Predictors of SARS CoV-2 Infection Among Healthcare Workers: The Impact of Community-Hospital Gradient

Abstract

Aim: We aimed to detect the risk factors for SARS-CoV-2 infection among healthcare workers (HCWs) in 2020, before vaccination era. Methods: We surveyed the SARS-CoV-2 infection among the HCWs in a hospital by screening of antibody levels and detection of viral RNA by reverse transcription polymerase chain reaction (RT-PCR) between May 2020 to December 2020. Occupational and non-occupational potential predictors of disease were surveyed for the HCWs included in this study. Results: Among 1925 personnel in the hospital, 1732 were included to the study with the response rate of 90%. Overall seroprevalence was 15% at the end of 2020, before vaccinations started. In multivariate analysis, being janitorial staff (OR:2.24, CI:1.21-4.14, p=0.011), being medical secretary (OR: 4.17, CI: 2.12-8.18, p<0.001), having at least one household member with COVID-19 diagnosis (OR:8.98, CI: 6.64-12.15, p<0.001) and number of household members >3 (OR:1.67, CI:1.26-2.22, p<0.001) were found to be significantly associated with SARS-CoV-2 infection. Conclusion: By the end of 2020, just before the era of vaccination and variants, seroprevalence was 15% among HCWs. Medical secretary and janitorial staff were under increased risk of SARS-CoV-2 infection. Community-hospital gradient can explain the mode of transmission for infection among HCWs. In the setting of this study, community measures were less strict, whereas hospital infection control was adequate and provided necessary personal protective equipment. Increasing risk in larger households and households with diagnosed COVID-19 patient indicates community acquired transmission of the infection.