Background The prevalence of SARS-CoV-2 infection among HCWs provide information to for the spread of COVID-19 within health care facilities, and to detect the risk groups. Objective We aimed to describe the rate of SARS-CoV-2 seroprevalence and its determinants among health care workers. Data sources We used Web of Science, Scopus, MEDLINE, EBSCOhost and Cochrane Library. Study eligibility criteria We included the reports of SARS-CoV-2 seroprevalence with a sample size of minimum 1,000 HCWs. Methods The study was registered at the International Prospective Register of Systematic Reviews (PROSPERO, no: CRD42021230456). We used PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. The keywords were “COVID-19, “SARS-Co-2”, “Coronavirus”, “seroprevalence”, “health care workers” and “risk factors”. Results In total 4329 reports were retrieved, the duplications were removed, after filtering according to the title and abstract 25 studies were selected. Risk of bias was assessed in 25 studies; it was low in 13 studies, medium in four studies, and high in eight studies. In meta-analysis by using the random effect model, the weighted average of seroprevalence was calculated as 8% (CI: 6%-10%). The pooled seroprevalence rates of the selected variables that have a rate over the average were male HCWs with 9% (95% CI 7%-11%); HCWs from ethnic minorities with 13% (95% CI: 9% - 17%); high exposure 9% (95% CI: %6 - %13); exposure to the virus outside the health care setting %22 (95% CI: %14 - %32). Conclusions Our analysis indicate a SARS-CoV-2 seroprevalence rate of 8% among studies included >1,000 HCWs for the year 2020 before vaccinations started. The most common risk factors associated with higher seroprevalence rate were ethnicity, male gender, and having higher number of household contacts. Working as a frontline HCW was inconsistent in its association with higher seroprevalence.

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Objective: We aimed to describe the risks of health care workers (HCWs) getting COVID-19, and analyze the transmission routes and dynamics of the infection. Methods: This is a prospective observational study. We screened 624 HCWs from April 1 to May 15, 2020, in a hospital with 300 hospital beds, in Istanbul, Turkey. All the HCWs working at high-risk areas (COVID wards, emergency departments, and intensive care units) were routinely screened every four weeks. The HCWs were grouped as high, moderate, low and none according to their risk of infection. Results: Out of 1300 total HCWs, 42 (3.2%) were diagnosed as COVID-19, 39 (3%) were confirmed by polymerase chain reaction (PCR) test. Among 42 symptomatic cases, 26 (62%) HCWs were hospitalized, mainly because of isolation needs, 62% received hydroxychloroquine (HCQ) alone, 11.5% HCQ + azithromycin, and 11.5% favipiravir only. All survived. We detected nine asymptomatic cases out of 550 HCWs (1.6%) in our screening for antibody levels. In none of the nine asymptomatic HCWs, SARS-CoV-2 RNA was not detected by PCR. In multivariate analysis for detecting the risk factors of the SARS-CoV-2 infection, working in high-risk areas (OR:5.2, CI:1.99-13.6, p=0.001), and not to use proper personal protective equipment (PPE) (OR:5.9, CI:1.66-21.2, p=0.006) increased the risk of infection. Conclusion: Routine screening of asymptomatic HCWs with antibody tests might be useful, but its effectiveness was limited. The HCWs working in high-risk areas had significantly higher risk. The strict use of appropriate PPE was effective in prevention.

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Objective: We aimed to demonstrate the benefits of implementing a clinical pathway to decrease the inappropriate use of antibiotics in upper respiratory tract infections (URTI) in an emergency department (ED). Methods: The study was performed in a hospital with 300 beds. All patients who applied with URTI from 1st to 30th of April 2017 were included and the appropriateness of the antibiotics were compared with the patients in the same period in 2016. A checklist for the clinical pathway of URTI was completed by the ED physicians. Results: 351 patients were included, 176 these patients were in pre-ASP period and 175 patients were in post-ASP period. The rate of prescriptions including antibiotics was 49% in pre-ASP period and has decreased to 29% in post-ASP period (p < 0.001). Adherence to clinical pathway has increased from 50% to 80% (p < 0.001). In the post-ASP period, clinical pathway was used in 133 out of 175 patients (76%) and the consequently rate of appropriate antibiotic use was 82%. Conclusion: The implementation of clinical pathway for URTI has decreased inappropriate antibiotic use in ED. As the secondary effect, using clinical pathway in ED also has increased the awareness of ED physicians who did not adhere to clinical pathway.