Risk of COVID-19 in healthcare workers working in intensive care setting

Abstract

Background The higher risk of COVID-19 in healthcare workers (HCWs) is well-known. However, the risk within HCWs is not fully understood. The objective was to compare the COVID-19 risk in intensive care unit (ICU) versus non-ICU locations. Methods A prospective surveillance study was conducted among HCWs at a large tertiary care facility in Riyadh between March 1st to November 30th, 2020. HCWs included both clinical (provide direct patient care) and non-clinical positions (do not provide direct patient care). Results A total 1,594 HCWs with COVID-19 were included; 103 (6.5%) working in ICU and 1491 (93.5%) working in non-ICU locations. Compared with non-ICU locations, ICU had more nurses (54.4% versus 22.1%, p<0.001) and less support staff (2.9% versus 53.1%, p<0.001). COVID-19 infection was similar in ICU and non-ICU locations (9.0% versus 9.8%, p=0.374). However, it was significantly higher in ICU nurses (12.3% versus 6.5%, p<0.001). Support staff had higher risk than other HCWs, irrespective of ICU working status (15.1% versus 7.2%, p<0.001). The crude relative risk (RR) of COVID-19 in ICU versus non-ICU locations was 0.92, 95% confidence interval [CI] was 0.76-1.11 (p=0.374). However, RR adjusted for professional category was significantly increased to 1.23, 95% CI 1.01-1.50 (p=0.036). Conclusion ICU had a significantly higher risk of COVID-19 infection only after adjusting for the distribution and risk of different professional categories. The later is probably determined by both exposure level and protection practices. The finding underscores the importance of strict implementation of preventive measures among all HCWs, including those performing non-clinical services.

The Relative Contributions of Occupational and Community Risk Factors for COVID-19 among Hospital Workers: The HOP-COVID Cohort Study

“…In line with a few previous studies, we found that non-caregivers in contact with patients and/or caregivers (notably staff in radiology, functional assessment and stretcher services) had a higher risk of COVID-19 than other staff [14,32,33]. Indeed, staff can be exposed to SARS-CoV-2 before the infected patient has received a firm diagnosis.…”

“…More than half of the cases of COVID-19 (56.8%) were probably hospital-acquired. This rate is higher than those previously reported in the literature (ranging from 25% to 48%) on the basis of self-reported infections [9,10,14,26]. Several studies found that exposure in a community setting was the greatest risk factor [27], and recent studies with genotyping data have shown that the community is the main source of SARS-CoV2 infection [3][4][5].…”

“…However, the literature data on the relative contributions of occupational and community sources of infection are contradictory. Whereas several studies (including some with SARS-CoV-2 genotyping data) reported that most infections were community-acquired, others stressed the importance of occupational risk factors [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. Furthermore, very few studies have focused on staff in geriatric wards and nursing homes [19,20], even though outbreaks have been reported in these settings [21][22][23].…”

aPDT for oral decontamination of hospitalized patients with COVID 19

“…The clinical management of these patients represents a great challenge for healthcare workers, especially when treatments involve exposure to saliva and/or blood. A fact that places them at greater risk of contamination and virus transmission [3] .…”

Use of portable single‐lead electrocardiogram device as an alternative for QTc monitoring in critically ill patients

“…Obtaining a 12‐lead ECG typically involves additional nursing staff being exposed to equipment fitted with numerous ECG wires, heightening the risk of contagious disease transmission. KM1L offers several benefits, including ease of use (patients can be instructed to operate it, reducing contact with healthcare personnel), remote data transmission (thus reducing the risk of contamination), compact size, and easy disinfection (Alshamrani et al., 2022 ; Chu et al., 2020 ; González et al., 2020 ; Klompas et al., 2021 ; Zaballos et al., 2023 ). In hospitalized patients, comparisons with a standard 12‐L ECG demonstrate the KM1L device's noteworthy numerical accuracy and exceptional agreement in identifying QTc prolongation (Marín et al., 2021 ).…”