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Choi SE, Sima C, Colom LP, Nguyen GT, Giannobile WV. Evaluation of Comprehensive COVID-19 Testing Program Outcomes in a US Dental Clinical Care Academic Setting. JAMA Netw Open 2022; 5:e2246530. [PMID: 36512355 PMCID: PMC9856527 DOI: 10.1001/jamanetworkopen.2022.46530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
IMPORTANCE Although many academic institutions have implemented infection control and prevention protocols, including regular asymptomatic self-testing, in response to the COVID-19 pandemic, the outcomes of mandatory surveillance testing programs at academic dental institutions that offer direct patient-facing clinical care has not yet been reported. OBJECTIVE To report the findings of a comprehensive surveillance COVID-19 testing program at an academic dental institution by assessing SARS-CoV-2 positivity rates and the potential association of test positivity with individual-level characteristics such as age, sex, and role. DESIGN, SETTING, AND PARTICIPANTS A retrospective cohort study was conducted using SARS-CoV-2 self-testing data from a mandatory surveillance program at the Harvard School of Dental Medicine. Test results obtained between August 24, 2020, and February 28, 2022, from students, faculty, and staff members were analyzed. Testing cadence varied from 1 to 3 times per week depending on risk status. The association of individual characteristics with test positivity was evaluated with univariate analyses and a bayesian multilevel logistic regression model. EXPOSURES Age by decade, sex, and role or position category (staff members, faculty, and students stratified by their involvement in clinical care activities), testing cadence, and testing date. MAIN OUTCOMES AND MEASURES Positive results from SARS-CoV-2 real-time reverse transcription-polymerase chain reaction self-tests were assessed. RESULTS Of the 390 study participants, 210 (53.8%) were women. Participants were grouped by age as follows: 20 to 29 years (190 [48.7%]), 30 to 39 years (88 [22.6%]), 40 to 49 years (44 [11.3%]), 50 to 59 years (42 [10.8%]), and 60 years or older (26 [6.7%]). Test results demonstrated an overall 0.27% positivity rate (61 test-positive cases), with a peak weekly positivity rate of 5.12% in the first week of January 2022. The mean (SD) test positivity rate among those involved in clinical activities was 0.25% (0.04) compared with 0.36% (0.09) among nonclinical participants. When adjusting for all considered covariates, test positivity was significantly associated with testing frequency (3 times vs 1 time per week: odds ratio [OR], 1.51 [95% credible interval (CrI), 1.07-3.69]) and timing of the test (after vs during the Alpha wave: OR, 0.33 [95% CrI, 0.11-0.88]; and Omicron vs Alpha: OR, 11.59 [95% CrI, 6.49-22.21]) but not with individual characteristics (age, sex, and role). CONCLUSIONS AND RELEVANCE These findings suggest that implementing an adaptive testing cadence based on the risk status of individuals may be effective in reducing the risk of SARS-CoV-2 infection within an institution. In this study, involvement in clinical activities did not pose additional risk of SARS-CoV-2 infection compared with other in-person activities in the presence of these control measures.
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Affiliation(s)
- Sung Eun Choi
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts
| | - Corneliu Sima
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts
| | - Laura Pesquera Colom
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts
| | - Giang T. Nguyen
- Harvard University Health Services, Cambridge, Massachusetts
| | - William V. Giannobile
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts
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Zahran S, Nir-Paz R, Paltiel O, Stein-Zamir C, Oster Y. Are Healthcare Workers Infected with SARS-CoV-2 at Home or at Work? A Comparative Prevalence Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12951. [PMID: 36232249 PMCID: PMC9564591 DOI: 10.3390/ijerph191912951] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
Prior to the widespread use of vaccinations, healthcare workers (HCWs) faced the double burden of caring for unprecedented numbers of critically ill COVID-19 patients while also facing the risk of becoming infected themselves either in healthcare facilities or at home. In order to assess whether SARS-CoV-2-positivity rates in HCWs reflected or differed from those in their residential areas, we compared the SARS-CoV-2-positivity rates during 2020 among HCWs in Hadassah Hebrew University Medical Centers (HHUMC), a tertiary medical center in Jerusalem, Israel, to those of the general population in Jerusalem, stratified by neighborhood. Additionally, we compared the demographic and professional parameters in every group. Four percent of the adult population (>18 years) in Jerusalem tested positive for SARS-CoV-2 during 2020 (24,529/605,426) compared to 7.1% of HHUMC HCWs (317/4470), rate ratio 1.75 (95% CI 1.57-1.95), with wide variability (range 0.38-25.0) among different neighborhoods. Of the 30 neighborhoods with more than 50 infected HCWs, 25 showed a higher positivity rate for HCWs compared to the general population. The higher risk of HCWs compared to residents representing the general population in most neighborhoods in Jerusalem may be explained by their behavior in and out of the hospital.
