scholarly journals Risk Groups for SARS-CoV-2 Infection among Healthcare Workers: Community Versus Hospital Transmission

2021 ◽  
Vol 13 (3) ◽  
pp. 724-729
Author(s):  
Fatihan Pınarlık ◽  
Zeliha Genç ◽  
Mahir Kapmaz ◽  
Süda Tekin ◽  
Önder Ergönül
Keyword(s):  
Healthcare Workers ◽  
Risk Groups ◽  
Rt Pcr ◽  
Increased Risk ◽  
Study Results ◽  
Hospital Infection Control ◽  
Household Members ◽  
Increasing Risk ◽  
Antibody Levels ◽  
Hospital Transmission

Background: We aimed to detect the risk factors for SARS-CoV-2 infection among healthcare workers (HCWs) in 2020 before the vaccination era. Methods: We surveyed SARS-CoV-2 infection among the HCWs in a hospital through screening for antibody levels and the detection of viral RNA by RT-PCR between May 2020 and December 2020. Occupational and non-occupational potential predictors of disease were surveyed for the HCWs included in this study. Results: Among 1925 personnel in the hospital, 1732 were included to the study with a response rate of 90%. The overall infection rate of HCWs was 16.3% at the end of 2020, before vaccinations started. In the multivariate analysis, being janitorial staff (OR: 2.24, CI: 1.21–4.14, p = 0.011), being a medical secretary (OR: 4.17, CI: 2.12–8.18, p < 0.001), having at least one household member with a COVID-19 diagnosis (OR: 8.98, CI: 6.64–12.15, p < 0.001), and number of household members > 3 (OR: 1.67, CI: 1.26–2.22, p < 0.001) were found to be significantly associated with SARS-CoV-2 infection. Conclusions: Medical secretaries and janitorial staff were under increased risk of SARS-CoV-2 infection. The community-hospital gradient can explain the mode of transmission for infection among HCWs. In the setting of this study, community measures were less strict, whereas hospital infection control was adequate and provided necessary personal protective equipment. Increasing risk in larger households and households with diagnosed COVID-19 patient indicates the community-acquired transmission of the infection.

scholarly journals Predictors of SARS CoV-2 Infection Among Healthcare Workers: The Impact of Community-Hospital Gradient

2021 ◽  
Author(s):  
Fatihan Pinarlik ◽  
Zeliha Akbulut ◽  
Mahir Kapmaz ◽  
Suda Tekin ◽  
Onder Ergonul
Keyword(s):  
Healthcare Workers ◽  
Community Hospital ◽  
Increased Risk ◽  
Study Results ◽  
Hospital Infection Control ◽  
Household Members ◽  
Increasing Risk ◽  
Polymerase Chain ◽  
Antibody Levels ◽  
The Impact

Aim: We aimed to detect the risk factors for SARS-CoV-2 infection among healthcare workers (HCWs) in 2020, before vaccination era. Methods: We surveyed the SARS-CoV-2 infection among the HCWs in a hospital by screening of antibody levels and detection of viral RNA by reverse transcription polymerase chain reaction (RT-PCR) between May 2020 to December 2020. Occupational and non-occupational potential predictors of disease were surveyed for the HCWs included in this study. Results: Among 1925 personnel in the hospital, 1732 were included to the study with the response rate of 90%. Overall seroprevalence was 15% at the end of 2020, before vaccinations started. In multivariate analysis, being janitorial staff (OR:2.24, CI:1.21-4.14, p=0.011), being medical secretary (OR: 4.17, CI: 2.12-8.18, p<0.001), having at least one household member with COVID-19 diagnosis (OR:8.98, CI: 6.64-12.15, p<0.001) and number of household members >3 (OR:1.67, CI:1.26-2.22, p<0.001) were found to be significantly associated with SARS-CoV-2 infection. Conclusion: By the end of 2020, just before the era of vaccination and variants, seroprevalence was 15% among HCWs. Medical secretary and janitorial staff were under increased risk of SARS-CoV-2 infection. Community-hospital gradient can explain the mode of transmission for infection among HCWs. In the setting of this study, community measures were less strict, whereas hospital infection control was adequate and provided necessary personal protective equipment. Increasing risk in larger households and households with diagnosed COVID-19 patient indicates community acquired transmission of the infection.

scholarly journals Eastern Cape Healthcare Workers Acquisition of SARS-CoV-2 (ECHAS): Cross-Sectional (Nested Cohort) Study Protocol

