Update Alert 6: Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers

Chou, Roger; Dana, Tracy; Selph, Shelley; Totten, Annette M; Buckley, David I; Fu, Rongwei

doi:10.7326/l20-1323

Cited by 25 publications

(16 citation statements)

References 14 publications

(33 reference statements)

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“…These include SARS, H1N1, H7N9, MERS, EBOLA, and more recently, COVID-19 (see Supplementary Table 1). Such outbreaks place a serious strain on the health-care systems that try to contain and manage them, including health-care workers (HCW) who are at increased risk for nosocomial infections (1). In addition to the threat to their own physical health, HCW can experience psychological distress as a collateral cost of the risk of infection and the demands of dealing with a public health emergency (2).…”

Section: Introductionmentioning

confidence: 99%

Factors Associated With Psychological Distress in Health-Care Workers During an Infectious Disease Outbreak: A Rapid Systematic Review of the Evidence

2021

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Objective: Health-care workers (HCW) are at risk for psychological distress during an infectious disease outbreak, such as the coronavirus pandemic, due to the demands of dealing with a public health emergency. This rapid systematic review examined the factors associated with psychological distress among HCW during an outbreak.Method: We systematically reviewed literature on the factors associated with psychological distress (demographic characteristics, occupational, social, psychological, and infection-related factors) in HCW during an outbreak (COVID-19, SARS, MERS, H1N1, H7N9, and Ebola). Four electronic databases were searched (2000 to 15 November 2020) for relevant peer-reviewed research according to a pre-registered protocol. A narrative synthesis was conducted to identify fixed, modifiable, and infection-related factors linked to distress and psychiatric morbidity.Results: From the 4,621 records identified, 138 with data from 143,246 HCW in 139 studies were included. All but two studies were cross-sectional. The majority of the studies were conducted during COVID-19 (k = 107, N = 34,334) and SARS (k = 21, N = 18,096). Consistent evidence indicated that being female, a nurse, experiencing stigma, maladaptive coping, having contact or risk of contact with infected patients, and experiencing quarantine, were risk factors for psychological distress among HCW. Personal and organizational social support, perceiving control, positive work attitudes, sufficient information about the outbreak and proper protection, training, and resources, were associated with less psychological distress.Conclusions: This review highlights the key factors to the identify HCW who are most at risk for psychological distress during an outbreak and modifying factors to reduce distress and improve resilience. Recommendations are that HCW at risk for increased distress receive early interventions and ongoing monitoring because there is evidence that HCW distress can persist for up to 3 years after an outbreak. Further research needs to track the associations of risk and resilience factors with distress over time and the extent to which certain factors are inter-related and contribute to sustained or transient distress.

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Section: Introductionmentioning

confidence: 99%

Factors Associated With Psychological Distress in Health-Care Workers During an Infectious Disease Outbreak: A Rapid Systematic Review of the Evidence

2021

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“…The reported transmission rates in healthcare settings are variable [ 8 , 9 , 10 , 11 ]. Since the beginning of the pandemic, national and local guidelines have been implemented to reduce the transmission of SARS-CoV-2 among HCW, including adherence to strict hygiene standards, using suitable personal protective equipment (PPE) and applying social distancing, including outside the hospital [ 12 , 13 , 14 , 15 ]. A proactive SARS-CoV-2 screening program for the HCW of “Giovanni XXIII” Pediatric Hospital of Bari was implemented in order to quantify the circulation of SARS-CoV-2 among asymptomatic HCW and to create a safe hospital environment for staff and patients.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of Preventive Measures in Keeping Low Prevalence of SARS-CoV-2 Infection in Health Care Workers in a Referral Children’s Hospital in Southern Italy

