Effectiveness of Preventive Measures in Keeping Low Prevalence of SARS-CoV-2 Infection in Health Care Workers in a Referral Children’s Hospital in Southern Italy

Abstract

The coronavirus disease 2019 (COVID-19) pandemic now represents a major threat to public health. Health care workers (HCW) are exposed to biological risk. Little is currently known about the risk of HCW operating in pediatric wards for SARS-CoV-2 infection. The aim is to assess the prevalence of SARS-CoV-2 infection in HCW in a third-level children’s hospital in Southern Italy. An observational cohort study of all asymptomatic HCW (physician, technicians, nurses, and logistic and support operators) was conducted. HCW were screened, on a voluntary basis, for SARS-CoV-2 by RT-PCR on nasopharyngeal swab performed during the first wave of COVID-19. The study was then repeated, with the same modalities, at a 7-month interval, during the “second wave” of the COVID-19 pandemic. At the initial screening between 7 and 24 April 2020, 525 HCW were tested. None of them tested positive. At the repeated screening, conducted between 9 and 20 November 2020, 627 HCW were tested, including 61 additional ones resulting from COVID-emergency recruitment. At this second screening, eight subjects (1.3%) tested positive, thus being diagnosed as asymptomatic carriers of SARS-CoV-2. They were one physician, five nurses, and two HCW from the logistic/support services. They were employed in eight different wards/services. In all cases, the epidemiological investigation showed convincing evidence that the infection was acquired through social contacts. The study revealed a very low circulation of SARS-CoV-2 infection in HCW tested with RT-PCR. All the infections documented in the second wave of epidemic of SARS-CoV-2 were acquired outside of the workplace, confirming that in a pediatric hospital setting, HCW education, correct use of personal protective equipment, and separation of the COVID-patient pathway and staff flow may minimize the risk derived from occupational exposure.

COVID-19 and Inherited Metabolic Disorders: One-Year Experience of a Referral Center

“…This finding is widely in keeping with the trend observed in our hospital for children with COVID-19 [8] but, also, for healthcare workers, suggesting that the application of a stringent policy for DPI use and distancing turned out to be effective in preventing the intrahospital spread of SARS-CoV-2 infection. [9] The manifestation of SARS-CoV-2 infection is much less severe in children and adolescents than in adults and the elderly population [10]. In this series of patients with IMD, the manifestation of COVID-19 was very mild, with only one case requiring hospital admission, and none of them requiring admission to the ICU.…”

“…This finding is widely in keeping with the trend observed in our hospital for children with COVID-19 [ 8 ] but, also, for healthcare workers, suggesting that the application of a stringent policy for DPI use and distancing turned out to be effective in preventing the intrahospital spread of SARS-CoV-2 infection. [ 9 ]…”

SARS-CoV-2 seroprevalence in healthcare workers and risk factors

“…On the one hand, the seroprevalence of SARS-CoV-2 in HCW reached 7% In a study including 230,398 HCWs from 24 countries located all over the world (Europe, USA, China, Singapore, Mexico, India, South Korea), and 11% in a French national study ( 2 ), higher than in our hospital. On the other hand, lower seroprevalences were observed in Danish HCWs (4.04%) ( 3 ) and in a children's hospital in Southern Italy (1.3%)( 4 ). In the latter Italian study, the low seroprevalence was attributed to the strict application of preventive measures, with a strongly enforced policy of personal protective equipment (PPE) ( 4 ).…”

“…On the other hand, lower seroprevalences were observed in Danish HCWs (4.04%) ( 3 ) and in a children's hospital in Southern Italy (1.3%)( 4 ). In the latter Italian study, the low seroprevalence was attributed to the strict application of preventive measures, with a strongly enforced policy of personal protective equipment (PPE) ( 4 ).…”

Limited Additive Diagnostic Impact of Isolated Gastrointestinal Involvement for the Triage of Children with Suspected COVID-19

“…In order to reduce the risk of nosocomial spread of SARS-CoV-2, at the front desk we triage all children for familial exposure to SARS-CoV-2 and for the presence of a respiratory syndrome (fever, cough, or shortness of breath). Patients reporting familial exposure and/or respiratory syndrome are considered as potential cases of COVID-19 and thus evaluated in a dedicated, fast-track pathway [ 26 ].…”