2021 ◽  
Vol 18 (1) ◽  
pp. 323
Author(s):  
Oladele Vincent Adeniyi ◽  
David Stead ◽  
Mandisa Singata-Madliki ◽  
Joanne Batting ◽  
Leo Hyera ◽  
...  
Keyword(s):  
Cohort Study ◽  
Infection Rate ◽  
Healthcare Workers ◽  
Health Facilities ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Eastern Cape ◽  
Rt Pcr ◽  
Cross Sectional ◽  
Increased Risk

Healthcare workers (HCWs) are at increased risk of infection by the virulent severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Though data exist on the positivity rate of the SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) test as well as COVID-19-related deaths amongst HCWs in South Africa, the overall infection rate remains underestimated by these indicators. It is also unclear whether the humoral immune response after SARS-CoV-2 infection offers durable protection against reinfection. This study will assess the SARS-CoV-2 seroprevalence amongst HCWs in the Eastern Cape (EC) and examine the longitudinal changes (rate of decay) in the antibody levels after infection in this cohort. Using a multi-stage cluster sampling of healthcare workers in selected health facilities in the EC, a cross-sectional study of 2250 participants will be recruited. In order to assess the community infection rate, 750 antenatal women in the same settings will be recruited. Relevant demographic and clinical characteristics will be obtained by a self-administered questionnaire. A chemiluminescent microparticle immunoassay (CMIA) will be used for the qualitative detection of IgG antibodies against SARS-CoV-2 nucleocapsid protein. A nested cohort study will be conducted by performing eight-weekly antibody assays (X2) from 201 participants who tested positive for both SARS-CoV-2 RT-PCR and serology. Logistic regression models will be fitted to identify the independent risk factors for SARS-CoV-2 infection. The cumulative SARS-CoV-2 infection rate and infection fatality rate among the frontline HCWs will be estimated. In addition, the study will highlight the overall effectiveness of infection prevention and control measures (IPC) per exposure sites/wards at the selected health facilities. Findings will inform the South African Department of Health’s policies on how to protect HCWs better as the country prepares for the second wave of the SARS-CoV pandemic.

scholarly journals Household transmission and incidence of positive SARS-CoV-2 RT-PCR in symptomatic healthcare workers, clinical course and outcome: a French hospital experience

2020 ◽  
pp. oemed-2020-106866
Author(s):  
Evguenia Krastinova ◽  
Valérie Garrait ◽  
Marie-Thérèse Lecam ◽  
André Coste ◽  
Emmanuelle Varon ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Current Smoker ◽  
Infection Rates ◽  
Rt Pcr ◽  
Living Situation ◽  
Household Transmission ◽  
Occupational Profile ◽  
Household Members ◽  
French Hospital ◽  
At Home

ObjectivesAlthough healthcare workers (HCWs) have been particularly affected by SARS-CoV-2, detailed data remain scarce. In this study, we investigated infection rates, clinical characteristics, occupational exposure and household transmission among all symptomatic HCWs screened by SARS-CoV-2 RT-PCR between 17 March (French lockdown) and 20 April.MethodsSARS-CoV-2 RT-PCR was proposed to symptomatic (new cough or dyspnoea) HCWs at Creteil Hospital in one of the Parisian suburbs most severely affected by COVID-19. Data on occupational profile, living situation and household, together with self–isolation and mask use at home were collected, as well as the number of cases in the household.ResultsThe incidence rate of symptomatic SARS-CoV-2 was estimated to be 5% (110/2188). A total of 110 (35%) of the 314 HCWs tested positive and 9 (8%) were hospitalised. On multivariate analysis, factors independently associated with positive RT-PCR were occupational profile with direct patient facing (OR 3.1, 95% CI 1.1 to 8.8), p<0.03), and presence of anosmia (OR 5.7, 95% CI 3.1 to 10.6), p<0.0001). Being a current smoker was associated with negative RT-PCR (OR 0.3, 95% CI 0.1 to 0.7), p=0.005). Transmission from HCWs to household members was reported in 9 (14%) cases, and 2 deaths occurred. Overall, self-isolation was possible in 52% of cases, but only 31% of HCWs were able to wear a mask at home.ConclusionThis is the first study to report infection rates among HCWs during the peak of the SARS-CoV-2 epidemic in France and the lockdown period, highlighting the risk related to occupational profile and household transmission.

scholarly journals RISK OF HOSPITALISATION WITH COVID-19 AMONG TEACHERS COMPARED TO HEALTHCARE WORKERS AND OTHER WORKING-AGE ADULTS. A NATIONWIDE CASE-CONTROL STUDY