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Affiliation(s)
- Shadi Zahran
- Department of Internal Medicine, Hadassah Hebrew University Medical Center, Jerusalem 9112001, Israel
| | - Ran Nir-Paz
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190401, Israel
- Department of Clinical Microbiology and Infectious Diseases, Hadassah Hebrew University Medical Center, Jerusalem 9112001, Israel
| | - Ora Paltiel
- Faculty of Medicine, Braun School of Public and Community Medicine, Hebrew University of Jerusalem, Jerusalem 9190401, Israel
| | - Chen Stein-Zamir
- Faculty of Medicine, Braun School of Public and Community Medicine, Hebrew University of Jerusalem, Jerusalem 9190401, Israel
- Jerusalem District Health Office, Ministry of Health, Jerusalem 9134302, Israel
| | - Yonatan Oster
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190401, Israel
- Department of Clinical Microbiology and Infectious Diseases, Hadassah Hebrew University Medical Center, Jerusalem 9112001, Israel
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Jabs JM, Schwabe A, Wollkopf AD, Gebel B, Stadelmaier J, Erdmann S, Radicke F, Grundmann H, Kramer A, Monsef I, Rücker G, Rupp J, Scheithauer S, Schmucker C, Simon A, Mutters NT. The role of routine SARS-CoV-2 screening of healthcare-workers in acute care hospitals in 2020: a systematic review and meta-analysis. BMC Infect Dis 2022; 22:587. [PMID: 35780088 PMCID: PMC9250183 DOI: 10.1186/s12879-022-07554-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 06/08/2022] [Indexed: 02/08/2023] Open
Abstract
Background Healthcare workers (HCW) are at increased risk of infection with SARS-CoV-2. Vulnerable patient populations in particular must be protected, and clinics should not become transmission hotspots to avoid delaying medical treatments independent of COVID. Because asymptomatic transmission has been described, routine screening of asymptomatic HCW would potentially be able to interrupt chains of infection through early detection. Methods A systematic search was conducted in the Cochrane COVID-19 Study Register, Web of Science and WHO COVID‐19 Global literature on coronavirus with regard to non-incident related testing of healthcare workers using polymerase chain reaction on May 4th 2021. Studies since January 2020 were included. An assessment of risk of bias and representativeness was performed. Results The search identified 39 studies with heterogeneous designs. Data collection of the included studies took place from January to August 2020. The studies were conducted worldwide and the sample size of the included HCW ranged from 70 to 9449 participants. In total, 1000 of 51,700 (1.9%) asymptomatic HCW were tested positive for SARS-CoV-2 using PCR testing. The proportion of positive test results ranged between 0 and 14.3%. No study reported on HCW-screening related reductions in infected person-days. Discussion and conclusions The heterogeneous proportions might be explained by different regional incidences, lock-downs, and pre-analytical pitfalls that reduce the sensitivity of the nasopharyngeal swab. The very high prevalence in some studies indicates that screening HCW for SARS-CoV-2 may be important particularly in geographical regions and pandemic periods with a high-incidence. With low numbers and an increasing rate of vaccinated HCW, a strict cost–benefit consideration must be made, especially in times of low incidences. Since we found no studies that reported on HCW-screening related reductions in infected person-days, re-evaluation should be done when these are available. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07554-5.
