Dataset Information

Risk and protective factors for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection among healthcare workers: A test-negative case-control study in Quebec, Canada.

ABSTRACT:

Objectives

In Québec, Canada, we evaluated the risk of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection associated with (1) the demographic and employment characteristics among healthcare workers (HCWs) and (2) the workplace and household exposures and the infection prevention and control (IPC) measures among patient-facing HCWs.

Design

Test-negative case-control study.

Setting

Provincial health system.

Participants

HCWs with PCR-confirmed coronavirus disease 2019 (COVID-19) diagnosed between November 15, 2020, and May 29, 2021 (ie, cases), were compared to HCWs with compatible symptoms who tested negative during the same period (ie, controls).

Methods

Adjusted odds ratios (aORs) of infection were estimated using regression logistic models evaluating demographic and employment characteristics (all 4,919 cases and 4,803 controls) or household and workplace exposures and IPC measures (2,046 patient-facing cases and 1,362 controls).

Results

COVID-19 risk was associated with working as housekeeping staff (aOR, 3.6), as a patient-support assistant (aOR, 1.9), and as nursing staff (aOR, 1.4), compared to administrative staff. Other risk factors included being unexperienced (aOR, 1.5) and working in private seniors' homes (aOR, 2.1) or long-term care facilities (aOR, 1.5), compared to acute-care hospitals. Among patient-facing HCWs, exposure to a household contact was reported by 9% of cases and was associated with the highest risk of infection (aOR, 7.8). Most infections were likely attributable to more frequent exposure to infected patients (aOR, 2.7) and coworkers (aOR, 2.2). Wearing an N95 respirator during contacts with COVID-19 patients (aOR, 0.7) and vaccination (aOR, 0.2) were the measures associated with risk reduction.

Conclusion

In the context of the everchanging SARS-CoV-2 virus with increasing transmissibility, measures to ensure HCW protection, including vaccination and respiratory protection, and patient safety will require ongoing evaluation.

SUBMITTER: Carazo S

PROVIDER: S-EPMC9530374 | biostudies-literature | 2022 Sep

REPOSITORIES: biostudies-literature

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Publications

Risk and protective factors for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection among healthcare workers: A test-negative case-control study in Québec, Canada.

Carazo Sara S Villeneuve Jasmin J Laliberté Denis D Longtin Yves Y Talbot Denis D Martin Richard R Denis Geoffroy G Ducharme Francine F Paquet-Bolduc Bianka B Anctil Geneviève G Hegg-Deloye Sandrine S De Serres Gaston G

Infection control and hospital epidemiology 20220909 7

<h4>Objectives</h4>In Québec, Canada, we evaluated the risk of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection associated with (1) the demographic and employment characteristics among healthcare workers (HCWs) and (2) the workplace and household exposures and the infection prevention and control (IPC) measures among patient-facing HCWs.<h4>Design</h4>Test-negative case-control study.<h4>Setting</h4>Provincial health system.<h4>Participants</h4>HCWs with PCR-confirmed coronavi ...[more]

PMID: 36082690

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Project description:IntroductionProtecting healthcare workers (HCWs) from Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a priority to maintain a safe and functioning healthcare system. Our objective was to describe and compare the epidemiology, clinical characteristics, and lethality of SARS-CoV-2 infections among HCWs compared to non-HCWs.MethodsUsing reportable disease data at Public Health Ontario, we conducted a population-based cross-sectional study comparing demographic, exposure, and clinical variables between HCWs and non-HCWs with SARS-CoV-2 infections as of 30 September 2020. We calculated rates of infections over time and determined the frequency of within household transmissions using natural language processing based on residential address. We evaluated the risk of death using a multivariable logistic regression model adjusting for age, sex, comorbidities, symptoms, and long-term care home exposure.ResultsThere were 7,050 (12.5%) HCW SARS-CoV-2 infections in Ontario, Canada, of whom 24.9% were nurses, 2.3% were physicians, and the remaining 72.8% other specialties, including personal support workers. Overall HCWs had an infection rate of 1,276 per 100,000 compared to non-HCWs of 346 per 100,000 (3.7 times higher). This difference decreased from a 7 times higher rate in April to no difference in September 2020. Twenty-six percent of HCWs had a household member with SARS-CoV-2 infection; 6.8% were probable acquisitions, 12.3% secondary transmissions, and 6.9% unknown direction of transmission. Death among HCWs was 0.2% compared to 6.1% of non-HCWs. The risk of death in HCWs remained significantly lower than non-HCWs after adjustment (adjusted odds ratio 0.09; 95%CI 0.05-0.17).ConclusionHCWs represent a disproportionate number of diagnosed SARS-CoV-2 infections in Ontario, however this discrepancy is at least partially explained by limitations in testing earlier in the pandemic for non-HCWs. We observed a low risk of death in HCWs which could not be completely explained by other factors.