2021 ◽  
Author(s):  
Fenton Lynda ◽  
Gribben Ciara ◽  
Caldwell David ◽  
Colville Sam ◽  
Bishop Jen ◽  
...  
Keyword(s):  
General Practice ◽  
General Population ◽  
Healthcare Workers ◽  
Case Control Study ◽  
Case Control ◽  
Positive Test ◽  
Increased Risk ◽  
Working Age ◽  
Household Members ◽  
Control Study

AbstractObjectiveTo determine the risk of hospitalisation with COVID-19 and severe COVID-19 among teachers and their household members, overall and compared to healthcare workers and the general working-age population.DesignPopulation-based nested case-control study.SettingsScotland, March 2020 to January 2021. Before and after schools re-opened in early August 2020.ParticipantsAll cases of COVID-19 in Scotland in adults ages 21 to 65 (n = 83,817) and a random sample of controls matched on age, sex and general practice (n = 841,708).ExposureIndividuals identified as actively teaching in a Scottish school by the General Teaching Council for Scotland, and household members of such individuals identified via the Unique Property Reference Number.ComparatorIndividuals identified as healthcare workers in Scotland, their household members, and the remaining “general population” of working-age adults.Main outcomesThe primary outcome was hospitalisation with COVID-19 defined in anyone testing positive with COVID-19 in hospital, admitted to hospital within 28 days of a positive test, and/or diagnosed with COVID-19 on discharge from hospital. Severe COVID-19 was defined as individuals admitted to intensive care or dying within 28 days of a positive test or assigned COVID-19 as a cause of death.ResultsMost teachers were young (mean age 42), female (80%) and had no underlying conditions (84%). The cumulative incidence (risk) of hospitalisation with COVID-19 was below 1% for all of the working age adults. In the period after school re-opening, compared to the general population, in conditional logistic regression models adjusting for age, sex, general practice, deprivation, underlying conditions and number of adults in the household, the relative risk in teachers (among 18,479 cases and controls) for hospitalisation was rate ratio (RR) 0.97 (95%CI 0.72-1.29) and for severe COVID-19 was RR 0.27 (95%CI 0.09-0.77). Equivalent rate ratios for household members of teachers were 0.97 (95%CI 0.74-1.27) and 0.67 (95%CI 0.36-1.24), and for healthcare workers were 1.82 (95%CI 1.55-2.14) and 1.76 (95%CI 1.22-2.56), respectively.ConclusionCompared to working-age adults who are otherwise similar, teachers and their household members are not at increased risk of hospitalisation with COVID-19 and are at lower risk of severe COVID-19. These findings are broadly reassuring for adults engaged in face to face teaching.

scholarly journals Anti-SARS-CoV-2 IgG seroprevalence among non-vaccinated healthcare workers: a study from rural North India

2021 ◽  
Vol 8 (7) ◽  
pp. 3348
Author(s):  
Pratibha Mane ◽  
Jyoti Sangwan ◽  
Kirti Lohan
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Healthcare Workers ◽  
North India ◽  
Igg Antibodies ◽  
Rt Pcr ◽  
Positive Form ◽  
Care Workers ◽  
Increased Risk ◽  
The World

Background: Coronavirus disease 2019 (COVID-19) is an infectious disease reported in China initially which spread around the world in no time affecting millions of people. It is caused by a new coronavirus (SARS-CoV-2 or 2019 n-CoV). The healthcare workers (HCW) are at increased risk of acquiring the disease as well as antibody response.Methods: 457 health care workers (HCW) were recruited to give blood samples for anti-SARS CoV-2 IgG testing between September to October 2020.Results: Of the 457 participants, IgG antibodies against SARS-CoV-2 were detected in 116 health care workers (25.4%). The anti-SARS-CoV-2 antibodies were detected maximally in HCWs involved in laboratory work. Around 4 % of health care workers were RT-PCR positive form whom IgG were detected in 15 individuals (71.4%) only.Conclusions: The study concludes a higher prevalence among health care workers involved with patient’s samples and laboratory.

scholarly journals SARS-CoV-2 vaccine Alpha and Delta variant breakthrough infections are rare and mild, but happen relative early after vaccination

2021 ◽  
Author(s):  
Jelissa Katharina Peter ◽  
Fanny Wegner ◽  
Severin Gsponer ◽  
Fabrice Helfenstein ◽  
Tim Roloff ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Linear Models ◽  
Severe Disease ◽  
Patient Characteristics ◽  
Risk Groups ◽  
Local Health ◽  
Breakthrough Infection ◽  
Retrospective Case ◽  
Factors Associated ◽  
Increased Risk

