Transmission Routes of Severe Acute Respiratory Syndrome Coronavirus 2 Among Healthcare Workers of a French University Hospital in Paris, France

Contejean, Adrien; Leporrier, J.; Canouï, Etienne; Fourgeaud, Jacques; Mariaggi, Alice-Andrée; Alby-Laurent, Fanny; Lafont, Emmanuel; Beaudeau, Lauren; Rouzaud, Claire; Lecieux, Fabienne; Greffet, Agnès; L’Honneur, Anne-Sophie; Tréluyer, Jean‐Marc; Casetta, Anne; Frange, Pierre; Leruez‐Ville, Marianne; Rozenberg, Flore; Lortholary, Olivier; Kernéis, Solen

doi:10.1093/ofid/ofab054

Cited by 7 publications

(14 citation statements)

References 11 publications

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Section: Discussionsupporting

confidence: 81%

“…As also shown by others, our results suggest that direct contact with infected household members, relatives or, to a lesser degree, colleagues were the main sources of HCW acquisition of COVID-19 [5, 6, 9]. Nevertheless, COVID-19 patient-facing activities seem to further enhance the risk, although previous results were heterogenous [2, 5, 7, 9, 20, 21]. One explanation for this heterogeneity across settings and wards may be the various degrees of HCW education and training to follow IPC protocols and best practices.…”

Section: Discussionsupporting

confidence: 74%

“…As in the general population, younger male HCWs with comorbidities, in contact with an infected household member or who participated in gathering events are at higher risk for contracting COVID-19 [5][6][7][8]. Specific occupational exposures were identified: regular patientfacing activities and contacts with infected colleagues [2,5,6,9,10]. PPE-conferred protection was mainly studied for Influenza, Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS), but evidence is controversial for COVID-19 [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

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SARS-CoV-2 Exposures of Healthcare Workers from Primary Care, Long-Term Care Facilities and Hospitals: A Nationwide Matched Case-Control Study

Belan

Charmet

Schaeffer

et al. 2022

Preprint

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Objectives. Healthcare workers (HCWs) are at higher risk of contracting coronavirus disease 19 (COVID 19) than the general population. This study assessed the roles of various exposures and personal protective equipment (PPE) use on that risk for HCWs working in primary care, long term care facilities (LTCFs) or hospitals. Methods. We conducted a matched case-control (1:1) study (10 April; 9 July 2021). Cases (HCWs with confirmed COVID-19) and controls (HCWs without any COVID 19 positive test or symptoms) recruited by email were invited to complete an online questionnaire on their exposures and PPE use. Questions covered the 10 days preceding symptom onset for cases (or testing if asymptomatic) or inclusion for controls. Results. A total of 4152 matched cases and controls were included. The multivariable conditional logistic regression analysis retained exposure to an infected person outside work (adjusted odds ratio, 19.9 [95% confidence intervaI, 12.4, 31.9]), an infected colleague (2.26 [1.53, 3.33]) or COVID-19 patients (2.37 [1.66, 3.40]), as independent predictors of COVID-19 in HCWs, while partial or complete immunization was protective. Eye protection (0.57 [0.37, 0.87]) and wearing a gown (0.58 [0.34, 0.97]) during COVID-19 patient care were protective, while wearing an apron slightly increased the risk of infection (1.47 [1.00, 2.18]). N95-respirator protection was comparable to that of surgical masks. Results were consistent across healthcare-facility categories. Conclusions. HCWs were more likely to get COVID-19 in their personal sphere than during occupational activities. Our results suggest that eye protection for HCWs during patient care should be actively promoted.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionsupporting

confidence: 74%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

SARS-CoV-2 Exposures of Healthcare Workers from Primary Care, Long-Term Care Facilities and Hospitals: A Nationwide Matched Case-Control Study

Belan

Charmet

Schaeffer

et al. 2022

Preprint

Self Cite

View full text Add to dashboard Cite

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“…Previous studies report failure to evaluate the effect of remembering bias and other environmental factors as limitations. 13 18–27 This study was planned prospectively, and negativities such as possible false recall and lack of data, which are among the weaknesses of retrospective studies, were minimised. Also, more categorised information has been obtained by using a standardised risk classification in the follow-up and management of exposed HCWs.…”

