Risk of SARS-CoV-2 exposure among hospital healthcare workers in relation to patient contact and type of care.
Ontology highlight
ABSTRACT: Aim
We aimed to assess prevalence of IgG antibodies to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and factors associated with seropositivity in a large cohort of healthcare workers (HCWs).Methods
From 11 May until 11 June 2020, 3981 HCWs at a large Swedish emergency care hospital provided serum samples and questionnaire data. Presence of IgG antibodies to SARS-CoV-2 was measured as an indicator of SARS-CoV-2 exposure.Results
The total seroprevalence was 18% and increased during the study period. Among the seropositive HCWs, 11% had been entirely asymptomatic. Participants who worked with COVID-19 patients had higher odds for seropositivity: adjusted odds ratio 1.96 (95% confidence intervals 1.59-2.42). HCWs from three of the departments managing COVID-19 patients had significantly higher seroprevalences, whereas the prevalence among HCWs from the intensive care unit (also managing COVID-19 patients) was significantly lower.Conclusions
SUBMITTER: Klevebro S
PROVIDER: S-EPMC8521364 | biostudies-literature | 2021 Nov
REPOSITORIES: biostudies-literature
Publications
Risk of SARS-CoV-2 exposure among hospital healthcare workers in relation to patient contact and type of care.
Klevebro Susanna S Bahram Fuad F Elfström K Miriam KM Hellberg Ulrika U Hober Sophia S Merid Simon Kebede SK Kull Inger I Nilsson Peter P Tornvall Per P Wang Gang G Conneryd Lundgren Kalle K Ponzer Sari S Dillner Joakim J Melén Erik E
Scandinavian journal of public health 20210619 7
<h4>Aim</h4>We aimed to assess prevalence of IgG antibodies to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and factors associated with seropositivity in a large cohort of healthcare workers (HCWs).<h4>Methods</h4>From 11 May until 11 June 2020, 3981 HCWs at a large Swedish emergency care hospital provided serum samples and questionnaire data. Presence of IgG antibodies to SARS-CoV-2 was measured as an indicator of SARS-CoV-2 exposure.<h4>Results</h4>The total seroprevalence was ...[more]
Similar Datasets
Project description:BackgroundSARS-CoV-2 cases in Germany increased in early March 2020. By April 2020, cases among health care workers (HCW) were detected across departments at a tertiary care hospital in Berlin, prompting a longitudinal investigation to assess HCW SARS-CoV-2 serostatus with an improved testing strategy and associated risk factors.MethodsIn May/June and December 2020, HCWs voluntarily provided blood for serology and nasopharyngeal/oropharyngeal (NP/OP) samples for real-time polymerase chain reaction (PCR) and completed a questionnaire. A four-tiered SARS-CoV-2 serological testing strategy including two different enzyme-linked immunosorbent assays (ELISA) and biological neutralization test (NT) was used. ELISA-NT correlation was assessed using Pearson's correlation coefficient. Sociodemographic and occupational factors associated with seropositivity were assessed with multivariate logistic regression.ResultsIn May/June, 18/1477 (1.2%) HCWs were SARS-CoV-2 seropositive, followed by 56/1223 (4.6%) in December. Among those tested in both, all seropositive in May/June remained seropositive by ELISA and positive by NT after 6 months. ELISA ratios correlated well with NT titres in May/June (R = 0.79) but less so in December (R = 0.41). Those seropositive reporting a past SARS-CoV-2 positive PCR result increased from 44.4% in May/June to 85.7% in December. HCWs with higher occupational risk (based on profession and working site), nurses, males, and those self-reporting COVID-19-like symptoms had significantly higher odds of seropositivity.ConclusionsThis investigation provides insight into the burden of HCW infection in this local outbreak context and the antibody dynamics over time with an improved robust testing strategy. It also highlights the continued need for effective infection control measures particularly among HCWs with higher occupational risk.