Introduction: COVID-19 vaccines significantly reduce SARS-CoV-2 (SCoV2)-related hospitalization and mortality in randomized controlled clinical trials, as well as in real-world effectiveness against different circulating SCoV2-lineages. However, some vaccine recipients show breakthrough infection and it remains unknown, which host and viral factors contribute to this risk and how many resulted in severe outcomes. Our aim was to identify demographic and clinical risk factors for SCoV2 breakthrough infections and severe disease in fully vaccinated individuals and to compare patient characteristics in breakthrough infections caused by SCoV2 Alpha or Delta variant. Methods: We conducted an exploratory retrospective case-control study from 28th of December to 25th of October 2021 dominated by the Delta SCoV2 variant. All cases of infection had to be reported by law to the local health authorities. Vaccine recipients data was anonymously available from the national Vaccination Monitoring Data Lake and the main local vaccine center. We compared anonymized patients characteristics of breakthrough infection (n=492) to two overlapping control groups including all vaccine recipients from the Canton of Basel-City (group 1 n=126586 and group 2 n=109382). We also compared patients with breakthrough infection caused by the Alpha to Delta variant. We used different multivariate generalized linear models (GLM). Results: We found only 492/126586 (0.39%) vaccine recipients with a breakthrough infection after vaccination during the 10 months observational period. Most cases were asymptomatic or mild (478/492 97.2%) and only very few required hospitalization (14/492, 2.8%). The time to a positive SCoV2 test shows that most breakthrough infections occurred between a few days to about 170 days after full vaccination, with a median of 78 days (interquartile range, IQR 47-124 days). Factors associated with a lower odds for breakthrough infection were: age (OR 0.987, 95%CI 0.983-0.992), previous COVID-19 infection prior to vaccination (OR 0.296, 95%CI 0.117-0.606), and (self-declared) serious side-effects from previous vaccines (OR 0.289, 95%CI 0.033-1.035). Factors associated with a higher odds for breakthrough infection were: vaccination with the Pfizer/BioNTech vaccine (OR 1.459, 95%CI 1.238-1.612), chronic disease as vaccine indication (OR 2.109, 95%CI 1.692-2.620), and healthcare workers (OR 1.404, 95%CI 1.042-1.860). We did not observe a significantly increased risk for immunosuppressed patients (OR 1.248, 95% CI 0.806-1.849). Conclusions: Our study shows that breakthrough infections are rare and show mild illness, but that it occurs early after vaccination with more than 50% of cases within 70 to 80 days post-full vaccination. This clearly implies that boost vaccination should be much earlier initiated compared to the currently communicated 180-day threshold. This has important implications especially for risk groups associated with more frequent breakthrough infections such as healthcare workers, and people in high-risk care facilities. Due to changes in the epidemiological dynamic with new variants emerging, continuous monitoring of breakthrough infections is helpful to provide evidence on booster vaccines and patient groups at risk for potential complications.

scholarly journals Optimizing Benefits of Testing Key Workers for Infection with SARS-CoV-2: A Mathematical Modeling Analysis

2020 ◽  
Author(s):  
Frank G Sandmann ◽  
Peter J White ◽  
Mary Ramsay ◽  
Mark Jit
Keyword(s):  
Asymptomatic Infection ◽  
Transmission Risk ◽  
Decision Analytic Model ◽  
Analytic Model ◽  
Healthcare Staff ◽  
Rt Pcr ◽  
Modeling Analysis ◽  
Household Members ◽  
Increasing Risk ◽  
The Impact

Abstract Background Internationally, key workers such as healthcare staff are advised to stay at home if they or household members experience coronavirus disease 2019 (COVID-19)–like symptoms. This potentially isolates/quarantines many staff without SARS-CoV-2, while not preventing transmission from staff with asymptomatic infection. We explored the impact of testing staff on absence durations from work and transmission risks to others. Methods We used a decision-analytic model for 1000 key workers to compare the baseline strategy of (S0) no RT-PCR testing of workers to testing workers (S1) with COVID-19–like symptoms in isolation, (S2) without COVID-19–like symptoms but in household quarantine, and (S3) all staff. We explored confirmatory re-testing scenarios of repeating all initial tests, initially positive tests, initially negative tests, or no re-testing. We varied all parameters, including the infection rate (0.1–20%), proportion asymptomatic (10–80%), sensitivity (60–95%), and specificity (90–100%). Results Testing all staff (S3) changes the risk of workplace transmission by −56.9 to +1.0 workers/1000 tests (with reductions throughout at RT-PCR sensitivity ≥65%), and absences by −0.5 to +3.6 days/test but at heightened testing needs of 989.6–1995.9 tests/1000 workers. Testing workers in household quarantine (S2) reduces absences the most by 3.0–6.9 days/test (at 47.0–210.4 tests/1000 workers), while increasing risk of workplace transmission by 0.02–49.5 infected workers/1000 tests (which can be minimized when re-testing initially negative tests). Conclusions Based on optimizing absence durations or transmission risk, our modeling suggests testing staff in household quarantine or all staff, depending on infection levels and testing capacities.

