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Vu TV, Alongi AM, Chow C, Brinster CJ, Brown RE, Fuhrman G, Money SR. The Surgeon's Risk of SARS-CoV-2 Infection During the Initial Peak of the COVID-19 Pandemic in New Orleans. Am Surg 2023; 89:4872-4873. [PMID: 33847533 DOI: 10.1177/00031348211011090] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Surgeons who care for patients with active SARS-CoV-2 infection represent a unique population of health care providers whose risk of infection has not been elucidated. The objective of this study was to examine SARS-CoV-2 seroprevalence among surgeons who cared for patients with active SARS-CoV-2 infection compared to other employees within our health care system and also the general public of New Orleans. 105 surgeons at our facilities provided direct surgical care to patients with active SARS-CoV-2 infection and underwent voluntary antibody testing. 2/105 (1.9% CI .2%-6.7%) tested positive for SARS-CoV-2 antibodies. 13 343 hospital employees underwent antibody testing and 1066/13 343 (8.0% CI 7.5%-8.5%) tested positive (1.9% vs. 8.0%; P = .03). We saw a significantly lower SARS-CoV-2 seroprevalence among surgeons who directly cared for infected patients versus other hospital employees. When compared to community seroprevalence (6.9% CI 6.0%-8.0%), seroprevalence among our surgeons is also significantly lower (1.9% vs. 6.9%; P = .04).
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Affiliation(s)
- Tung V Vu
- Department of Surgery, Ochsner Clinic Foundation, New Orleans, LA, USA
| | - Ashlyn M Alongi
- Department of Surgery, Ochsner Clinic Foundation, New Orleans, LA, USA
| | - Christopher Chow
- Department of Surgery, Ochsner Clinic Foundation, New Orleans, LA, USA
| | | | - Russell E Brown
- Department of Surgery, Ochsner Clinic Foundation, New Orleans, LA, USA
| | - George Fuhrman
- Department of Surgery, Ochsner Clinic Foundation, New Orleans, LA, USA
| | - Samuel R Money
- Department of Surgery, Ochsner Clinic Foundation, New Orleans, LA, USA
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2
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Jensen S, Traugott M, Ramazanova D, Haslacher H, Mucher P, Perkmann T, Jeleff M, Kutalek R, Wenisch C, Crevenna R, Jordakieva G. SARS-CoV-2 infections in "less visible" hospital staff: The roles and safety of environmental services and allied health professionals. J Infect Public Health 2023; 16:1379-1385. [PMID: 37437431 PMCID: PMC10238113 DOI: 10.1016/j.jiph.2023.05.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 04/18/2023] [Accepted: 05/31/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND During the early SARS-CoV-2 pandemic, all healthcare workers had specific and essential functions. However, environmental services (e.g., cleaning staff) and allied health professionals (e.g., physiotherapists) are often less recognised inpatient care. The aim of our study was to evaluate SARS-CoV-2-infection rates and describe risk factors relevant to workplace transmission and occupational safety amongst healthcare workers in COVID-19 hospitals before the introduction of SARS-CoV-2-specific vaccines. METHODS This cross-sectional study (from May 2020 to March 2021, standardised WHO early-investigation protocol) is evaluating workplace or health-related data, COVID-19-patient proximity, personal protective equipment (PPE) use, and adherence to infection prevention and control (IPC) measures, anti-SARS-CoV-2-antibody status, and transmission pathways. RESULTS Out of n = 221 HCW (n = 189 cleaning/service staff; n = 32 allied health professionals), n = 17 (7.7 %) were seropositive. While even SARS-CoV-2-naïve HCW reported SARS-CoV-2-related symptoms, airway symptoms, loss of smell or taste, and appetite were the most specific for a SARS-CoV-2-infection. Adherence to IPC (98.6 %) and recommended PPE use (98.2 %) were high and not associated with seropositivity. In 70.6 %, transmission occurred in private settings; in 23.5 %, at the workplace (by interaction with SARS-CoV-2-positive colleagues [17.6 %] or patient contact [5.9 %]), or remained unclear (one case). CONCLUSIONS Infection rates were higher in all assessed 'less visible' healthcare-worker groups compared to the general population. Our data indicates that, while IPC measures and PPE may have contributed to the prevention of patient-to-healthcare-worker transmissions, infections were commonly acquired outside of work and transmitted between healthcare workers within the hospital. This finding emphasises the importance of ongoing education on transmission prevention and regular infection screenings at work.