| S-EPMC8784861 | biostudies-literature
Project description:Hospital healthcare workers (HCWs) are at increased risk of contracting COVID-19 infection. We aimed to determine the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies in HCWs in Ireland. Two tertiary referral hospitals in Irish cities with diverging community incidence and seroprevalence were identified; COVID-19 had been diagnosed in 10.2% and 1.8% of staff respectively by the time of the study (October 2020). All staff of both hospitals (N = 9038) were invited to participate in an online questionnaire and blood sampling for SARS-CoV-2 antibody testing. Frequencies and percentages for positive SARS-CoV-2 antibody were calculated and adjusted relative risks (aRR) for participant characteristics were calculated using multivariable regression analysis. In total, 5788 HCWs participated (64% response rate). Seroprevalence of antibodies to SARS-CoV-2 was 15% and 4.1% in hospitals 1 and 2, respectively. Thirty-nine percent of infections were previously undiagnosed. Risk for seropositivity was higher for healthcare assistants (aRR 2.0, 95% confidence interval (CI) 1.4-3.0), nurses (aRR: 1.6, 95% CI 1.1-2.2), daily exposure to patients with COVID-19 (aRR: 1.6, 95% CI 1.2-2.1), age 18-29 years (aRR: 1.4, 95% CI 1.1-1.9), living with other HCWs (aRR: 1.3, 95% CI 1.1-1.5), Asian background (aRR: 1.3, 95% CI 1.0-1.6) and male sex (aRR: 1.2, 95% CI 1.0-1.4). The HCW seroprevalence was six times higher than community seroprevalence. Risk was higher for those with close patient contact. The proportion of undiagnosed infections call for robust infection control guidance, easy access to testing and consideration of screening in asymptomatic HCWs. With emerging evidence of reduction in transmission from vaccinated individuals, the authors strongly endorse rapid vaccination of all HCWs.
| S-EPMC8314060 | biostudies-literature
Project description:BackgroundHealthcare workers (HCWs) have an increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection due to occupational exposure. Strict measures generally focus on the patient-to-HCW contacts. However, interactions between the HCWs also pose a high risk for SARS-CoV-2 exposure.AimsThis study was aimed to investigate the effect of social contacts on the level of SARS-CoV-2 exposure risk among workers by broadening the current risk assessment algorithm.MethodsContact tracing records of the workers in a large university hospital between 19th March and 31st December 2020 were analysed. Multivariate conditional logistic regression models were estimated to evaluate factors associated with high-risk exposure for contacts among workers.ResultsOf the 329 exposed clusters, 260 (79%) were HCW-to-HCW contacted clusters. High-risk exposure was higher in the HCW-to-HCW contacts (44%), when compared to the patient-to-HCW contacts (5%) (P < 0.001). A total of 1827 HCWs contacted a laboratory-confirmed COVID-19-positive co-worker. Among the HCW-to-HCW contacts, high-risk exposure was higher in the support staff (49%, P < 0.001), in non-patient care settings (47%, P < 0.001) and in the social contacts (57%, P < 0.001). Social contacts between workers increased the high-risk exposure (adjusted odds ratio: 3.50, 95% confidence interval 2.62-4.69) in multivariate analysis.ConclusionsA significant association between social contacts among workers and high-risk exposure of SARS-CoV-2 was observed. The results of the study emphasize the need for policies regarding the improved protection of HCWs in social settings in addition to patient care services.
| S-EPMC8524522 | biostudies-literature
Project description:SARS-CoV-2 may pose an occupational health risk to healthcare workers. Here, we report the seroprevalence of SARS-CoV-2 antibodies, self-reported symptoms and occupational exposure to SARS-CoV-2 among healthcare workers at a large acute care hospital in Sweden. The seroprevalence of IgG antibodies against SARS-CoV-2 was 19.1% among the 2149 healthcare workers recruited between April 14th and May 8th 2020, which was higher than the reported regional seroprevalence during the same time period. Symptoms associated with seroprevalence were anosmia (odds ratio (OR) 28.4, 95% CI 20.6-39.5) and ageusia (OR 19.2, 95% CI 14.3-26.1). Seroprevalence was also associated with patient contact (OR 2.9, 95% CI 1.9-4.5) and covid-19 patient contact (OR 3.3, 95% CI 2.2-5.3). These findings imply an occupational risk for SARS-CoV-2 infection among healthcare workers. Continued measures are warranted to assure healthcare workers safety and reduce transmission from healthcare workers to patients and to the community.