et al. 2021

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The coronavirus disease 2019 (COVID-19) pandemic now represents a major threat to public health. Health care workers (HCW) are exposed to biological risk. Little is currently known about the risk of HCW operating in pediatric wards for SARS-CoV-2 infection. The aim is to assess the prevalence of SARS-CoV-2 infection in HCW in a third-level children’s hospital in Southern Italy. An observational cohort study of all asymptomatic HCW (physician, technicians, nurses, and logistic and support operators) was conducted. HCW were screened, on a voluntary basis, for SARS-CoV-2 by RT-PCR on nasopharyngeal swab performed during the first wave of COVID-19. The study was then repeated, with the same modalities, at a 7-month interval, during the “second wave” of the COVID-19 pandemic. At the initial screening between 7 and 24 April 2020, 525 HCW were tested. None of them tested positive. At the repeated screening, conducted between 9 and 20 November 2020, 627 HCW were tested, including 61 additional ones resulting from COVID-emergency recruitment. At this second screening, eight subjects (1.3%) tested positive, thus being diagnosed as asymptomatic carriers of SARS-CoV-2. They were one physician, five nurses, and two HCW from the logistic/support services. They were employed in eight different wards/services. In all cases, the epidemiological investigation showed convincing evidence that the infection was acquired through social contacts. The study revealed a very low circulation of SARS-CoV-2 infection in HCW tested with RT-PCR. All the infections documented in the second wave of epidemic of SARS-CoV-2 were acquired outside of the workplace, confirming that in a pediatric hospital setting, HCW education, correct use of personal protective equipment, and separation of the COVID-patient pathway and staff flow may minimize the risk derived from occupational exposure.

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“…Healthcare workers (HCWs) experienced early unmitigated occupational exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) until approximately mid-March 2020, prior to implementation of standardized infection prevention protocols including universal masking, patient symptom screening, and ubiquitous telehealth, and before risk factors for transmission in healthcare settings were identified [3][4][5][6]. Reported risk factors for SARS-CoV-2 infection in HCWs include hospital department, healthcare profession, personal protective equipment (PPE) availability and use, performance of aerosol-generating procedures (AGPs), and duty hours [7]. Previously reported non-occupational (community) factors include household contacts with COVID-19 and public transportation use [7,8].…”

Section: Introductionmentioning

confidence: 99%

“…Reported risk factors for SARS-CoV-2 infection in HCWs include hospital department, healthcare profession, personal protective equipment (PPE) availability and use, performance of aerosol-generating procedures (AGPs), and duty hours [7]. Previously reported non-occupational (community) factors include household contacts with COVID-19 and public transportation use [7,8].…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with SARS-CoV-2 Infection in Resident Physicians and Fellows in New York City During the First COVID-19 Wave

Pawloski¹,

Kolod²,

Rf³

et al. 2021

Preprint

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Risk factors for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are not well-defined in resident physicians and fellows (trainees). We aimed to identify sociodemographic, occupational and community factors associated with SARS-CoV-2 infection among trainees during the first wave of the coronavirus disease 2019 (COVID-19) pandemic in New York City (NYC). In this retrospective cohort study, we administered an electronic survey between June 26 and August 31, 2020 to trainees at the Mount Sinai Health System in NYC to assess risk factors for SARS-CoV-2 infection between February 1 and June 30, 2020. We used Bayesian generalized linear mixed effect regression and structural equation models to examine associations. SAR-CoV-2 infection was determined by self-reported IgG antibody and reverse transcriptase-polymerase chain reaction results and confirmed with laboratory results. Among 2354 trainees invited to participate, 328 (14%) completed the survey and reported test results. The cumulative incidence of SARS-CoV-2 infection was 20.1%. Assignment to medical-surgical units (odds ratio [OR], 2.51; 95% CI, 1.18-5.34), and training in emergency medicine, critical care and anesthesiology (OR, 2.93; 95% CI, 1.24-6.92) were independently associated with infection. Deployment to care for unfamiliar patient populations was protective against infection (OR, 0.16; 95% CI, 0.03-0.73). Community factors were not significantly associated with infection after adjustment for occupational factors. Our findings may inform tailored infection prevention strategies for trainees responding to the COVID-19 pandemic.

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Update Alert 6: Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers

Cited by 25 publications

References 14 publications

Factors Associated With Psychological Distress in Health-Care Workers During an Infectious Disease Outbreak: A Rapid Systematic Review of the Evidence

Factors Associated With Psychological Distress in Health-Care Workers During an Infectious Disease Outbreak: A Rapid Systematic Review of the Evidence

Effectiveness of Preventive Measures in Keeping Low Prevalence of SARS-CoV-2 Infection in Health Care Workers in a Referral Children’s Hospital in Southern Italy

Factors Associated with SARS-CoV-2 Infection in Resident Physicians and Fellows in New York City During the First COVID-19 Wave

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