COVID-19 screening of health-care workers in a London maternity hospital

Khalil, Asma; Hill, Robert A.; Ladhani, Shamez; Pattisson, Katherine; O’Brien, Pat

doi:10.1016/s1473-3099(20)30403-5

Cited by 50 publications

(50 citation statements)

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“…Included patients were diagnosed with COVID-19 between February 28 and April 17, 2020. The majority (4436, 88.7%) were males and the median age was 35 years [interquartile range (IQR) [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43]. By 60 days after COVID-19 diagnosis, 14 patients (0.28%) had died, 10 (0.2%) were still in hospital, and two (0.04%) were still in ICU.…”

Section: Resultsmentioning

confidence: 99%

The First Consecutive 5000 Patients with COVID-19 in Qatar; a Nation-wide Cohort Study

Omrani

Almaslamani

Daghfal

et al. 2020

Preprint

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Background There are limited data on Coronavirus Disease 2019 (COVID-19) outcomes at a national level, and none after 60 days of follow up. The aim of this study was to describe national, 60-day all-cause mortality associated with COVID-19, and to identify risk factors associated with admission to an intensive care unit (ICU). Methods This was a retrospective cohort study including the first consecutive 5000 patients with COVID-19 in Qatar who completed 60 days of follow up by June 17, 2020. Outcomes included all-cause mortality at 60 days after COVID-19 diagnosis, and risk factors for admission to ICU. Results Included patients were diagnosed with COVID-19 between February 28 and April 17, 2020. The majority (4436, 88.7%) were males and the median age was 35 years [interquartile range (IQR) 28-43]. By 60 days after COVID-19 diagnosis, 14 patients (0.28%) had died, 10 (0.2%) were still in hospital, and two (0.04%) were still in ICU. Fatal COVID-19 cases had a median age of 59.5 years (IQR 55.8-68), and were mostly males (13, 92.9%). All included pregnant women (26, 0.5%), children (131, 2.6%), and healthcare workers (135, 2.7%) were alive and not hospitalized at the end of follow up. A total of 1424 patients (28.5%) required hospitalization, out of which 108 (7.6%) were admitted to ICU. Most frequent co-morbidities in hospitalized adults were diabetes (23.2%), and hypertension (20.7%). Multivariable logistic regression showed that older age [adjusted odds ratio (aOR) 1.041, 95% confidence interval (CI) 1.022-1.061 per year increase; P <0.001], male sex (aOR 4.375, 95% CI 1.964-9.744; P <0.001), diabetes (aOR 1.698, 95% CI 1.050-2.746; P 0.031), chronic kidney disease (aOR 3.590, 95% CI 1.596-8.079, P 0.002), and higher BMI (aOR 1.067, 95% CI 1.027-1.108 per unit increase; P 0.001), were all independently associated with increased risk of ICU admission. Conclusions In a relatively younger national cohort with a low co-morbidity burden, COVID-19 was associated with low all-cause mortality. Independent risk factors for ICU admission included older age, male sex, higher BMI, and co-existing diabetes or chronic kidney disease.

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Section: Resultsmentioning

confidence: 99%

The First Consecutive 5000 Patients with COVID-19 in Qatar; a Nation-wide Cohort Study

Omrani

Almaslamani

Daghfal

et al. 2020

Preprint

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“…HCWs baseline characteristics SARS-CoV-2 can rapidly spread to patients and HCWs in hospitals, and HCWs generally have been particularly hard hit with high reported rates of infection 2,3,5,24 . Our cohort is representative of a multi-ethnic urban UK population of working age, and more specifically of the NHS workforce across different clinical roles and departments.…”

Section: Discussionmentioning

confidence: 99%

“…The global pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to more than 6 million infections and 300,000 deaths worldwide at the time of writing 1 . Healthcare workers (HCW) may be at greater infection risk compared to the general population [2][3][4][5] . Many infections are asymptomatic 6 , therefore surveillance of symptomatic coronavirus disease 2019 (COVID- 19) underestimates the infection burden.…”

