Risk of SARS-CoV-2 exposure among hospital healthcare workers in relation to patient contact and type of care

Klevebro, Susanna; Bahram, Fuad; Elfström, K. Miriam; Hellberg, Ulrika; Hober, Sophia; Merid, Simon Kebede; Kull, Inger; Nilsson, Peter; Tornvall, Per; Wang, Gang; Lundgren, Kalle Conneryd; Ponzer, Sari; Dillner, Joakim

doi:10.1177/14034948211022434

Cited by 9 publications

(11 citation statements)

References 14 publications

(27 reference statements)

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“…In the previously described Stockholm HCW cohort, all healthcare providers in the capital region of Sweden were asked about participation in a study of past or present SARS-CoV-2 infections [ 8 , 9 ]. Among the major healthcare providers who agreed to participate, a very high proportion (>90%) of the HCWs at work were enrolled, following written informed consent [ 8 , 9 ]. This report focuses on the two largest healthcare providers, Karolinska University Hospital and Stockholm South General Hospital.…”

Section: Methodsmentioning

confidence: 99%

“…At Karolinska ( Fig 1 ), there were 9449 employees with complete testing data who were also followed for past or future sick leave [ 7 ]. At South Hospital the participants instead completed a questionnaire about symptoms (3981 HCWs) [ 9 ]. All HCWs at work were eligible for inclusion (physicians, nurses, assistant nurses, psychologists, social workers, physiotherapists, care administrators, medical secretaries, occupational therapists, speech therapists and nutritionists etc).…”

Section: Methodsmentioning

confidence: 99%

“…Conversely, presence of high amounts of virus associated with future disease, but not past disease [ 7 ]. For detailed patient flow charts of the cohort study, please see references [ 7 , 9 ]. In the present report, we considered HCWs who tested positive but did not have the post-symptomatic testing pattern (presence of antibodies or only low amounts of virus) as potentially infectious, as it is well established that subjects are not infectious when returning to work after the stipulated number of days have passed after symptoms have resolved.…”

Section: Methodsmentioning

confidence: 99%

“…The first wave of the SARS-CoV-2 epidemic affected Sweden in March-June 2020, particularly in the Stockholm region [ 6 ]. The Stockholm HCW study of past or present SARS-CoV-2 invited all healthcare workers (HCWs) in the region for PCR and antibody testing in April-June 2020, with about 27,000 HCWs enrolled [ 7 – 9 ]. Whereas antibodies and low amounts of virus in PCR (high Ct values) were associated with past disease (post-symptomatic subjects) [ 7 , 8 ], high amounts of virus in PCR predicted future disease in the next 1–2 weeks [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Potential SARS-CoV-2 infectiousness among asymptomatic healthcare workers

et al. 2021

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A majority of SARS-CoV-2 infections are transmitted from a minority of infected subjects, some of which may be symptomatic or pre-symptomatic. We aimed to quantify potential infectiousness among asymptomatic healthcare workers (HCWs) in relation to prior or later symptomatic disease. We previously (at the onset of the SARS-CoV-2 epidemic) performed a cohort study of SARS-CoV-2 infections among 27,000 healthcare workers (HCWs) at work in the capital region of Sweden. We performed both SARS-CoV-2 RT-PCR and serology. Furthermore, the cohort was comprehensively followed for sick leave, both before and after sampling. In the present report, we used the cohort database to quantify potential infectiousness among HCWs at work. Those who had sick leave either before or after sampling were classified as post-symptomatic or pre-symptomatic, whereas the virus-positive subjects with no sick leave were considered asymptomatic. About 0.2% (19/9449) of HCW at work were potentially infectious and pre-symptomatic (later had disease) and 0.17% (16/9449) were potentially infectious and asymptomatic (never had sick leave either before nor after sampling). Thus, 33% and 28% of all the 57 potentially infectious subjects were pre-symptomatic or asymptomatic, respectively. When a questionnaire was administered to HCWs with past infection, only 10,5% of HCWs had had no indication at all of having had SARS-CoV-2 infection (“truly asymptomatic”). Our findings provide a unique quantification of the different groups of asymptomatic, potentially infectious HCWs.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Potential SARS-CoV-2 infectiousness among asymptomatic healthcare workers

et al. 2021

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“…Galanis et al on pooled analysis from worldwide studies observed the seroprevalence of antibodies in HCWs as 8.7% (95% CI 6.7-10.9%), with risk factors of infection recognized to be suboptimal hand hygiene before and after patient contact, longer work hours, and improper personal protective equipment (PPE) usage [10]. Seroprevalence studies in HCWs have indicated the presence of SARS-CoV-2 antibodies ranging from 4% to 22% globally, although there are very few studies that have been conducted in India and none with a prospective design to estimate the incident risk [11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Seroprevalence of SARS-CoV-2 and Risk Assessment Among Healthcare Workers at a Dedicated Tertiary Care COVID-19 Hospital in Delhi, India: A Cohort Study

