SARS-CoV-2 infection among asymptomatic healthcare workers of the emergency department in a tertiary care facility

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

“…Similar to prior report updates, estimates did not indicate an association between sex (13 studies [ 3–6 , 9 , 11–13 , 15 , 17–20 ]) or age (12 studies [ 3–5 , 9 , 11–13 , 15 , 17–20 ]) and risk for SARS-CoV-2 infection or seropositivity. Fifteen new studies found no consistent association between health worker role (nurse vs. physician) and risk for SARS-CoV-2 infection ( 3–5 , 7–12 , 14–16 , 18–20 ). In the only study that controlled for confounders, the adjusted odds ratio (OR) for risk for SARS-CoV-2 seropositivity for nurse versus physician was 1.52 (95% CI, 1.18 to 1.95) ( 4 ).…”

“…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 ). There was no new evidence for infection control training and education ( Supplement Table 3 ).…”

“…We applied the same inclusion criteria used for prior updates, with previously described protocol modifications ( 2 ) to focus on higher-quality evidence. Eighteen studies on risk factors for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection were added for this update ( 3–20 ).…”

“…The original rapid review included 34 studies on risk factors for coronavirus infections (3 studies on SARS-CoV-2 infection, 29 studies on SARS-CoV-1 infection, and 2 studies on Middle East respiratory syndrome–CoV infection) ( 1 ); 46 studies (44 studies on SARS-CoV-2 infection, 0 studies on SARS-CoV-1 infection, and 2 studies on Middle East respiratory syndrome–CoV infection) were added in prior updates ( 2 , 21–25 ). 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 ).…”

“…In 4 studies that controlled for confounders, adjusted ORs ranged from 1.92 to 2.79 ( 4 , 12 , 17 , 20 ). Nine new studies reported inconsistent associations between direct patient contact or contact with patients with COVID-19 and risk for SARS-CoV-2 infection or seropositivity primarily based on unadjusted risk estimates ( 3–5 , 7 , 8 , 10 , 14 , 18 , 19 ). In 2 studies that controlled for potential confounders, direct contact with patients with COVID-19 was associated with increased risk for infection versus no contact (adjusted OR, 1.69 [CI, 1.28 to 2.24]) ( 14 ) and versus a nonclinical health care worker role (adjusted OR, 3.08 [CI, 1.09 to 8.78]) ( 13 ).…”