The role of routine SARS-CoV-2 screening of healthcare-workers in acute care hospitals in 2020: a systematic review and meta-analysis

Abstract

Background Healthcare workers (HCW) are at increased risk of infection with SARS-CoV-2. Vulnerable patient populations in particular must be protected, and clinics should not become transmission hotspots to avoid delaying medical treatments independent of COVID. Because asymptomatic transmission has been described, routine screening of asymptomatic HCW would potentially be able to interrupt chains of infection through early detection. Methods A systematic search was conducted in the Cochrane COVID-19 Study Register, Web of Science and WHO COVID‐19 Global literature on coronavirus with regard to non-incident related testing of healthcare workers using polymerase chain reaction on May 4th 2021. Studies since January 2020 were included. An assessment of risk of bias and representativeness was performed. Results The search identified 39 studies with heterogeneous designs. Data collection of the included studies took place from January to August 2020. The studies were conducted worldwide and the sample size of the included HCW ranged from 70 to 9449 participants. In total, 1000 of 51,700 (1.9%) asymptomatic HCW were tested positive for SARS-CoV-2 using PCR testing. The proportion of positive test results ranged between 0 and 14.3%. No study reported on HCW-screening related reductions in infected person-days. Discussion and conclusions The heterogeneous proportions might be explained by different regional incidences, lock-downs, and pre-analytical pitfalls that reduce the sensitivity of the nasopharyngeal swab. The very high prevalence in some studies indicates that screening HCW for SARS-CoV-2 may be important particularly in geographical regions and pandemic periods with a high-incidence. With low numbers and an increasing rate of vaccinated HCW, a strict cost–benefit consideration must be made, especially in times of low incidences. Since we found no studies that reported on HCW-screening related reductions in infected person-days, re-evaluation should be done when these are available.

The effects of public health and social measures (PHSM) implemented during the COVID‐19 pandemic: An overview of systematic reviews

“…It is uncertain whether symptom‐based surveillance testing in long‐term care settings reduces infections and lowers the likelihood of outbreaks as well as the number of deaths among residents (one high‐confidence review, GRADE applied) [26]. PCR testing of health workers may reduce the risk and incidence of COVID‐19 in health care settings (one critically low‐confidence review)[36]. …”

“…• It is uncertain whether symptom-based surveillance testing in long-term care settings reduces infections and lowers the likelihood of outbreaks as well as the number of deaths among residents (one highconfidence review, GRADE applied) [26]. • PCR testing of health workers may reduce the risk and incidence of COVID-19 in health care settings (one critically low-confidence review) [36]. Testing at mass gatherings • Mass testing may reduce the number of infections and mortality from COVID-19; however, there is insufficient evidence to determine the effectiveness of mass testing without other measures, such as lockdowns (one critically low-confidence review) [37].…”

Evidence for the spread of SARS-CoV-2 and olfactory cell lineage impairment in close-contact infection Syrian hamster models

“…Accordingly, if someone infected with SARS-CoV-2 talks or eats with others without a mask for 30 minutes, he or she can spread the infection to others. The percentage of people contracting SARS-CoV-2 and being asymptomatic is estimated to range from 1.2 to 12.9% (Al-Sadeq and Nasrallah, 2020;Jabs et al, 2022). It has now been more than 2 years since COVID-19 became endemic, and the spread of infection has not been well-controlled.…”

Delayed SARS-CoV-2 Spread and Olfactory Cell Lineage Impairment in Close-Contact Infection Syrian Hamster Models

“…Accordingly, if someone infected with SARS-CoV-2 talks or eats with others without a mask for 30 minutes, he or she can spread the infection to others. The percentage of people contracting SARS-CoV-2 and being asymptomatic is estimated to range from 1.2 to 12.9% (37, 38). It has now been more than 2 years since COVID-19 became endemic, and the spread of infection has not been well-controlled.…”