Risk of COVID-19 in health-care workers in Denmark: an observational cohort study

Iversen, Kasper; Bundgaard, Henning; Hasselbalch, Rasmus Bo; Kristensen, Jonas Henrik; Nielsen, Pernille B; Pries-Heje, Mia Marie; Knudsen, Andreas Dehlbæk; Christensen, Casper Emil; Fogh, Kamille; Norsk, Jakob; Andersen, Ove; Fischer, Thea Kølsen; Jensen, Claus Antonio Juul; Larsen, Margit Hørup; Torp‐Pedersen, Christian; Rungby, Jørgen; Ditlev, Sisse B.; Hageman, Ida; Møgelvang, Rasmus; Hother, Christoffer; Gybel-Brask, Mikkel; Sørensen, Erik; Harritshøj, Lene Holm; Folke, Fredrik; Sten, Curt; Benfield, Thomas; Nielsen, Susanne Dam; Ullum, Henrik

doi:10.1016/s1473-3099(20)30589-2

Cited by 409 publications

(559 citation statements)

References 18 publications

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“…In conclusion, HCWs in this study were at modestly lower risk for SARS-CoV-2 infection as compared with other studies of HCWs from the New York area and Spain, and similar seropositive rates as reported in Denmark [ 4 , 22 , 23 ]. Across occupation groups, nurses were at the highest-level risk from work-related exposures.…”

Section: Discussionsupporting

confidence: 85%

Seroprevalence and Correlates of SARS-CoV-2 Antibodies in Health Care Workers in Chicago

Wilkins

Gray

Wallia

et al. 2020

Open Forum Infectious Diseases

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Background Identifying factors associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among health care workers (HCWs) may help health systems optimize SARS-CoV-2 infection control strategies. Methods We conducted a cross-sectional analysis of baseline data from the Northwestern HCW SARS-CoV-2 Serology Cohort Study. We used the Abbott Architect Nucleocapsid IgG assay to determine seropositivity. Logistic regression models (adjusted for demographics and self-reported community exposure to coronavirus disease 2019 [COVID-19]) were fit to quantify the associations between occupation group, health care delivery tasks, and community exposure and seropositive status. Results A total of 6510 HCWs, including 1794 nurses and 904 non-patient-facing administrators, participated. The majority were women (79.6%), 74.9% were White, 9.7% were Asian, 7.3% were Hispanic, and 3.1% were non-Hispanic Black. The crude prevalence of seropositivity was 4.8% (95% CI, 4.6%–5.2%). Seropositivity varied by race/ethnicity as well as age, ranging from 4.2% to 9.6%. Out-of-hospital exposure to COVID-19 occurred in 9.3% of HCWs, 15.0% (95% CI, 12.2%–18.1%) of whom were seropositive; those with family members diagnosed with COVID-19 had a seropositivity rate of 54% (95% CI, 44.2%–65.2%). Support service workers (10.4%; 95% CI, 4.6%–19.4%), medical assistants (10.1%; 95% CI, 5.5%–16.6%), and nurses (7.6%; 95% CI, 6.4%–9.0%) had significantly higher seropositivity rates than administrators (referent; 3.3%; 95% CI, 2.3%–4.4%). However, after adjustment, nursing was the only occupation group with a significantly higher odds (odds ratio, 1.9; 95% CI, 1.3–2.9) of seropositivity. Exposure to patients receiving high-flow oxygen therapy and hemodialysis was significantly associated with 45% and 57% higher odds for seropositive status, respectively. Conclusions HCWs are at risk for SARS-CoV-2 infection from longer-duration exposures to people infected with SARS-CoV-2 within health care settings and their communities of residence.

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Section: Discussionsupporting

confidence: 85%

Seroprevalence and Correlates of SARS-CoV-2 Antibodies in Health Care Workers in Chicago

Wilkins

Gray

Wallia

et al. 2020

Open Forum Infectious Diseases

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“…These rates are significantly higher than those found within the general population (38.5% and 30.4%, respectively, according to a recent meta-analysis) 9 and equally considerably higher when compared to HCW prevalence rates in the United States 11,12 or in other European countries. 13,14 In addition, a higher rate of dysgeusia was particularly highlighted in our European cohort which had not been previously described. The higher prevalence rates of both olfactory and taste disturbance are unexpected when T A B L E 4 Influence of available variables on recovery rate in the population of health care workers who experienced smell and/or taste dysfunction First Symptom P = .6 P = .9 P = .7 P = .6 P = .7 P = .9…”

Section: Discussionsupporting

confidence: 43%

Olfactory and taste dysfunction among mild‐to‐moderate symptomatic COVID‐19 positive health care workers: An international survey

