Frequency, Associated Risk Factors, and Characteristics of COVID-19 Among Healthcare Personnel in a Spanish Health Department

Abstract

Introduction This study examines the frequency, associated factors, and characteristics of healthcare personnel coronavirus disease 2019 (COVID-19) cases in a healthcare department that comprises a tertiary hospital and its associated 12 primary healthcare centers. Methods This study included healthcare personnel that showed symptoms or were in contact with a COVID-19 case patient from March 2 to April 19, 2020. Their evolution and characteristics (age, sex, professional category, type of contact) were recorded. Correlations between the different characteristics and risk of developing COVID-19 and severe COVID-19 were analyzed using chi-square tests. Their magnitudes were quantified with ORs, AORs, and their 95% CIs using a logistic regression model. Results Of the 3,900 healthcare professionals in the department, 1,791 (45.9%) showed symptoms or were part of a contact tracing study. The prevalence of those with symptoms was 20.1% (784/3,900; 95% CI=18.8%, 21.4%), with COVID-19 was 4.0% (156/3,900; 95% CI=3.4%, 4.6%), and with severe COVID-19 was 0.5% (18/3,900; 95% CI=0.2%, 0.7%). The frequency of COVID-19 in symptomatic healthcare personnel with a non-protected exposure was 22.8% (112/491) and 13.7% (40/293) in those with a protected exposure (AOR=2.2, 95% CI=1.2, 3.9). The service in which the healthcare personnel performed their activity was not significantly associated with being diagnosed with COVID-19. A total of 26.3% (10/38) of male healthcare personnel with COVID-19 required hospitalization, compared with 6.8% (8/118) among female healthcare personnel (OR=4.9, 95% CI=1.8, 13.6). Conclusions A surveillance and monitoring program centered around healthcare personnel enables an understanding of the risk factors that lead to COVID-19 among this population. This knowledge allows the refinement of the strategies for disease control and prevention in healthcare personnel during the COVID-19 pandemic.

Occupational exposure to severe acute respiratory coronavirus virus 2 (SARS-CoV-2) and risk of infection among healthcare personnel

“…Among occupational settings, some studies have suggested patients are a more likely source of infection, 2,7 while others have suggested increased occupational exposure risk from other HCP. 5,14 Contrary to the study by Zabarsky et al, HCP in our evaluation were three times more likely to test positive after an exposure to an employee compared to a patient. 15 This is consistent with a study of 5,374 HCP exposures in Minnesota which found that 1.3% of HCP tested positive within 14 days of exposure from a patient source, compared to 3.8% from a HCP source.…”

“…4 Additionally, a study by Algado-Sellés et al suggested that HCP with confirmed COVID-19 were three times as likely to have a workplace social interaction be the source of infection compared to patient-care related exposures. 5 HCP role may also be a factor. In a cross-sectional serosurvey in Chicago among HCP, nurses were more likely to be seropositive than other HCP.…”

Update Alert 7: Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers

“…Another study found that N95 and surgical masks were each associated with decreased risk for SARS-CoV-2 infection versus no mask based on unadjusted estimates; an N95 mask was associated with decreased risk versus a surgical mask (OR, 0.76 [CI, 0.63 to 0.92]) ( 18 ). Use of PPE (not limited to masks) was associated with decreased risk for infection versus no PPE in 1 study ( 5 ) (adjusted OR, 0.45 [CI, 0.26 to 0.83]). Two other studies did not find an association between PPE use and risk for infection but reported an imprecise estimate ( 3 ) or did not control for confounders ( 20 ).…”

“…For this update, 12 cohort studies ( 3–9 , 11 , 14 , 15 , 18 , 19 ) and 6 cross-sectional studies ( 10 , 12 , 13 , 16 , 17 , 20 ) were added ( Supplement Table 1 ). Four studies were done in the United States ( 4 , 7 , 18 , 20 ), 10 in Europe (Spain [ 5 , 11 , 14 ], Italy [ 8 , 9 ], the United Kingdom [ 12 , 17 ], France [ 13 ], Sweden [ 15 ], and the Netherlands [ 15 ]), 2 in India ( 6 , 10 ), and 1 each in China ( 19 ) and Egypt ( 3 ). As with studies included in prior updates, the studies had methodological limitations, including potential recall bias, low or unclear participation rates, small sample sizes, and potential collinearity.…”

SARS-CoV-2 positivity rates in asymptomatic workers at a cancer referral center in Mexico City: A prospective observational study in the context of adapting hospitals back to regular practice

“…However, in their study, physicians had the highest number of positive tests 7 . Algado-Sellés et al reported a COVID-19 prevalence of 4% (95% CI: 3.4–4.6) in Spanish health workers 8 , but they only assessed symptomatic cases; however, they considered that the prevalence would be 4.7–5-3% if they included asymptomatic cases. The aforementioned authors stated that positivity rates were higher due to exposure to patients.…”