Prospective Observational Study of Screening Asymptomatic Healthcare Workers for SARS-CoV-2 at a Canadian Tertiary Care Center

Kumar, Deepali; Ferreira, Victor H; Chruscinski, Andrzej; Kulasingam, Vathany; Pugh, Trevor J.; Dus, Tamara; Wouters, Brad; Oza, Amit M.; Ierullo, Matthew; Ku, Terrance; Majchrzak-Kita, Beata; Humar, Sonika; Bahinskaya, Ilona; Pinzon, Natalia; Zhang, Jianhua; Heisler, Lawrence E.; Krzyzanowski, Paul M.; Lam, Bernard; Lungu, Ilinca M.; Manase, Dorin; Pace, Krista; Mashouri, Pouria; Brudno, Michael; Garrels, Michael; Mazzulli, Tony; Cybulsky, Myron I.; Humar, Atul

doi:10.1101/2020.07.21.20159053

Cited by 7 publications

(9 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although the research has not yet been peer reviewed, the prevalence of SARS-CoV-2 IgG antibody detection among HCWs at another Canadian tertiary-care center during the same study period was low (1.4%-3.4%). 15 If immunity can be achieved through infection or vaccination, immunity will likely increase with time, making our NPV estimate conservative. Fourth, we did not perform viral culture to confirm the infectivity of participants with SARS-CoV-2 RNA detected by RT-PCR.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a home-based 7-day infection control strategy for healthcare workers following high-risk exposure to severe acute respiratory coronavirus virus 2 (SARS-CoV-2): A cohort study

Benea

Rendon

Papenburg

et al. 2020

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

Objective: Evidence-based infection control strategies are needed for healthcare workers (HCWs) following high-risk exposure to severe acute respiratory coronavirus virus 2 (SARS-CoV-2). In this study, we evaluated the negative predictive value (NPV) of a home-based 7-day infection control strategy. Methods: HCWs advised by their infection control or occupational health officer to self-isolate due to a high-risk SARS-CoV-2 exposure were enrolled between May and October 2020. The strategy consisted of symptom-triggered nasopharyngeal SARS-CoV-2 RNA testing from day 0 to day 7 after exposure and standardized home-based nasopharyngeal swab and saliva testing on day 7. The NPV of this strategy was calculated for (1) clinical coronavirus disease 2019 (COVID-19) diagnosis from day 8–14 after exposure, and for (2) asymptomatic SARS-CoV-2 detected by standardized nasopharyngeal swab and saliva specimens collected at days 9, 10, and 14 after exposure. Interim results are reported in the context of a second wave threatening this essential workforce. Results: Among 30 HCWs enrolled, the mean age was 31 years (SD, ±9), and 24 (80%) were female. Moreover, 3 were diagnosed with COVID-19 by day 14 after exposure (secondary attack rate, 10.0%), and all cases were detected using the 7-day infection control strategy: the NPV for subsequent clinical COVID-19 or asymptomatic SARS-CoV-2 detection by day 14 was 100.0% (95% CI, 93.1%–100.0%). Conclusions: Among HCWs with high-risk exposure to SARS-CoV-2, a home-based 7-day infection control strategy may have a high NPV for subsequent COVID-19 and asymptomatic SARS-CoV-2 detection. Ongoing data collection and data sharing are needed to improve the precision of the estimated NPV, and here we report interim results to inform infection control strategies in light of a second wave threatening this essential workforce.

show abstract

Section: Discussionmentioning

confidence: 99%

Evaluation of a home-based 7-day infection control strategy for healthcare workers following high-risk exposure to severe acute respiratory coronavirus virus 2 (SARS-CoV-2): A cohort study

Benea

Rendon

Papenburg

et al. 2020

Infect. Control Hosp. Epidemiol.

View full text Add to dashboard Cite

show abstract

“…Following duplicate removal, title and abstract screening, and full-text screening, 61 met all inclusion criteria and were included in the review (Figure 1). Included studies (k = 61) varied in study design, comprising 6 cross-sectional studies [21][22][23][24][25][26], 7 case-control series [27,28], 22 prospective cohort studies , 1 longitudinal cohort study [51], 7 retrospective cohort studies [52][53][54][55][56][57][58], 7 prospective observational studies (i.e., observing the number of new cases in a facility after the implementation of IPC measures) [59][60][61][62][63][64][65], 1 retrospective observational study [66], 3 outbreak investigation reports [67][68][69], 1 post hoc analysis [70], 1 sequential follow-up study [71], 1 short-term prospective survey [72], 2 surveillance studies [73,74], and 7 mathematical modelling studies [75][76][77][78][79][80][81]. All studies were conducted before COVID-19 vaccinations became available in December 2020.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Fifteen studies were performed in the United States (USA) [28,36,38,41,45,49,51,52,55,69,72,[78][79][80][81]. Other included studies were performed in India [32], France [72], Canada [29,63], Italy [22,42,44,57,60,62,74], the United King-dom (UK) [35,40,50,53,58,65,75,76], Belgium [21,39], Korea [30,31,54,56], Taiwan [73], Germany [33,37,59,67,68,71] China [48], Finland [25], Spain [26], Japan …”