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Affiliation(s)
- Sebastian Jensen
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria
| | - Marianna Traugott
- 4th Medical Department, Department of Infectious Diseases and Tropical Medicine, Kaiser-Franz-Josef Hospital, Vienna, Austria
| | - Dariga Ramazanova
- Center for Medical Statistics, Informatics and Intelligent Systems CeMSIIS, Medical University of Vienna, Vienna, Austria
| | - Helmuth Haslacher
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Patrick Mucher
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Thomas Perkmann
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Maren Jeleff
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Ruth Kutalek
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Christoph Wenisch
- 4th Medical Department, Department of Infectious Diseases and Tropical Medicine, Kaiser-Franz-Josef Hospital, Vienna, Austria
| | - Richard Crevenna
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria
| | - Galateja Jordakieva
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, Vienna, Austria.
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3
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Abhold J, Wozniak A, Mulcahy J, Walsh S, Zepeda E, Demmer R, Yendell S, Hedberg C, Ulrich A, Wurtz R, Beebe T. Demographic, social, and behavioral correlates of SARS-CoV-2 seropositivity in a representative, population-based study of Minnesota residents. PLoS One 2023; 18:e0279660. [PMID: 37319239 PMCID: PMC10270347 DOI: 10.1371/journal.pone.0279660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Monitoring COVID-19 infection risk in the general population is a public health priority. Few studies have measured seropositivity using representative, probability samples. The present study measured seropositivity in a representative population of Minnesota residents prior to vaccines and assess the characteristics, behaviors, and beliefs of the population at the outset of the pandemic and their association with subsequent infection. METHODS Participants in the Minnesota COVID-19 Antibody Study (MCAS) were recruited from residents of Minnesota who participated in the COVID-19 Household Impact Survey (CIS), a population-based survey that collected data on physical health, mental health, and economic security information between April 20 and June 8 of 2020. This was followed by collection of antibody test results between December 29, 2020 and February 26, 2021. Demographic, behavioral, and attitudinal exposures were assessed for association with the outcome of interest, SARS-CoV-2 seroprevalence, using univariate and multivariate logistic regression. RESULTS Of the 907 potential participants from the CIS, 585 respondents then consented to participate in the antibody testing (64.4% consent rate). Of these, results from 537 test kits were included in the final analytic sample, and 51 participants (9.5%) were seropositive. The overall weighted seroprevalence was calculated to be 11.81% (95% CI, 7.30%-16.32%) at of the time of test collection. In adjusted multivariate logistic regression models, significant associations between seroprevalence and the following were observed; being from 23-64 and 65+ age groups were both associated with higher odds of COVID-19 seropositivity compared to the 18-22 age group (17.8 [1.2-260.1] and 24.7 [1.5-404.4] respectively). When compared to a less than $30k annual income reference group, all higher income groups had significantly lower odds of seropositivity. Reporting practicing a number of 10 (median reported value in sample) or more of 19 potential COVID-19 mitigation factors (e.g. handwashing and mask wearing) was associated with lower odds of seropositivity (0.4 [0.1-0.99]) Finally, the presence of at least one household member in the age range of 6 to 17 years old was associated with higher odds of seropositivity (8.3 [1.2-57.0]). CONCLUSIONS The adjusted odds ratio of SARS-CoV-2 seroprevalence was significantly positively associated with increasing age and having household member(s) in the 6-17 year age group, while increasing income levels and a mitigation score at or above the median were shown to be significantly protective factors.