| S-EPMC7544689 | biostudies-literature
Project description:BackgroundSmear-negative pulmonary tuberculosis (TB) accounts for a considerable proportion of TB transmission, which especially endangers health care workers (HCW). Novel Mycobacterium-tuberculosis-specific interferon-gamma release assays (IGRAs) may offer the chance to define the burden of TB in HCW more accurately than the Mantoux tuberculin skin test (TST), but the data that is available regarding their performance in tracing smear-negative TB in the low-incidence, in-hospital setting, is limited. We conducted a large-scale, in-hospital contact investigation among HCW of a German university hospital after exposure to a single case of extensive smear-negative, culture-positive TB with pulmonary involvement. The objective of the present study was to evaluate an IGRA in comparison to the TST and to identify risk factors for test positivity.MethodsContacts were prospectively enrolled, evaluated using a standardized questionnaire, the IGRA QuantiFERON(R)-TB Gold in Tube (QFT-GIT) and the TST, and followed-up for two years. Active TB was ruled out by chest x-ray in QFT-GIT-positive subjects. Independent predictors of test positivity were established through the use of logistic regression analysis.ResultsOut of the 143 subjects analyzed, 82 (57.3%) had close contact, but only four (2.8%) experienced cumulative exposure to the index case >40 hours. QFT-GIT results were positive in 13 subjects (9.1%), while TST results were positive in 40 subjects (28.0%) at an induration >5 mm. Overall agreement was poor between both tests (kappa = 0.15). Age was the only predictor of QFT-GIT-positivity (Odds ratio 2.7, 95% confidence interval 1.32-5.46), while TST-positivity was significantly related to Bacillus Calmette-Guérin vaccination and foreign origin. Logistic regression analysis showed no relation between test results and exposure. No secondary cases of active TB were detected over an observational period of two years.ConclusionOur findings suggest a low contagiosity of the particular index case. The frequency of positive QFT-GIT results may in fact reflect the pre-existing prevalence of latent TB infection among the study population. TB transmission seems unlikely and contact tracing not generally warranted after cumulative exposure <40 hours. However, the substantially lower frequency of positive QFT-GIT results compared to the TST may contribute to enhanced TB control in health care.
| S-EPMC2698921 | biostudies-literature
Project description:BackgroundMethicillin-resistant Staphylococcus aureus (MRSA) is a major public health concern worldwide. Healthcare workers (HCWs) are an important source of transmission of MRSA. We conducted a prospective study to define the frequency of S. aureus nasal colonization with emphasis on the carriage of MRSA in HCWs in relation to the intensity of patient contact.MethodsOut-of-hospital care emergency medical technicians and students, and HCWs in the emergency department, intensive care unit and a long-term care facility (LTCF) were enrolled to compare the prevalence of MRSA and methicillin-susceptible S. aureus (MSSA) nasal colonization. The MRSA isolates were further identified by their microbiological and molecular characteristics.FindingsS. aureus was isolated from 63 of 248 HCWs (25.4%). The overall MRSA nasal carriage rate was 15/248, 6%, and the prevalence was higher in the HCWs who had worked for 5-10 years (12.8%), and among female HCWs (10.3%) than male HCWs (0.9%). LTCFs had the highest prevalence (12%). In contrast, the overall carriage of MSSA was 48/248, 19.4%, and most carriers worked for ≥5 years (52.1%). Hospital nurses had the highest rate of MSSA carriage (21.4%). Most of the MRSA isolates were SCCmec IV/ST59 or ST45 (60%), and were resistant to erythromycin and clindamycin (53%).ConclusionsHospital nurses have highest S. aureus nasal carriage, whereas HCWs in the LTCFs comprise a significant reservoir of MRSA colonization. The differences in the characteristics of MRSA and MSSA nasal carriage among HCWs highlights the importance on long-term nasal screening of S. aureus in healthcare facilities.
| S-EPMC8336196 | biostudies-literature
Project description:BackgroundWe aimed to detect the risk factors for SARS-CoV-2 infection among healthcare workers (HCWs) in 2020 before the vaccination era.MethodsWe 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.ResultsAmong 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.ConclusionsMedical 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.
| S-EPMC8395820 | biostudies-literature
Project description:BackgroundCOVID-19 pandemic has led to a loss of human life in millions and devastating socio-economic consequences worldwide. So far, vaccination is the most effective long-term strategy to control and prevent severe COVID-19 disease. The aim of the current study was to evaluate the humoral immune responses raised against the BNT162b2 vaccine in hospital healthcare workers.MethodsTotal number of 173 healthcare workers enrolled in the study. Their blood samples were collected in three different time intervals after the second SARS-CoV-2 vaccination and evaluated by the ELISA method to detect anti-spike protein IgM and IgG antibodies. The baseline characteristics of all participants were collected using questionnaires and were evaluated for finding any significant data.ResultsOur results demonstrated that the levels of antibodies were higher in the young group (21-30 years old) and also among male participants. Moreover, the highest levels of antibodies were detected from the group that received the third shot vaccination.ConclusionsOur results indicate that age, gender and third-dose vaccination can affect the levels of humoral immune responses against the BNT162b2 vaccine in healthcare workers.
