all the HCW. We calculated the incidence of COVID-19 infection in both these groups based on the positive real time-polymerase chain reaction (RT-PCR) result and also looked for any significant difference in incidence between these two groups.Results: The incidence of COVID-19 infection amongst the high risk HCW was 13% and that of low risk HCW was 14%.Conclusions: We found no significant difference in COVID-19 infection between the high risk and low risk HCW. Thus, along with protective measures, behavior modifications induced by working in high risk areas, prevented the high risk HCW from getting increased COVID-19 infection compared to the low risk HCW.


2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Thamudi D. Sundarapperuma ◽  
Champa J. Wijesinghe ◽  
Priyadarshika Hettiarachchi ◽  
Sudharshani Wasalathanthri

Background. Gestational diabetes mellitus (GDM) is a global concern. GDM mothers have a 7-fold relative risk of developing type 2 diabetes mellitus (T2DM) in their later life. User-friendly and culturally acceptable dietary interventions can minimize this risk. Therefore, this study aims at exploring the perceptions of GDM mothers and health care workers regarding factors that influence postpartum dietary practices aimed at attenuating the trajectory from GDM to DM. Methods. The study was conducted in selected MOH areas in three districts of Sri Lanka. Six focus group discussions were conducted with thirty mothers with a history of GDM and six in-depth interviews with six health care workers. The phenomenon of interest was to obtain inputs of two stakeholder groups on healthy food habits of GDM mothers during the postpartum period. Framework analysis was used to analyse the data. Data were coded using the analytical framework, abstracted from transcripts, and summarized verbatim in Microsoft Excel in a matrix comprised of one row per participant and one column per code. Finally, the matrix was reviewed intensely and themes were generated. Results. Overall, seven themes emerged from both cases: (1) myths and traditions specific to the postpartum period, (2) lack of motivation, (3) time pressure, (4) financial barriers, (5) negligence of mothers and families, (6) lack of awareness regarding GDM and its postpartum dietary recommendations, and (7) cultural barriers. Conclusions. This study provides an insight into the existing knowledge, common practices, and attitudes regarding food habits among postpartum mothers with a history of GDM. Since the postpartum period is unique, identifying barriers is crucial when introducing dietary modification protocols in order to prevent or attenuate the progression of GDM to T2DM in these mothers. The knowledge gained will be used to introduce feasible, scientifically sound, and culturally acceptable postpartum dietary recommendations for GDM mothers.


Author(s):  
Aya Mostafa ◽  
Sahar Kandil ◽  
Manal H El-Sayed ◽  
Samia Girgis ◽  
Hala Hafez ◽  
...  

Abstract Background The scale of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among health care workers (HCWs), particularly in resource-limited settings, remains unclear. To address this concern, universal (non-symptom-based) screening of HCWs was piloted to determine the proportion of SARS-CoV-2 infection and the associated epidemiological and clinical risk factors at a large public health care facility in Egypt. Methods Baseline voluntary screening of 4040 HCWs took place between 22 April and 14 May 2020 at 12 hospitals and medical centres in Cairo. Epidemiological and clinical data were collected using an online survey. All participants were tested for SARS-CoV-2 using reverse transcription polymerase chain reaction (RT-PCR) and rapid IgM and IgG serological tests. Results Of the 4040 HCWs screened, 170 [4.2%; 95% confidence interval (CI): 3.6-4.9] tested positive for SARS-CoV-2 by either of the three tests (i.e. infected); 125/170 (73.5%) tested PCR-positive. Most infected HCWs were nurses (97/170, 57.5%). Median age of infected HCWs was 31.5 [interquartile range (IQR): 27.0–41.3] years. Of infected HCWs, 78 (45.9%) reported contact with a suspected case and 47 (27.6%) reported face-to-face contact within 2 m with a confirmed case. The proportion of infection among symptomatic HCWs (n = 54/616) was 8.8% (95% CI: 6.7-11.3); 6/54 (11.1%) had fever ≥38°C and 7/54 (13.0%) reported severe symptoms. Most infected HCWs were asymptomatic (116/170, 68.2%). The proportion of infection among asymptomatic HCWs (n = 116/3424) was 3.4% (95% CI: 2.8-4.0). Conclusions The high rate of asymptomatic infections among HCWs reinforces the need for expanding universal regular testing. The infection rate among symptomatic HCWs in this study is comparable with the national rate detected through symptom-based testing. This suggests that infections among HCWs may reflect community rather than nosocomial transmission during the early phase of the COVID-19 epidemic in Egypt.


2020 ◽  
Vol 11 ◽  
pp. 215145932093055 ◽  
Author(s):  
Timothy T. Wills ◽  
Wilhelm A. Zuelzer ◽  
Bryant W. Tran

Background: The novel coronavirus disease (COVID-19) has afflicted millions of people worldwide since its first case was reported in December 2019. Personal protective equipment (PPE) has been tailored accordingly, but as of April 2020, close to 10 000 health care workers in the United States have contracted COVID-19 despite wearing recommended PPE. As such, standard guidelines for PPE may be inadequate for the health care worker performing high-risk aerosolizing procedures such as endotracheal intubation. In this brief technical report, we describe the integration of an orthopedic hood cover as an item for full barrier protection against COVID-19 transmission. Technical Description: The Coronavirus Airway Task Force at Virginia Commonwealth University Medical Center approved this initiative and went live with the full barrier suit during the last week of March 2020. The PPE described in this report includes a Stryker T4 Hood, normally used in conjunction with the Stryker Steri-Shield T4 Helmet. Instead of the helmet, the hood is secured to the head via a baseball cap and binder clip. This head covering apparatus is to be used as an accessory to other PPE items that include an N95 mask, waterproof gown, and disposable gloves. The motor ventilation system is not used in order to prevent airborne viral entry into the hood. Discussion: An advantage of the full barrier suit is an additional layer of droplet protection during intubation. The most notable disadvantage is the absence of a ventilation system within the hood covering. Conclusion: Modification of existing PPE may provide protection for health care workers during high-risk aerosolizing procedures such as endotracheal intubation. Although the integration of this medical equipment meets the immediate needs of an escalating crisis, further innovation is on the horizon. More research is needed to confirm the safety of modified PPE.


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