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Affiliation(s)
- J M Jabs
- Institute for Hygiene and Public Health, Bonn University Hospital, Venusberg-Campus 1, 53127, Bonn, Germany
| | - A Schwabe
- Institute for Hygiene and Public Health, Bonn University Hospital, Venusberg-Campus 1, 53127, Bonn, Germany
| | - A D Wollkopf
- Institute for Hygiene and Public Health, Bonn University Hospital, Venusberg-Campus 1, 53127, Bonn, Germany
| | - B Gebel
- Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - J Stadelmaier
- Institute for Evidence in Medicine, Faculty of Medicine and Medical Center, University of Freiburg, Breisacher Str. 86, 79110, Freiburg, Germany
| | - S Erdmann
- Institute for Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
| | - F Radicke
- Institute for Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
| | - H Grundmann
- Institute for Infection Prevention and Hospital Hygiene, Faculty of Medicine and Medical Center, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - A Kramer
- Institute for Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
| | - I Monsef
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Cochrane Haematology, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - G Rücker
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Zinkmattenstraße 6a, 79108, Freiburg, Germany
| | - J Rupp
- Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - S Scheithauer
- Institute of Infection Control and Infectious Diseases, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - C Schmucker
- Institute for Evidence in Medicine, Faculty of Medicine and Medical Center, University of Freiburg, Breisacher Str. 86, 79110, Freiburg, Germany
| | - A Simon
- Clinic for Pediatric Oncology and Hematology, Saarland University Hospital, Kirrberger Straße, 66421, Homburg, Saar, Germany
| | - Nico T Mutters
- Institute for Hygiene and Public Health, Bonn University Hospital, Venusberg-Campus 1, 53127, Bonn, Germany.
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Oster Y, Benenson S, Nir-Paz R, Buda I, Cohen MJ. The effect of a third BNT162b2 vaccine on breakthrough infections in health care workers: a cohort analysis. Clin Microbiol Infect 2022; 28:735.e1-735.e3. [PMID: 35143997 PMCID: PMC8820100 DOI: 10.1016/j.cmi.2022.01.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/10/2022] [Accepted: 01/22/2022] [Indexed: 12/20/2022]
Abstract
OBJECTIVES In August 2021, 6 months after mass vaccination of the Israeli population with the two-dose BNT162b2 mRNA vaccine, a surge of coronavirus disease 2019 infections, mostly from the delta variant, appeared also among the vaccinated. In response, the Israeli Ministry of Health initiated a booster (third dose) vaccination program. We assessed the protective effect of the third dose among health care workers (HCWs). METHODS Infections with severe acute respiratory syndrome coronavirus 2 are monitored systematically among HCWs at the Hadassah tertiary care medical centre in Jerusalem, Israel. In this cohort, we included breakthrough infections, defined as those occurring >180 days since the second vaccine dose. The follow-up period lasted 120 days. We compared infection rates between HCWs who received the booster dose and those who received only the two-dose regimen. RESULTS The rate of breakthrough infections among HCWs who received only the two-dose regimen was 21.4% (85 of 398). The rate in the boosted group was 0.7% (35/4973; relative risk 30, 95% CI 20-50). Those results were seen in all age groups. DISCUSSION The significantly lower rate of breakthrough infections in boosted HCWs indicates substantial protection by a third vaccine dose.