| S-EPMC9782529 | biostudies-literature
Project description:ObjectivesIn patient-facing healthcare workers delivering secondary care, what is the evidence behind UK Government personal protective equipment (PPE) guidance on surgical masks versus respirators for SARS-CoV-2 protection?DesignTwo independent reviewers performed a rapid review. Appraisal was performed using Critical Appraisal Skills Programme checklists and Grading of Recommendations, Assessment, Development and Evaluations methodology. Results were synthesised by comparison of findings and appraisals.Data sourcesMEDLINE, Google Scholar, UK Government COVID-19 website and grey literature.Eligibility criteriaStudies published on any date containing primary data comparing surgical facemasks and respirators specific to SARS-CoV-2, and studies underpinning UK Government PPE guidance, were included.ResultsOf 30 identified, only 3 laboratory studies of 14 different respirators and 12 surgical facemasks were found. In all three, respirators were significantly more effective than facemasks when comparing protection factors, reduction factors, filter penetrations, total inspiratory leakages at differing particle sizes, mean inspiratory flows and breathing rates. Tests included live viruses and inert particles on dummies and humans. In the six clinical studies (6502 participants) included the only statistically significant result found continuous use of respirators more effective in clinical respiratory illness compared with targeted use or surgical facemasks. There was no consistent definition of 'exposure' to determine the efficacy of respiratory protective equipment (RPE). It is difficult to define 'safe'.ConclusionsThere is a paucity of evidence on the comparison of facemasks and respirators specific to SARS-CoV-2, and poor-quality evidence in other contexts. The use of surrogates results in extrapolation of non-SARS-CoV-2 specific data to guide UK Government PPE guidance. The appropriateness of this is unknown given the uncertainty over the transmission of SARS-CoV-2.This means that the evidence base for UK Government PPE guidelines is not based on SARS-CoV-2 and requires generalisation from low-quality evidence of other pathogens/particles. There is a paucity of high-quality evidence regarding the efficacy of RPE specific to SARS-CoV-2. UK Government PPE guidelines are underpinned by the assumption of droplet transmission of SARS-CoV-2.These factors suggest that the triaging of filtering face piece class 3 respirators might increase the risk of COVID-19 faced by some.
| S-EPMC7569706 | biostudies-literature
Project description:IntroductionHospital-wide SARS-CoV-2 seroprevalence is rarely explored and can identify areas of unexpected risk. We determined the seroprevalence against SARS-CoV-2 in all health care workers (HCW) at a hospital.MethodsCross-sectional study (14-27/04/2020). We determined SARS-CoV-2 IgG by ELISA in all HCW including external workers of a teaching hospital in Madrid. They were classified by professional category, working area, and risk for SARS-CoV-2 exposure.ResultsAmong 2919 HCW, 2590 (88,7%) were evaluated. The mean age was 43.8 years (SD 11.1), and 73.9% were females. Globally, 818 (31.6%) workers were IgG positive with no differences for age, sex or previous diseases. Of these, 48.5% did not report previous symptoms. Seropositivity was more frequent in high- (33.1%) and medium- (33.8%) than in low-risk areas (25.8%, p=0.007), but not for hospitalization areas attending COVID-19 and non-COVID-19 patients (35.5 vs 38.3% p>0.05). HWC with a previous SARS-CoV2 PCR-positive test were IgG seropositive in 90.8%. By multivariate logistic regression analysis seropositivity was significantly associated with being physicians (OR 2.37, CI95% 1.61-3.49), nurses (OR 1.67, CI95% 1.14-2.46), nurse assistants (OR 1.84, CI95% 1.24-2.73), HCW working at COVID-19 hospitalization areas (OR 1.71, CI95% 1.22-2.40), non-COVID-19 hospitalization areas (OR 1.88, CI95% 1.30-2.73), and at the Emergency Room (OR 1.51, CI95% 1.01-2.27).ConclusionsSeroprevalence uncovered a high rate of infection previously unnoticed among HCW. Patients not suspected of having COVID-19 as well as asymptomatic HCW may be a relevant source for nosocomial SARS-CoV-2 transmission.
| S-EPMC9168001 | biostudies-literature