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Affiliation(s)
- Jordan Abhold
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States of America
| | - Abigail Wozniak
- Opportunity & Inclusive Growth Institute, Federal Reserve Bank of Minneapolis, Minneapolis, MN, United States of America
| | - John Mulcahy
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States of America
| | - Sara Walsh
- Health Sciences, NORC at the University of Chicago, Chicago, IL, United States of America
| | - Evelyn Zepeda
- Health Sciences, NORC at the University of Chicago, Chicago, IL, United States of America
| | - Ryan Demmer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States of America
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Stephanie Yendell
- Health Risk Intervention Unit, Minnesota Department of Health, St. Paul, MN, United States of America
| | - Craig Hedberg
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, United States of America
| | - Angela Ulrich
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, United States of America
- Center for Infectious Disease Research and Policy, Office of the Vice President for Research, University of Minnesota, Minneapolis, MN, United States of America
| | - Rebecca Wurtz
- School of Public Health, University of Minnesota, Minneapolis, MN, United States of America
| | - Timothy Beebe
- School of Public Health, University of Minnesota, Minneapolis, MN, United States of America
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4
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Alghader MRM, Valvi D, de la Hoz RE. Transmission and Risk Factors of COVID-19 among Health Care Workers. Semin Respir Crit Care Med 2023; 44:340-348. [PMID: 37015285 DOI: 10.1055/s-0043-1766118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
Coronavirus disease 2019 (COVID-19) poses a significant occupational risk factor to health care workers (HCWs). As in previous events, this occupational risk amplifies and compounds the adverse impact of the pandemic. We conducted a narrative review summarizing risk factors associated with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) transmission in HCWs. We searched for original observational studies (including case-control, cross-sectional, prospective and retrospective cohorts) using PubMed, Scopus, and Google Scholar. A total of 22 articles were reviewed, including eligible English articles published between April 2020 and May 2022. Job category, work environment, personal protective equipment (PPE) noncompliance, lack of PPE awareness and training, unvaccinated status, and competing community and household exposures were identified as risk factors for SARS-CoV-2 transmission among HCWs. Effective measures to protect HCWs from SARS-CoV-2 need to account for the identified occupational risk factors. Identifying and understanding COVID-19 risk factors among HCWs must be considered a public health priority for policy makers to mitigate occupational and community transmission in current and future epidemics.
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Affiliation(s)
- Majdi R M Alghader
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Damaskini Valvi
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Rafael E de la Hoz
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
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5
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Chou R, Dana T. Major Update: Masks for Prevention of SARS-CoV-2 in Health Care and Community Settings-Final Update of a Living, Rapid Review. Ann Intern Med 2023; 176:827-835. [PMID: 37186920 PMCID: PMC10234287 DOI: 10.7326/m23-0570] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Optimal use of masks for preventing COVID-19 is unclear. PURPOSE To update an evidence synthesis on N95, surgical, and cloth mask effectiveness in community and health care settings for preventing SARS-CoV-2 infection. DATA SOURCES MEDLINE, EMBASE, medRxiv (3 June 2022 to 2 January 2023), and reference lists. STUDY SELECTION Randomized trials of interventions to increase mask use and risk for SARS-CoV-2 infection and observational studies of mask use that controlled for potential confounders. DATA EXTRACTION Two investigators sequentially abstracted study data and rated quality. DATA SYNTHESIS Three randomized trials and 21 observational studies were included. In community settings, mask use may be associated with a small reduced risk for SARS-CoV-2 infection versus no mask use, on the basis of 2 randomized trials and 7 observational studies. In routine patient care settings, surgical masks and N95 respirators may be associated with similar risk for SARS-CoV-2 infection, on the basis of 1 new randomized trial with some imprecision and 4 observational studies. Evidence from observational studies was insufficient to evaluate other mask comparisons due to methodological limitations and inconsistency. LIMITATION Few randomized trials, studies had methodological limitations and some imprecision, suboptimal adherence and pragmatic aspects of randomized trials potentially attenuated benefits, very limited evidence on harms, uncertain applicability to Omicron variant predominant era, meta-analysis not done due to heterogeneity, unable to formally assess for publication bias, and restricted to English-language articles. CONCLUSION Updated evidence suggests that masks may be associated with a small reduction in risk for SARS-CoV-2 infection in community settings. Surgical masks and N95 respirators may be associated with similar infection risk in routine patient care settings, but a beneficial effect of N95 respirators cannot be ruled out. PRIMARY FUNDING SOURCE None.
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Affiliation(s)
- Roger Chou
- Pacific Northwest Evidence-based Practice Center and the Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon (R.C., T.D.)
| | - Tracy Dana
- Pacific Northwest Evidence-based Practice Center and the Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon (R.C., T.D.)