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Affiliation(s)
- Yonatan Oster
- The Faculty of Medicine, Hebrew University of Jerusalem, Israel; Department of Clinical Microbiology and Infectious Diseases, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
| | - Shmuel Benenson
- The Faculty of Medicine, Hebrew University of Jerusalem, Israel; Department of Clinical Microbiology and Infectious Diseases, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Ran Nir-Paz
- The Faculty of Medicine, Hebrew University of Jerusalem, Israel; Department of Clinical Microbiology and Infectious Diseases, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Inon Buda
- General Management, Hadassah Hebrew University Medical Centre, Jerusalem, Israel
| | - Matan J Cohen
- Clalit Health Services, Jerusalem District, Affiliated with the Hebrew University, Jerusalem, Israel
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Zuglian G, Ripamonti D, Tebaldi A, Cuntrò M, Riva I, Farina C, Rizzi M. The changing pattern of bacterial and fungal respiratory isolates in patients with and without COVID-19 admitted to intensive care unit. BMC Infect Dis 2022; 22:185. [PMID: 35196993 PMCID: PMC8865172 DOI: 10.1186/s12879-022-07176-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 02/10/2022] [Indexed: 11/18/2022] Open
Abstract
Objectives Severe acute respiratory syndrome 2 (SARS-CoV-2) pandemic has had a heavy impact on national health system, especially in the first wave. That impact hit principally the intensive care units (ICUs). The large number of patients requiring hospitalization in ICUs lead to a complete upheaval of intensive wards. The increase in bed, the fewer number of nurses per patient, the constant use of personal protective equipment, the new antimicrobial surveillance protocols could have had deeply effects on microbiological flora of these wards. Moreover, the overconsumption of antimicrobial therapy in COVID-19 patients, like several studies report, could have impact of this aspect. Aim of this study is to evaluate the changing pattern of microbiological respiratory isolates during and before COVID-19 pandemic in a tertiary hospital ICUs. Methods A retrospective, observational study was conducted in ICUs of “ASST Papa Giovanni XXIII”, a large tertiary referral hospital in Northern Italy. We have retrospectively collected the microbiological data from bronchoalveolar lavage (BAL) and tracheal aspirate (TA) of patients with COVID-19, hospitalized in ICUs from 22nd February 2020 to 31st May 2020 (Period 1), and without COVID-19, from 22nd February 2019 to 31st May 2019 (Period 2). We compared the prevalence and the antibiotic profile of bacterial and fungal species in the two time periods. Results The prevalence of Pseudomonas spp. shows a statistically significant increase from patients without COVID-19 compared to COVID-19 positive as well as the prevalence of Enterococcus spp. On the contrary, the prevalence of Gram negative non fermenting bacteria (GN-NFB), Haemophilus influenzae and Streptococcus pneumoniae showed a significant reduction between two periods. There was a statistically significant increase in resistance of Pseudomonas spp. to carbapenems and piperacillin/tazobactam and Enterobacterales spp. for piperacillin/tazobactam, in COVID-19 positive patients compared to patients without COVID-19. We did not observe significant changing in fungal respiratory isolates. Conclusions A changing pattern in prevalence and resistance profiles of bacterial and fungal species was observed during COVID-19 pandemic.
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Affiliation(s)
- Gianluca Zuglian
- Infectious Diseases Unit, ASST "Papa Giovanni XXIII", Piazza OMS, 1, 24127, Bergamo, Italy.
| | - Diego Ripamonti
- Infectious Diseases Unit, ASST "Papa Giovanni XXIII", Piazza OMS, 1, 24127, Bergamo, Italy
| | - Alessandra Tebaldi
- Infectious Diseases Unit, ASST "Papa Giovanni XXIII", Piazza OMS, 1, 24127, Bergamo, Italy
| | - Marina Cuntrò
- Microbiology and Virology Laboratory, ASST "Papa Giovanni XXIII", Bergamo, Italy
| | - Ivano Riva
- Intensive Care Unit, ASST "Papa Giovanni XXIII", Bergamo, Italy
| | - Claudio Farina
- Microbiology and Virology Laboratory, ASST "Papa Giovanni XXIII", Bergamo, Italy
| | - Marco Rizzi
- Infectious Diseases Unit, ASST "Papa Giovanni XXIII", Piazza OMS, 1, 24127, Bergamo, Italy
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Munivenkatappa A, Sahay RR, Deshpande GR, Patil DY, Shete AM, Sapkal GN, Kumar R, Narayana M, Yadav PD, Shettar V. A case with SARS-CoV-2 reinfection from India. Indian J Med Microbiol 2021; 40:166-168. [PMID: 34789389 PMCID: PMC8590946 DOI: 10.1016/j.ijmmb.2021.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 12/29/2022]
Abstract
A healthcare worker presented with fever, cough, headache and tested positive by SARS-CoV-2 real time reverse transcriptase polymerase chain reaction (qRT-PCR). He got admitted to hospital and recovered after 14 days. After 2 months, as a screening protocol considering the high risk setup he got tested and again found to be positive for SARS-CoV-2 by qRT-PCR. Our patient had detectable levels of Anti-SARS-CoV-2 IgG antibodies during the reinfection but found negative for Neutralizing antibodies (NAb). Our findings suggest that the person after the initial infection might not develop the desired protective immunity to prevent the reinfection as demonstrated by absence of NAb.