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

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.

scholarly journals COVID-19 among Healthcare Workers: A Prospective Serological-Epidemiological Cohort Study in a Standard Care Hospital in Rural Germany

2021 ◽  
Vol 18 (20) ◽  
pp. 10999
Author(s):  
Stephanie Hoffmann ◽  
Juliane Schiebel ◽  
Frank Hufert ◽  
Heinz-Detlef Gremmels ◽  
Jacob Spallek
Keyword(s):  
Healthcare Workers ◽  
Population Group ◽  
Risk Groups ◽  
Vital Role ◽  
Care Hospital ◽  
Care Level ◽  
Primary Care Level ◽  
Increased Risk ◽  
Frequent Exposure ◽  
Epidemiological Cohort

Healthcare workers (HCW) play a vital role in the SARS-CoV-2 pandemic control. The aim of this study was to assess the prevalence of SARS-CoV-2 antibodies and the risk of COVID-19 infections in a cohort of HCW from four different risk groups (from intensive care unit to administration) of a hospital of a primary care level in rural Germany. The outcomes were monthly measures of antibody seroprevalence over a period of 6 months. Overall, a seroprevalence of 13.41% was determined, with significantly higher prevalence rates among HCW working in areas with more frequent contact to confirmed or suspected cases (30.30%, p = 0.003). The group specific differences in the risk of infection from COVID-19 were detected, as HCW groups with frequent exposure seemed to have an increased risk (RR = 3.18, p = 0.02; CI95 1.09–9.24). The findings contribute to the epidemiological understanding of the virus spread in an unvaccinated population group, which is highly relevant for the pandemic management.

scholarly journals The protective effect of SARS-COV-2 antibodies in Scottish healthcare workers

2021 ◽  
pp. 00080-2021
Author(s):  
Hani Abo-Leyah ◽  
Stephanie Gallant ◽  
Diane Cassidy ◽  
Yan Hui Giam ◽  
Justin Killick ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Local Population ◽  
Antibody Test ◽  
Asymptomatic Infection ◽  
Rt Pcr ◽  
Antibody Testing ◽  
Natural Production ◽  
Increased Risk ◽  
Health And Social Care ◽  
Almost All

BackgroundHealthcare workers (HCW) are believed to be at increased risk of SARS-CoV-2 infection. It is not known to what extent the natural production of antibodies to SARS-CoV-2 is protective against re-infection.MethodsA prospective observational study of HCW's in Scotland (UK) from May to September 2020. The Siemens SARS-CoV-2 total antibody assay was used to establish seroprevalence in this cohort. Controls, matched for age and sex to the general local population, were studied for comparison. New infections (up to 2/12/2020) post antibody testing were recorded to determine if the presence of SARS-CoV-2 antibodies protect against re-infection.ResultsA total of 2063 health and social care workers were recruited for this study. At enrolment 300 HCW had a positive antibody test (14.5%). 11/231 control sera tested positive (4.8%). HCW therefore had an increased likelihood of a positive test (Odds ratio 3.4 95% CI 1.85–6.16, p<0.0001). Dentists were most likely to test positive. 97.3% of patients who had previously tested positive for SARS-CoV-2 by RT-PCR had positive antibodies. 18.7% had an asymptomatic infection. There were 38 new infections with SARS-CoV-2 in HCW who were previously antibody negative and one symptomatic RT-PCR positive re-infection. The presence of antibodies was therefore associated with an 85% reduced risk of re-infection with SARS-CoV-2 (HR 0.15, 95% CI 0.06 to 0.35, p=0.026).ConclusionHCW were three times more likely to test positive for SARS-CoV-2 than the general population. Almost all infected individuals developed an antibody response which was 85% effective in protecting against re-infection with SARS-CoV-2.

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