Background Healthcare workers (HCWs) have an increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection due to occupational exposure. Strict measures generally focus on the patient-to-HCW contacts. However, interactions between the HCWs also pose a high risk for SARS-CoV-2 exposure. Aims This study was aimed to investigate the effect of social contacts on the level of SARS-CoV-2 exposure risk among workers by broadening the current risk assessment algorithm. Methods Contact tracing records of the workers in a large university hospital between 19th March and 31st December 2020 were analysed. Multivariate conditional logistic regression models were estimated to evaluate factors associated with high-risk exposure for contacts among workers. Results Of the 329 exposed clusters, 260 (79%) were HCW-to-HCW contacted clusters. High-risk exposure was higher in the HCW-to-HCW contacts (44%), when compared to the patient-to-HCW contacts (5%) (P < 0.001). A total of 1827 HCWs contacted a laboratory-confirmed COVID-19-positive co-worker. Among the HCW-to-HCW contacts, high-risk exposure was higher in the support staff (49%, P < 0.001), in non-patient care settings (47%, P < 0.001) and in the social contacts (57%, P < 0.001). Social contacts between workers increased the high-risk exposure (adjusted odds ratio: 3.50, 95% confidence interval 2.62–4.69) in multivariate analysis. Conclusions A significant association between social contacts among workers and high-risk exposure of SARS-CoV-2 was observed. The results of the study emphasize the need for policies regarding the improved protection of HCWs in social settings in addition to patient care services.
Objective: It is important to put forward the characteristics of the COVID-19 cases to fight the disease effectively. The aim of this study is to determine the epidemiological characteristics of COVID-19 cases in Turkey. And also to determine the risk factors associated with intensive care unit (ICU) admission and death. Methods: In this cross-sectional study, the characteristics of the confirmed COVID-19 cases who applied to a University Hospital in Turkey between March 19th and June 11th, 2020, were analyzed. Variables such as epidemic trend, case fatality rate, need for hospitalization, ICU admission rate, and ICU mortality were calculated. In addition, risk factors affecting ICU admission and death were determined by logistic regression analysis. Results: 19.8% of 654 cases participating in the study were asymptomatic at admission. ICU admission rate was 7.6% and case fatality rate found to be 7.8%. Age, male gender, and cancer were associated with ICU admission. Each 1-unit increase in age increased ICU admissions by 8% (OR: 1.08; CI: 1.06-1.10). Men had a 2.71 times higher risk of ICU admission (OR: 2.71; CI: 1.37-5.39); and cancer patients showed 3.72 (OR: 3.72; CI: 1.35-10.20) times more ICU admissions (p<0.05). Age, cancer, and ICU admission were associated with death. Each 1-unit increase in age increased the risk of death by 10% (OR: 1.10; CI: 1.06-1.15). The risk of death was found to be 5.22 times higher in cancer patients (OR: 5.22; GA: 1.09-24.89) and 87.42 times higher in those admitted to ICU (OR: 87.42; GA: 30.15-153.46) (p<0.05). Conclusions: It was revealed that the course of the disease worsens, and deaths increase with age. Male gender has been associated with the increased need for intensive care. Cancer was significantly associated both with ICU admission and death. Attention should be paid to the groups of elderly, men and those with a comorbidity. More detailed studies with larger samples are of critical importance in fighting against the pandemic. Key Words: Turkey, COVID-19, coronavirus, SARS-CoV-2, epidemiology.
Amaç: Çalışmanın amacı bir üniversite hastanesinde COVID-19 tanısı almış sağlık çalışanlarının hastane içinde oluşturdukları kümelerin epidemiyolojik olarak değerlendirilmesi ve bulaş özellikleri açısından incelenmesidir. Yöntem: Hastanemizde pandeminin başından itibaren COVID-19 olan çalışanların ve temaslılarının telefon görüşmesi ile takibi ve risk değerlendirmesi yapılmaktadır. Bu tanımlayıcı çalışmada, Dokuz Eylül Üniversitesi Hastanesi’nde 20 Mart 2020 ile 10 Eylül 2020 tarihleri arasında oluşan kümelerdeki epidemiyolojik veriler kullanılmıştır. Aynı birimde, aynı zaman diliminde 3 ve üzeri sağlık çalışanının tanı aldığı durumlar küme olarak kabul edilmiştir. Yaş, cinsiyet, meslek, semptom varlığı temas risk durumu gibi tanımlayıcı özellikler yanında her küme için bulaş zinciri takvimleri oluşturulmuştur. Atak hızları, %95 güven aralığı ile birlikte hesaplanmıştır. Bulgular: Çalışmada değerlendirilen tarihlerde toplam 98 sağlık çalışanı COVİD-19 tanısı almış, bu çalışanlar içinde toplam 4 küme tespit edilmiştir. Kümelerde toplam 19 olgu vardır, 9’u erkek (%47.4), 10’u kadındır (%52.6); yaş ortalaması 35.6 (±6.96)’dır. Olgulardan 8’i (%42.1) doktor, 6’sı (%31.6) hemşiredir. Kümelerdeki olgularla temaslı toplam 171 kişi vardır, toplam 314 temas değerlendirmesi yapılmıştır. Bu temaslılardan 14 kişi COVID-19 tanısı almıştır. Hastane içi sekonder atak hızı %8.19 (%95 GA: 4.74-13.05) bulunmuştur. Sonuç: Sağlık çalışanlarının yüksek riskli bir çalışma ortamı olmakla birlikte, kendi aralarındaki iş nedenli ya da sosyal temaslar da bu riski artırmaktadır. Küçük ve iyi havalandırması olmayan odaları paylaşmak, kalabalık çalışma ortamı, nöbet koşulları, uzun mesai saatleri hastane içi riski artıran nedenlerdendir. Çalışmamız, düzenli sürveyans ile toplanan verilerin belirli aralıklarla değerlendirilerek kümelerin epidemiyolojik özelliklerinin belirlenmesini sağlamış, bulaşın azaltılmasına yönelik önlemlerin alınmasına katkıda bulunmuştur.
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