Andrews

Pendolino

Ottaviano

et al. 2020

Laryngoscope Investig Oto

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Objectives To determine the prevalence of olfactory and taste dysfunction (OD; TD) among COVID‐19 positive health care workers (HCWs), their associated risk factors and prognosis. Methods Between May and June 2020, a longitudinal multicenter study was conducted on symptomatic COVID‐19 PCR confirmed HCWs (COVID‐19 positive) in London and Padua. Results Hundred and fourteen COVID‐19 positive HCWs were surveyed with a response rate of 70.6% over a median follow‐up period of 52 days. UK prevalence of OD and TD was 73.1% and 69.2%, respectively. There was a male to female ratio of 1:3 with 81.6% being white, 43.7% being nurses/health care assistants (HCAs), and 39.3% being doctors. In addition, 53.2% of them worked on COVID‐19 wards. Complete recovery was reported in 31.8% for OD and 47.1% for TD with a 52 days follow‐up. The job role of doctors and nurses negatively influenced smell ( P = .04 and P = .02) and taste recovery ( P = .02 and P = .01). Ethnicity (being white) showed to positively influence only taste recovery ( P = .04). Sex (being female) negatively influenced OD and TD recovery only in Paduan HCWs ( P = .02 and P = .011, respectively). Working on a COVID‐19 ward did not influence prognosis. Conclusions The prevalence of OD and TD was considerably higher in HCWs. The prognosis for OD and TD recovery was worse for nurses/HCAs and doctors but working on a COVID‐19 ward did not influence prognosis. Sixty‐eight percent of surveyed HCWs at 52 days continued to experience OD or TD requiring additional future medical management capacity. Level of Evidence 4.

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“…This suggests a risk similar to that of the general Danish population (1 July 12 831 COVID-19 infected/total population 5.8 mill=0.22%) ( www.SSI.dk ). 15 Similarly, previous studies have found no evidence of an overrepresentation of patients with inflammatory rheumatic disease among SARS-CoV-2 infected. 2–4 …”

Section: Discussionmentioning

confidence: 78%

Self-protection strategies and health behaviour in patients with inflammatory rheumatic diseases during the COVID-19 pandemic: results and predictors in more than 12 000 patients with inflammatory rheumatic diseases followed in the Danish DANBIO registry

et al. 2021

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AimsIn Danish patients with inflammatory rheumatic diseases to explore self-protection strategies and health behaviour including adherence to disease-modifying antirheumatic treatment (DMARD) during the initial phase of the COVID-19 pandemic and again after the reopening of the society started. Furthermore, to identify characteristics of patients with high levels of anxiety and self-isolation.MethodsPatients in routine care followed prospectively in the nationwide DANBIO registry were invited to answer an online questionnaire regarding disease activity and COVID-19 infection, behaviour in March and June 2020. Responses were linked to patient data in DANBIO. Characteristics potentially associated with anxiety, self-isolation and medication adherence (gender/age/diagnosis/education/work status/comorbidity/DMARD/smoking/EQ-5D/disease activity) were explored with multivariable logistic regression analyses.ResultsWe included 12 789 patients (8168 rheumatoid arthritis/2068 psoriatic arthritis/1758 axial spondyloarthritis/795 other) of whom 65% were women and 36% treated with biological DMARD. Self-reported COVID-19 prevalence was 0.3%. Patients reported that they were worried to get COVID-19 infection (March/June: 70%/45%) and self-isolated more than others of the same age (48%/38%). The fraction of patients who changed medication due to fear of COVID-19 were 4.1%/0.6%. Female gender, comorbidities, not working, lower education, biological treatment and poor European Quality of life, 5 dimensions were associated with both anxiety and self-isolation.ConclusionIn >12 000 patients with inflammatory arthritis, we found widespread anxiety and self-isolation, but high medication adherence, in the initial phase of the COVID-19 pandemic. This persisted during the gradual opening of society during the following months. Attention to patients’ anxiety and self-isolation is important during this and potential future epidemics.

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Risk of COVID-19 in health-care workers in Denmark: an observational cohort study

Cited by 409 publications

References 18 publications

Seroprevalence and Correlates of SARS-CoV-2 Antibodies in Health Care Workers in Chicago

Seroprevalence and Correlates of SARS-CoV-2 Antibodies in Health Care Workers in Chicago

Olfactory and taste dysfunction among mild‐to‐moderate symptomatic COVID‐19 positive health care workers: An international survey

Self-protection strategies and health behaviour in patients with inflammatory rheumatic diseases during the COVID-19 pandemic: results and predictors in more than 12 000 patients with inflammatory rheumatic diseases followed in the Danish DANBIO registry

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