Section: Discussionmentioning

confidence: 99%

Investigation of the relation between risk assessment of exposure and nosocomial SARS-CoV-2 transmission in healthcare workers: a prospective single-centre study

et al. 2022

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ObjectivesHealthcare workers (HCWs) are among the risk groups for COVID-19. Determining transmission routes and risk levels during healthcare is of great importance in preventing nosocomial outbreaks. This study aimed to investigate the frequency of nosocomial transmission and factors affecting the transmission in HCW.MethodsHCWs admitted to the infectious diseases outpatient clinic due to contact with a COVID-19 patient and diagnosed with SARS-COV-2 by reverse-transcriptase PCR (RT-PCR) between 20 March 2020 and 30 June 2020 were included in the study.ResultsA total of 822 HCWs with 295 low, 284 intermediate and 243 high-risk exposures were included in the study. 27.1% of the HCWs were male, and the median age was 31.9 years (20–62). 89.5% of these patients were directly in charge of patient care. Of the index cases contacted, 72.6% were HCW, and 27.4% were non-HCW patients. Most of the risky exposure (51.7%) occurred in nurses. The occurrence frequency of high-risk exposure was lower in those assigned to direct patient care when compared with the occurrence frequency of moderate-risk or low-risk exposures (76.5%, 94.7, 95.3, respectively p<0.001). In most high-risk exposures (220/253), the index cases were HCWs (p<0.001). Symptoms were detected in 311 of the HCWs (37.8%) during the follow-up. The median time to perform SARS-CoV-2 RT-PCR was 5.3 days (IQR) after the last risky exposure. In multivariate analysis, SARS-CoV-2 RT-PCR positivity was 5.65 times higher in HCWs not directly involved in patient care than HCWs who are not involved in patient care (95% CI 2.437 to 13.111; p<0.001).ConclusionsThis study provides particularly useful information on post-exposure COVID-19 follow-up and management of working schedules and procedures of HCWs.

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“…The detection of being a medical secretary or janitorial staff as independent risk factors could be explained by the uncontrolled social gatherings because frontline workers are protected by strict measures. Contejean et al suggested that close contact with coworkers without a mask can be a risk factor for seropositivity [23]. Doctors and nurses are provided with larger office spaces that prevented crowded gatherings, although medical secretaries and janitorial staff had small offices and changing rooms.…”

Section: Discussionmentioning

confidence: 99%

Risk Groups for SARS-CoV-2 Infection among Healthcare Workers: Community Versus Hospital Transmission

Pınarlık

Genç

Kapmaz

et al. 2021

Infectious Disease Reports

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Background: We aimed to detect the risk factors for SARS-CoV-2 infection among healthcare workers (HCWs) in 2020 before the vaccination era. Methods: We surveyed SARS-CoV-2 infection among the HCWs in a hospital through screening for antibody levels and the detection of viral RNA by RT-PCR between May 2020 and 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 a response rate of 90%. The overall infection rate of HCWs was 16.3% at the end of 2020, before vaccinations started. In the multivariate analysis, being janitorial staff (OR: 2.24, CI: 1.21–4.14, p = 0.011), being a medical secretary (OR: 4.17, CI: 2.12–8.18, p < 0.001), having at least one household member with a 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. Conclusions: Medical secretaries and janitorial staff were under increased risk of SARS-CoV-2 infection. The 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 the community-acquired transmission of the infection.

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Transmission Routes of Severe Acute Respiratory Syndrome Coronavirus 2 Among Healthcare Workers of a French University Hospital in Paris, France

Cited by 7 publications

References 11 publications

SARS-CoV-2 Exposures of Healthcare Workers from Primary Care, Long-Term Care Facilities and Hospitals: A Nationwide Matched Case-Control Study

SARS-CoV-2 Exposures of Healthcare Workers from Primary Care, Long-Term Care Facilities and Hospitals: A Nationwide Matched Case-Control Study

Investigation of the relation between risk assessment of exposure and nosocomial SARS-CoV-2 transmission in healthcare workers: a prospective single-centre study

Risk Groups for SARS-CoV-2 Infection among Healthcare Workers: Community Versus Hospital Transmission

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