MERS-CoV infection among healthcare workers and risk factors for death: Retrospective analysis of all laboratory-confirmed cases reported to WHO from 2012 to 2 June 2018

Abstract

a b s t r a c tBackground: Approximately half of the reported laboratory-confirmed infections of Middle East respiratory syndrome coronavirus (MERS-CoV) have occurred in healthcare settings, and healthcare workers constitute over one third of all secondary infections. This study aimed to describe secondary cases of MERS-CoV infection among healthcare workers and to identify risk factors for death. Methods: A retrospective analysis was conducted on epidemiological data of laboratory-confirmed MERS-CoV cases reported to the World Health Organization from September 2012 to 2 June 2018. We compared all secondary cases among healthcare workers with secondary cases among non-healthcare workers. Multivariable logistic regression identified risk factors for death. Results: Of the 2223 laboratory-confirmed MERS-CoV cases reported to WHO, 415 were healthcare workers and 1783 were non-healthcare workers. Compared with non-healthcare workers cases, healthcare workers cases were younger (P < 0.001), more likely to be female (P < 0.001), non-nationals (P < 0.001) and asymptomatic (P < 0.001), and have fewer comorbidities (P < 0.001) and higher rates of survival (P < 0.001).Year of infection (2013-2018) and having no comorbidities were independent protective factors against death among secondary healthcare workers cases. Conclusion: Being able to protect healthcare workers from high threat respiratory pathogens, such as MERS-CoV is important for being able to reduce secondary transmission of MERS-CoV in healthcareassociated outbreaks. By extension, reducing infection in healthcare workers improves continuity of care for all patients within healthcare facilities.

Middle East respiratory syndrome

“…To date, secondary transmission has occasionally occurred between close contacts of individuals with laboratory-confirmed MERS-CoV in household settings. 33,34 However, secondary transmission in health-care facilities has repeatedly occurred in several countries and has, on occasion, resulted in large outbreaks (appendix p 5)-such as Jeddah, Saudi Arabia (2014), Seoul, South Korea (2015), and Riyadh, Saudi Arabia (2015, 2016, and 2018). In health-care settings, human-to-human transmission occurs between patients, between patients and healthcare workers, and from patients to visitors.…”

“…In health-care settings, human-to-human transmission occurs between patients, between patients and healthcare workers, and from patients to visitors. 21,33 Approximately half of the MERS-CoV cases reported to WHO 2 to date have resulted from human-to-human transmission in health-care facilities. 21,33 birth products); however, genomic studies to definitively show transmission from these products to humans have not yet been done.…”

“…21,33 Approximately half of the MERS-CoV cases reported to WHO 2 to date have resulted from human-to-human transmission in health-care facilities. 21,33 birth products); however, genomic studies to definitively show transmission from these products to humans have not yet been done. Human primary intestinal epithelial cells, small intestine explants, and the intestinal tract are highly susceptible to MERS-CoV and can sustain viral replication.…”

Novel Coronavirus disease 2019 (COVID-19): The importance of recognising possible early ocular manifestation and using protective eyewear

“…7 Of the 2223 laboratory-confirmed MERS-CoV cases reported to WHO, 415 were healthcare workers, representing over one-third of all secondary transmission. 8 SARS and MERS spread principally by direct transmission and respiratory droplets. 9 10 However, SARS-CoV, and perhaps also MERS-CoV, may shed and be transferred to environmental surfaces, and thence contaminate hands and mucous membranes subsequently.…”

Social distancing: implications for the operating room in the face of COVID-19

“…La propagation liée aux soins de santé de maladies semblables a déjà été rapportée par le passé. Par exemple, parmi 2223 cas confirmés par laboratoire de coronavirus du syndrome respiratoire du Moyen-Orient (MERS), 19 % touchaient des travailleurs de la santé 4. Lors de l'épidémie de syndrome respiratoire aigu sévère (SRAS) à Toronto en 2003, 44 % des infections ont affecté des travailleurs de la santé.…”