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Affiliation(s)
- Ashok Munivenkatappa
- Indian Council of Medical Research-National Institute of Virology, Bangalore Unit, Karnataka, 560029, India.
| | - Rima R Sahay
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, 411021, India.
| | - Gururaj R Deshpande
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, 411021, India.
| | - Deepak Y Patil
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, 411021, India.
| | - Anita M Shete
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, 411021, India.
| | - Gajanan N Sapkal
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, 411021, India.
| | - Ravish Kumar
- Employees' State Insurance Corporation Medical College and Hospital, Gulbarga, Karnataka, 585106, India.
| | - Marappa Narayana
- Employees' State Insurance Corporation Medical College and Hospital, Gulbarga, Karnataka, 585106, India.
| | - Pragya D Yadav
- Indian Council of Medical Research-National Institute of Virology, Pune, Maharashtra, 411021, India.
| | - Vijay Shettar
- Employees' State Insurance Corporation Medical College and Hospital, Gulbarga, Karnataka, 585106, India.
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Sah P, Fitzpatrick MC, Zimmer CF, Abdollahi E, Juden-Kelly L, Moghadas SM, Singer BH, Galvani AP. Asymptomatic SARS-CoV-2 infection: A systematic review and meta-analysis. Proc Natl Acad Sci U S A 2021; 118:e2109229118. [PMID: 34376550 PMCID: PMC8403749 DOI: 10.1073/pnas.2109229118] [Citation(s) in RCA: 252] [Impact Index Per Article: 84.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Quantification of asymptomatic infections is fundamental for effective public health responses to the COVID-19 pandemic. Discrepancies regarding the extent of asymptomaticity have arisen from inconsistent terminology as well as conflation of index and secondary cases which biases toward lower asymptomaticity. We searched PubMed, Embase, Web of Science, and World Health Organization Global Research Database on COVID-19 between January 1, 2020 and April 2, 2021 to identify studies that reported silent infections at the time of testing, whether presymptomatic or asymptomatic. Index cases were removed to minimize representational bias that would result in overestimation of symptomaticity. By analyzing over 350 studies, we estimate that the percentage of infections that never developed clinical symptoms, and thus were truly asymptomatic, was 35.1% (95% CI: 30.7 to 39.9%). At the time of testing, 42.8% (95% prediction interval: 5.2 to 91.1%) of cases exhibited no symptoms, a group comprising both asymptomatic and presymptomatic infections. Asymptomaticity was significantly lower among the elderly, at 19.7% (95% CI: 12.7 to 29.4%) compared with children at 46.7% (95% CI: 32.0 to 62.0%). We also found that cases with comorbidities had significantly lower asymptomaticity compared to cases with no underlying medical conditions. Without proactive policies to detect asymptomatic infections, such as rapid contact tracing, prolonged efforts for pandemic control may be needed even in the presence of vaccination.