Section: Introductionmentioning

confidence: 99%

Healthcare Workers Bioresource: Study outline and baseline characteristics of a prospective healthcare worker cohort to study immune protection and pathogenesis in COVID-19

et al. 2020

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Background: Most biomedical research has focused on sampling COVID-19 patients presenting to hospital with advanced disease, with less focus on the asymptomatic or paucisymptomatic. We established a bioresource with serial sampling of health care workers (HCWs) designed to obtain samples before and during mainly mild disease, with follow-up sampling to evaluate the quality and duration of immune memory. Methods: We conducted a prospective observational study on HCWs from three hospital sites in London, initially at a single centre (recruited just prior to first peak community transmission in London), but then extended to multiple sites 3 weeks later (recruitment still ongoing, target n=1,000). Asymptomatic participants attending work complete a health questionnaire, and provide a nasal swab (for SARS-CoV-2 RNA by RT-PCR tests) and blood samples (mononuclear cells, serum, plasma, RNA and DNA are biobanked) at 16 weekly study visits, and at 6 and 12 months. Results: Preliminary baseline results for the first 731 HCWs (400 single-centre, 331 multicentre extension) are presented. Mean age was 38±11 years; 67% are female, 31% nurses, 20% doctors, and 19% work in intensive care units. COVID-19-associated risk factors were: 37% black, Asian or minority ethnicities; 18% smokers; 13% obesity; 11% asthma; 7% hypertension and 2% diabetes mellitus. At baseline, 41% reported symptoms in the preceding 2 weeks. Preliminary test results from the initial cohort (n=400) are available: PCR at baseline for SARS-CoV-2 was positive in 28 of 396 (7.1%, 95% CI 4.9-10.0%) and 15 of 385 (3.9%, 2.4-6.3%) had circulating IgG antibodies. Conclusions: This COVID-19 bioresource established just before the peak of infections in the UK will provide longitudinal assessments of incident infection and immune responses in HCWs through the natural time course of disease and convalescence. The samples and data from this bioresource are available to academic collaborators by application https://covid-consortium.com/application-for-samples/.

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“…Frequent testing of all staff, including asymptomatic staff, to identify and isolate all active carriers may reduce the spread of infection within healthcare facilities given the high prevalence of asymptomatic staff in such organisations. 12 Face masks for patients and staff in clinical and even nonclinical settings should be considered, as although they may not significantly reduce the chance of acquiring infection, early suggestions indicate that this could avoid onward transmission; this is especially relevant to transmission from asymptomatic healthcare workers to patients, but also in the other direction. 13 An important and related point is that clinical acumen at an individual level, and clinical systems at an organisational level, must not disregard alternative clinical diagnoses and their appropriate management while screening for COVID-19.…”

Section: Infection Controlmentioning

confidence: 99%

Remodelling elective hospital services in the COVID-19 era – designing the new normal

King

Hothi

2020

Future Healthcare Journal

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The provision of elective clinical services has decreased during the initial phase of the coronavirus disease 2019 (COVID-19) pandemic to enable hospitals to focus on acute illness. Any end to the pandemic through widespread vaccination, effective treatment or development of herd immunity may be years away. Until then, hospitals will need to resume treating other diseases while also attempting to eradicate transmission of COVID-19 within the healthcare setting. In this article we suggest six major themes which could affect the design and delivery of elective clinical services: hospital avoidance, separation of high-and low-risk groups, screening, maintenance of adequate infection control, and new ways of working.

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COVID-19 screening of health-care workers in a London maternity hospital

Cited by 50 publications

References 3 publications

The First Consecutive 5000 Patients with COVID-19 in Qatar; a Nation-wide Cohort Study

The First Consecutive 5000 Patients with COVID-19 in Qatar; a Nation-wide Cohort Study

Healthcare Workers Bioresource: Study outline and baseline characteristics of a prospective healthcare worker cohort to study immune protection and pathogenesis in COVID-19

Remodelling elective hospital services in the COVID-19 era – designing the new normal

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