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      Specific risk factors for SARS-CoV-2 transmission among health care workers in a university hospital

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          Highlights

          • •

            HCWs face a high risk of SARS-CoV-2 transmission during serving health care

          • •

            Transmission may also occur in non-medical areas while speaking or eating

          • •

            Proper use of PPE and basic infection control precautions are essential

          Abstract

          Aim

          To investigate the specific risk factors for SARS-CoV-2 transmission among HCWs in a tertiary care university hospital.

          Methods

          Upper respiratory samples of HCWs were tested for SARS-CoV-2 by RT-PCR. A case-control study was conducted to explore the possible risk factors that lead to SARS-CoV-2 transmission to HCWs.

          Results

          Of 703 HCWs screened between March 20 and May 20, 2020, 50 (7.1%) were found to be positive for SARS-CoV-2. The positivity rates for SARS-CoV-2 among physicians, nurses, cleaning personnel, and the other occupations were 6.3%, 8.0%, 9.1%, and 2.6%, respectively. The infection rate was 8.3% among HCWs who worked in COVID-19 units and 3.4% among those who did not work in COVID-19 units (RR = 2.449, CI = 1.062–5.649, p = .027). The presence of a SARS-CoV-2 positive person in the household ( p = .016), inappropriate use of personnel protective equipment (PPE) while caring for patients with COVID-19 infection ( p = .003), staying in the same personnel break room as an HCW without a medical mask for more than 15 minutes ( p = .000), consuming food within one meter of an HCW ( p = .003), and failure to keep a safe social distance from an HCW ( p = .003) were statistically significant risk factors for infection.

          Conclusion

          HCWs have a high risk for SARS-CoV-2 transmission while providing care to COVID-19 patients. Transmission may also occur in non-medical areas of the hospital while speaking or eating. Periodic screening of HCWs for SARS-CoV-2 may enable early detection and isolation of infected HCWs.

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          Antibody responses to SARS-CoV-2 in patients with COVID-19

          Quan-Xin Long, Bai-Zhong Liu, Hai-Jun Deng … (2020)
          We report acute antibody responses to SARS-CoV-2 in 285 patients with COVID-19. Within 19 days after symptom onset, 100% of patients tested positive for antiviral immunoglobulin-G (IgG). Seroconversion for IgG and IgM occurred simultaneously or sequentially. Both IgG and IgM titers plateaued within 6 days after seroconversion. Serological testing may be helpful for the diagnosis of suspected patients with negative RT-PCR results and for the identification of asymptomatic infections.
          Article 0 comments Cited 1482 times – based on 0 reviews     Review now
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            Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers

            Roger Chou, Tracy Dana, David I Buckley … (2020)
            Background: Health care workers (HCWs) are at risk for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection. Purpose: To examine the burden of SARS-CoV-2, SARS-CoV-1, and Middle Eastern respiratory syndrome (MERS)-CoV on HCWs and risk factors for infection, using rapid and living review methods. Data Sources: Multiple electronic databases including the WHO Database of Publications on Coronavirus Disease and medRxiv preprint server (2003 through 27 March 2020, with ongoing surveillance through 24 April 2020), and reference lists. Study Selection: Studies published in any language reporting incidence of or outcomes associated with coronavirus infections in HCWs and studies on the association between risk factors (demographic characteristics, role, exposures, environmental and administrative factors, and personal protective equipment [PPE] use) and HCW infections. New evidence will be incorporated on an ongoing basis by using living review methods. Data Extraction: One reviewer abstracted data and assessed methodological limitations; verification was done by a second reviewer. Data Synthesis: 64 studies met inclusion criteria; 43 studies addressed burden of HCW infections (15 on SARS-CoV-2), and 34 studies addressed risk factors (3 on SARS-CoV-2). Health care workers accounted for a significant proportion of coronavirus infections and may experience particularly high infection incidence after unprotected exposures. Illness severity was lower than in non-HCWs. Depression, anxiety, and psychological distress were common in HCWs during the coronavirus disease 2019 outbreak. The strongest evidence on risk factors was on PPE use and decreased infection risk. The association was most consistent for masks but was also observed for gloves, gowns, eye protection, and handwashing; evidence suggested a dose–response relationship. No study evaluated PPE reuse. Certain exposures (such as involvement in intubations, direct patient contact, or contact with bodily secretions) were associated with increased infection risk. Infection control training was associated with decreased risk. Limitation: There were few studies on risk factors for SARS-CoV-2, the studies had methodological limitations, and streamlined rapid review methods were used. Conclusion: Health care workers experience significant burdens from coronavirus infections, including SARS-CoV-2. Use of PPE and infection control training are associated with decreased infection risk, and certain exposures are associated with increased risk. Primary Funding Source: World Health Organization.
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              Molecular immune pathogenesis and diagnosis of COVID-19

              Xiaowei Li, Manman Geng, Yizhao Peng … (2020)
              Coronavirus disease 2019 (COVID-19) is a kind of viral pneumonia which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The emergence of SARS-CoV-2 has been marked as the third introduction of a highly pathogenic coronavirus into the human population after the severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV) in the twenty-first century. In this minireview, we provide a brief introduction of the general features of SARS-CoV-2 and discuss current knowledge of molecular immune pathogenesis, diagnosis and treatment of COVID-19 on the base of the present understanding of SARS-CoV and MERS-CoV infections, which may be helpful in offering novel insights and potential therapeutic targets for combating the SARS-CoV-2 infection.
              Article 0 comments Cited 300 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Güven Çelebi
                Journal
                Journal ID (nlm-ta): Am J Infect Control
                Journal ID (iso-abbrev): Am J Infect Control
                Title: American Journal of Infection Control
                Publisher: Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control and Epidemiology, Inc.
                ISSN (Print): 0196-6553
                ISSN (Electronic): 1527-3296
                Publication date PMC-release: 6 August 2020
                Publication date (Electronic): 6 August 2020
                Affiliations
                [1 ]Zonguldak Bülent Ecevit University, Medical Faculty, Infectious Diseases and Clinical Microbiology Department, Zonguldak, Turkey
                [2 ]Zonguldak Bülent Ecevit University Educational and Research Hospital, Infection Control Committee, Zonguldak, Turkey
                [3 ]Zonguldak Bülent Ecevit University, Medical Faculty, Pulmonary Medicine Department, Zonguldak, Turkey
                [4 ]Zonguldak Bülent Ecevit University, Medical Faculty, Medical Microbiology Department, Zonguldak, Turkey
                Author notes
                [* ]Corresponding author. guvencelebi@ 123456yahoo.com
                Article
                Publisher ID: S0196-6553(20)30765-3
                DOI: 10.1016/j.ajic.2020.07.039
                PMC ID: 7409872
                PubMed ID: 32771498
                SO-VID: 8d646ce7-49c4-4d4f-86f3-75b7f6687685
                Copyright © © 2020 Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control and Epidemiology, Inc.
                License:

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                Categories
                Subject: Article

                Keywords: health care worker,sars-cov-2,covid-19,transmission,risk factor
                Data availability:
                Keywords: health care worker, sars-cov-2, covid-19, transmission, risk factor

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