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Affiliation(s)
- Pratha Sah
- Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, CT 06520
| | - Meagan C Fitzpatrick
- Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, CT 06520
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, MD 21201
| | - Charlotte F Zimmer
- Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, CT 06520
| | - Elaheh Abdollahi
- Agent-Based Modelling Laboratory, York University, Toronto, ON M3J 1P3, Canada
| | - Lyndon Juden-Kelly
- Agent-Based Modelling Laboratory, York University, Toronto, ON M3J 1P3, Canada
| | - Seyed M Moghadas
- Agent-Based Modelling Laboratory, York University, Toronto, ON M3J 1P3, Canada
| | - Burton H Singer
- Emerging Pathogens Institute, University of Florida, Gainesville, FL 32610
| | - Alison P Galvani
- Center for Infectious Disease Modeling and Analysis, Yale School of Public Health, New Haven, CT 06520
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8
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Affiliation(s)
- Shmuel Benenson
- Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Yonatan Oster
- Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | | | - Ran Nir-Paz
- Hadassah Hebrew University Medical Center, Jerusalem, Israel
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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. Pediatr Rep 2021; 13:118-124. [PMID: 33806472 PMCID: PMC8006005 DOI: 10.3390/pediatric13010017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/08/2021] [Accepted: 03/01/2021] [Indexed: 12/24/2022] Open
Abstract
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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He L, Zeng Y, Zeng C, Zhou Y, Li Y, Xie X, Xu W, Luo W, Hu J, Yi Z, Wang X, Tang S, Xu L, Chen C. Positive Rate of Serology and RT-PCR for COVID-19 among Community Residents and Healthcare Workers in Wuhan, China. Jpn J Infect Dis 2020; 74:333-336. [PMID: 33390427 DOI: 10.7883/yoken.jjid.2020.691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aimed to evaluate the infection rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among different populations in Wuhan, China. This cross-sectional survey-based study examined the results of SARS-CoV-2-specific serological tests and RT-PCR tests for 4,454 community residents and 4,614 healthcare workers performed from May 15 to May 29, 2020. The healthcare workers were classified as administrative and logistical staff (n = 1,378), non-first-line healthcare workers (n = 2,630), or first-line healthcare workers (n = 606) according to their frequency of contact with coronavirus disease (COVID-19) patients. The positive rates of SARS-CoV-2-specific IgG, IgM, and RNA were 2.9%, 0.4%, and 0.1% for the community residents and 3.3%, 0.6%, and 0.2% for the healthcare workers, respectively. There were no statistically significant differences between the rates of the two groups. Spearman's correlation analysis showed that the frequency of contact with COVID-19 patients negatively correlated with the positive rates of RT-PCR (rs = -0.036, P = 0.016), but did not significantly correlate with the positive rates of IgM (rs = -0.006, P = 0.698) or IgG (rs = 0.017, P = 0.239). There was no statistically significant difference between the SARS-CoV-2-specific IgG, IgM, or RNA positive rates of the community residents and those of the healthcare workers. The positive rate of SARS-CoV-2 RNA was lower for the first-line healthcare workers than for the non-first-line healthcare workers and the administrative and logistical staff.
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Affiliation(s)
- Lu He
- Physical Examination Center, Renmin Hospital of Wuhan University, China
| | - Yuyang Zeng
- Department of Ophthalmology, Renmin Hospital of Wuhan University, China
| | - Cheng Zeng
- Department of Geratology, Hanyang Hospital Affiliated to Wuhan University of Science and Technology, China
| | - Yunyun Zhou
- Department of Ophthalmology, Renmin Hospital of Wuhan University, China
| | - Ying Li
- Physical Examination Center, Renmin Hospital of Wuhan University, China
| | - Xiaojie Xie
- Physical Examination Center, Renmin Hospital of Wuhan University, China
| | - Wei Xu
- Physical Examination Center, Renmin Hospital of Wuhan University, China
| | - Wen Luo
- Physical Examination Center, Renmin Hospital of Wuhan University, China
| | - Jing Hu
- Physical Examination Center, Renmin Hospital of Wuhan University, China
| | - Zuohuizi Yi
- Department of Ophthalmology, Renmin Hospital of Wuhan University, China
| | - Xiaoling Wang
- Department of Ophthalmology, Renmin Hospital of Wuhan University, China
| | - Shiqi Tang
- Physical Examination Center, Renmin Hospital of Wuhan University, China
| | - Lijuan Xu
- Physical Examination Center, Renmin Hospital of Wuhan University, China
| | - Changzheng Chen
- Department of Ophthalmology, Renmin Hospital of Wuhan University, China
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