A case–control study of factors associated with SARS-CoV-2 infection among healthcare workers in Colombia

Abstract

Background Healthcare Workers (HCW) are repeatedly exposed to SARS-CoV-2 infection. The aim of this study was to identify factors associated with SARS-CoV-2 infection among HCW in one of the largest cities in Colombia. Methods We conducted a case–control study, where cases had a positive reverse transcription-polymerase chain reaction and controls had a negative result. Participants were randomly selected and interviewed by phone. Analyses were performed using logistic regression models. Results A total of 110 cases and 113 controls were included. Men (AdjOR 4.13 95% CI 1.70–10.05), Nurses (AdjOR 11.24 95% CI 1.05–119.63), not using a high-performance filtering mask (AdjOR 2.27 95% CI 1.02–5.05) and inadequate use of personal protective equipment (AdjOR 4.82 95% CI 1.18–19.65) were identified as risk factors. Conversely, graduate (AdjOR 0.06 95% CI 0.01–0.53) and postgraduate (AdjOR 0.05 95% CI 0.005–0.7) education, feeling scared or nervous (AdjOR 0.45 95% CI 0.22–0.91), not always wearing any gloves, caps and goggles/face shields (AdjOR 0.10 95% CI 0.02–0.41), and the use of high-performance filtering or a combination of fabric plus surgical mask (AdjOR 0.27 95% CI 0.09–0.80) outside the workplace were protective factors. Conclusion This study highlights the protection provided by high-performance filtering masks or double masking among HCW. Modifiable and non-modifiable factors and the difficulty of wearing other protective equipment needs to be considered in designing, implementing and monitoring COVID-19 biosafety protocols for HCW.

Risk Factors for COVID-19 Infection Among Healthcare Workers. A First Report From a Living Systematic Review and meta-Analysis

“…Among these, 104 were excluded (Supplementary File 2). 16 full text articles were screened for eligibility [ 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ], 6 were excluded [ 24 , 28 , 31 , 32 , 33 , 36 ] and ultimately 10 eligible studies were included in this review and meta-analysis. Reasons for exclusion at full text review stage included lack of PCR confirmation of COVID-19 infection [ 24 , 31 , 32 , 33 , 36 ], and lack of evidence on risk estimates for COVID-19 risk factors [ 28 ].…”

“…Reasons for exclusion at full text review stage included lack of PCR confirmation of COVID-19 infection [ 24 , 31 , 32 , 33 , 36 ], and lack of evidence on risk estimates for COVID-19 risk factors [ 28 ]. Studies included were conducted in China [ 34 , 35 , 37 ], USA [ 26 , 29 ], India [ 23 , 27 ], Italy [ 25 ], Spain [ 30 ] and Colombia [ 38 ]. Of the studies included, 3 were retrospective cohorts [ 34 , 35 , 37 ], 2 were prospective cohorts [ 26 , 29 ], 3 were case controls [ 23 , 27 , 38 ] and one was a cross sectional [ 30 ] and one case series [ 25 ].…”

“…Studies included were conducted in China [ 34 , 35 , 37 ], USA [ 26 , 29 ], India [ 23 , 27 ], Italy [ 25 ], Spain [ 30 ] and Colombia [ 38 ]. Of the studies included, 3 were retrospective cohorts [ 34 , 35 , 37 ], 2 were prospective cohorts [ 26 , 29 ], 3 were case controls [ 23 , 27 , 38 ] and one was a cross sectional [ 30 ] and one case series [ 25 ]. More details on the included studies characteristics are available on Supplementary File 1.…”

“…Gender was reported as a risk factor for COVID-19 among HCWs [ 23 , 29 , 38 ]. In a study conducted in Colombia, male gender (AOR = 4.13 95% CI 1.70–10.05) was associated with laboratory diagnosis of COVID-19 among HCWs [ 38 ]. In India, male HCWs had higher odds of COVID-19 infection than their female counterparts [ 23 ].…”

Using a human factors-centric approach to development and testing of a face shield designed for health care workers: A COVID-19 case study for process and outcomes

“…[3] Using a cough simulator, face shields blocked 97% of large particle transmission to the providers' respirator mask, blocking disease transmission through facial mucous membranes. [4] A casecontrol study identified PPE misuse as a significant risk factor for HCP COVID-19 infection, [5] and a recent systematic review has shown significant reductions in HCP COVID-19 infection with the fastidious use of face shields. [6] During the initial wave of COVID-19, many aspects of the worldwide supply chain were interrupted by lockdowns, sourcing competition, export bans, and other distribution disruptions.…”