Sharma¹,

Chawla²,

Basu³

et al. 2021

Cureus

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BackgroundHealthcare workers (HCWs) have a substantially higher risk of Covid-19 infection but there is a paucity of information on the risk factors of disease transmission in high-burden real-world settings.The study objective was to determine the seroprevalence of SARS-CoV-2 among healthcare workers in a high-burden Covid-19 setting and to estimate the incidence and identify the risk factors of infection. MethodsThis was a prospective observational cohort study amongst doctors and nurses working at a dedicated Covid-19 tertiary care government hospital in Delhi, India. A baseline blood sample (2-3ml) was collected from all the participants to test for the presence of total SARS-CoV-2 antibodies. The HCWs that were seronegative (non-reactive) at baseline were followed-up for ≥21≤28 days with the collection of a second blood sample to assess for the incidence of SARS-CoV-2 infection. ResultsA total of 321 (51.3%, 95% C.I 47.4, 55.3) HCWs were detected with SARS-CoV-2 antibodies on baseline examination. The seroprevalence, when adjusted for assay characteristics, was 54.5% (95% C.I 50.3, 58.6). On bivariate analysis, SARS-CoV-2 antibody positivity lacked statistically significant association with either age, sex, occupation, cumulative duty duration, and smoking status. The incidence of seroconversion in the baseline seronegative cohort on follow-up after 21-28 days was observed in 35 (14.9%) HCWs (n=245). Furthermore, the self-reported adherence to infection prevention and control measures did not show a statistically significant association with antibody positivity in the HCWs, neither at baseline nor on followup. ConclusionsThe high risk of SARS-CoV-2 transmission in HCWs may be substantially reduced by adherence to Infection Prevention Control (IPC) and protective measures.

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Impact of age on the transmission of SARS-CoV-2 in healthcare workers

Corral-Gudino,

Del-Amo-Merino,

Abadía-Otero

et al. 2024

Wien Klin Wochenschr

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Summary Background The incidence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV‑2) infection was highest among older adults early in the COVID-19 pandemic; however, this pattern was later reversed with young adults showing the highest incidence. The aim of this study was to identify risk factors in healthcare workers (HCWs) associated with this evolution. Methods We conducted a survey nested within a prospective cohort study of 680 HCWs from a tertiary referral public hospital who received 2 doses of SARS-CoV‑2 vaccine in January and February 2021 (VACCICO-VAO cohort). In October 2022 all participants were invited to participate in a survey. Risk factors were tested for association with COVID-19 ever, the number of COVID-19 episodes, and the time to the first episode. Results Among 350 respondents (51% response rate, 90% female, mean age 48.1 years), 323 COVID-19 episodes were diagnosed during the study period. Multivariable analysis revealed that age < 35 years vs. > 50 years (odds ratio, OR 2.12, 95% confidence interval, CI 1.27–3.51; P = 0.004) and not maintaining social distance at social events (OR: 1.82, 95% CI: 1.16–3.19; P = 0.011) were associated with a higher risk of COVID-19. Age < 35 years (hazard ratio, HR 1.70, 95% CI 1.14–2.54; P = 0.010), and not maintaining social distance (HR 1.34, 95% CI 1.05–1.72; P = 0.020) were also associated with the time to the first episode. Conclusions The youngest HCWs had the highest incidence rate of COVID-19, which was not explained by occupational risk factors or health conditions. The increase in nonoccupational exposure since the end of the lockdowns in summer 2020 could by a key factor. Graphic abstract

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Risk of SARS-CoV-2 exposure among hospital healthcare workers in relation to patient contact and type of care

Cited by 9 publications

References 14 publications

Potential SARS-CoV-2 infectiousness among asymptomatic healthcare workers

Potential SARS-CoV-2 infectiousness among asymptomatic healthcare workers

Seroprevalence of SARS-CoV-2 and Risk Assessment Among Healthcare Workers at a Dedicated Tertiary Care COVID-19 Hospital in Delhi, India: A Cohort Study

Impact of age on the transmission of SARS-CoV-2 in healthcare workers

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