Section: Study Characteristicsmentioning

confidence: 99%

“…In terms of single IPC measures implemented, COVID-19 surveillance was identified most often in the literature (k = 17), particularly asymptomatic RT-PCR testing of employees [28,30,35,[38][39][40]49,57,63,65,74]. Asymptomatic testing was carried out in a number of ways: universally [30,35,[38][39][40]49,57,63,65,74], on a voluntary basis [37], following an outbreak [21,36], according to environmental surface testing [24] or contact tracing [35,40], and during point prevalence surveys in hospitals and nursing homes [36,69].…”

Section: Surveillance Measuresmentioning

confidence: 99%

See 1 more Smart Citation

COVID-19 Prevention and Control Measures in Workplace Settings: A Rapid Review and Meta-Analysis

Ingram

Downey

Roe

et al. 2021

IJERPH

View full text Add to dashboard Cite

Workplaces can be high-risk environments for SARS-CoV-2 outbreaks and subsequent community transmission. Identifying, understanding, and implementing effective workplace SARS-CoV-2 infection prevention and control (IPC) measures is critical to protect workers, their families, and communities. A rapid review and meta-analysis were conducted to synthesize evidence assessing the effectiveness of COVID-19 IPC measures implemented in global workplace settings through April 2021. Medline, Embase, PubMed, and Cochrane Library were searched for studies that quantitatively assessed the effectiveness of workplace COVID-19 IPC measures. The included studies comprised varying empirical designs and occupational settings. Measures of interest included surveillance measures, outbreak investigations, environmental adjustments, personal protective equipment (PPE), changes in work arrangements, and worker education. Sixty-one studies from healthcare, nursing home, meatpacking, manufacturing, and office settings were included, accounting for ~280,000 employees based in Europe, Asia, and North America. Meta-analyses showed that combined IPC measures resulted in lower employee COVID-19 positivity rates (0.2% positivity; 95% CI 0–0.4%) than single measures such as asymptomatic PCR testing (1.7%; 95% CI 0.9–2.9%) and universal masking (24%; 95% CI 3.4–55.5%). Modelling studies showed that combinations of (i) timely and widespread contact tracing and case isolation, (ii) facilitating smaller worker cohorts, and (iii) effective use of PPE can reduce workplace transmission. Comprehensive COVID-19 IPC measures incorporating swift contact tracing and case isolation, PPE, and facility zoning can effectively prevent workplace outbreaks. Masking alone should not be considered sufficient protection from SARS-CoV-2 outbreaks in the workplace.

show abstract

“…While not yet peer-reviewed, the prevalence of SARS-CoV-2 IgG antibody detection among HCWs at a Canadian tertiary healthcare center during the same study period was low (1.4-3.4%). 15 If immunity can be achieved through infection or vaccination, immunity will likely increase with time, making our NPV estimate conservative. Fourth, we did not perform viral culture to confirm the infectivity of participants with SARS-CoV-2 RNA detected by RT-PCR.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a home-based 7-day infection control strategy for healthcare workers following high-risk exposure to SARS-CoV-2: a cohort study

Benea

Rendon

Papenburg

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Evidence-based infection control strategies are needed for healthcare workers (HCWs) following high-risk exposure to SARS-CoV-2. This study evaluated the negative predictive value (NPV) of a home-based 7-day infection control strategy. Methods: HCWs advised by their Infection Control or Occupational Health officer to self-isolate due to a high-risk SARS-CoV-2 exposure were enrolled between May-September 2020. The strategy consisted of symptom-triggered nasopharyngeal SARS-CoV-2 RNA testing from day 0-6 post exposure, followed by standardized home-based nasopharyngeal swab and saliva testing on day 7. The NPV of this strategy was calculated for i) clinical COVID-19 diagnosis from day 8-14 post exposure, and for ii) asymptomatic SARS-CoV-2 detected by standardized nasopharyngeal swab and saliva specimens collected at days 9-10 and 14 post exposure. Interim results are reported in the context of a second wave threatening this essential workforce. Results: Among 30 HCWs enrolled to date (age 31±9 years, 24 [80.0%] female), 3 were diagnosed with COVID-19 by day 14 post exposure (secondary attack rate 10.0%), with all cases detected by the 7-day infection control strategy: NPV for subsequent clinical COVID-19 or asymptomatic SARS-CoV-2 detection by day 14 was 100.0% (95%CI: 93.1-100.0%). Interpretation: Among HCWs with high-risk exposure to SARS-CoV-2, a home-based 7-day infection control strategy may have a high NPV for subsequent COVID-19 and asymptomatic SARS-CoV-2 detection. While ongoing data collection and data sharing are needed to improve the precision of the estimated NPV, we report interim results to inform infection control strategies in light of a second wave threatening this essential workforce.

show abstract

Prospective Observational Study of Screening Asymptomatic Healthcare Workers for SARS-CoV-2 at a Canadian Tertiary Care Center

Cited by 7 publications

References 14 publications

Evaluation of a home-based 7-day infection control strategy for healthcare workers following high-risk exposure to severe acute respiratory coronavirus virus 2 (SARS-CoV-2): A cohort study

Evaluation of a home-based 7-day infection control strategy for healthcare workers following high-risk exposure to severe acute respiratory coronavirus virus 2 (SARS-CoV-2): A cohort study

COVID-19 Prevention and Control Measures in Workplace Settings: A Rapid Review and Meta-Analysis

Evaluation of a home-based 7-day infection control strategy for healthcare workers following high-risk exposure to SARS-CoV-2: a cohort study

Contact Info

Product

Resources

About