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6
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Groenewold MR, Billock R, Free H, Burrer SL, Sweeney MH, Wong J, Lavender A, Argueta G, Crawford HL, Erukunuakpor K, Karlsson ND, Armenti K, Thomas H, Gaetz K, Dang G, Harduar-Morano L, Modji K, Luckhaupt SE. Excess risk of SARS-CoV-2 infection among in-person nonhealthcare workers in six states, September 2020-June 2021. Am J Ind Med 2023. [PMID: 37153939 DOI: 10.1002/ajim.23487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 04/19/2023] [Accepted: 04/24/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND While the occupational risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection for healthcare personnel in the United States has been relatively well characterized, less information is available on the occupational risk for workers employed in other settings. Even fewer studies have attempted to compare risks across occupations and industries. Using differential proportionate distribution as an approximation, we evaluated excess risk of SARS-CoV-2 infection by occupation and industry among non-healthcare workers in six states. METHODS We analyzed data on occupation and industry of employment from a six-state callback survey of adult non-healthcare workers with confirmed SARS-CoV-2 infection and population-based reference data on employment patterns, adjusted for the effect of telework, from the U.S. Bureau of Labor Statistics. We estimated the differential proportionate distribution of SARS-CoV-2 infection by occupation and industry using the proportionate morbidity ratio (PMR). RESULTS Among a sample of 1111 workers with confirmed SARS-CoV-2 infection, significantly higher-than-expected proportions of workers were employed in service occupations (PMR 1.3, 99% confidence interval [CI] 1.1-1.5) and in the transportation and utilities (PMR 1.4, 99% CI 1.1-1.8) and leisure and hospitality industries (PMR 1.5, 99% CI 1.2-1.9). CONCLUSIONS We found evidence of significant differences in the proportionate distribution of SARS-CoV-2 infection by occupation and industry among respondents in a multistate, population-based survey, highlighting the excess risk of SARS-CoV-2 infection borne by some worker populations, particularly those whose jobs require frequent or prolonged close contact with other people.
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Affiliation(s)
- Matthew R Groenewold
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio, USA
| | - Rachael Billock
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio, USA
| | - Hannah Free
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio, USA
| | - Sherry L Burrer
- Emergency Preparedness and Response Office, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Marie Haring Sweeney
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio, USA
| | - Jessie Wong
- California Department of Public Health, Sacramento, California, USA
| | | | | | | | | | - Nicole D Karlsson
- New Hampshire Department of Health and Human Services, Concord, New Hampshire, USA
| | - Karla Armenti
- University of New Hampshire, Durham, New Hampshire, USA
| | - Hannah Thomas
- New Hampshire Department of Health and Human Services, Concord, New Hampshire, USA
| | - Kim Gaetz
- North Carolina Department of Health and Human Services, Raleigh, North Carolina, USA
| | - Gialana Dang
- North Carolina Department of Health and Human Services, Raleigh, North Carolina, USA
- Western States Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Denver, Colorado, USA
| | - Laurel Harduar-Morano
- Pennsylvania Department of Health, Harrisburg, Pennsylvania, USA
- Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Komi Modji
- Wisconsin Department of Health Services, Division of Public Health, Madison, Wisconsin, USA
| | - Sara E Luckhaupt
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio, USA
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7
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Russell A, Jenkins JL, Zhang A, Wilson LM, Bass EB, Hsu EB. A review of infectious disease epidemiology in emergency medical service clinicians. Am J Infect Control 2022:S0196-6553(22)00846-X. [PMID: 36509183 DOI: 10.1016/j.ajic.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 12/02/2022] [Accepted: 12/03/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND The emergency medical service (EMS) workforce is at high risk of occupationally-acquired infections. This review synthesized existing literature on the prevalence, incidence, and severity of infections in the EMS workforce. METHODS We searched PubMed, Embase, CINAHL, and SCOPUS from January 1, 2006 to March 15, 2022 for studies in the US that involved EMS clinician or firefighter populations and reported 1 or more health outcomes related to occupationally-acquired infections. RESULTS Of the 25 studies that met the inclusion criteria, most focused on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, with prevalence rates ranging from 1.1% to 36.2% (median 6.7%). The prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in 4 studies ranged from 1.9% to 6.4%, and the prevalence of Hepatitis C in 1 study was 1.3%. Few studies reported incidence rates. The prevalence or incidence of these infections generally did not differ by age or gender, but 4 studies reported differences by race or ethnicity. In the 4 studies that compared infection rates between EMS clinicians and firefighters, EMS clinicians had a higher chance of hospitalization or death from SAR-CoV-2 (odds ratio 4.23), a higher prevalence of Hepatitis C in another study (odds ratio 1.74), and no significant difference in MRSA colonization in a separate study. CONCLUSIONS More research is needed to better characterize the incidence and severity of occupationally-acquired infections in the EMS workforce.
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Affiliation(s)
- Anna Russell
- Department of Health Policy and Management, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - J Lee Jenkins
- Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Allen Zhang
- Department of Health Policy and Management, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Lisa M Wilson
- Department of Health Policy and Management, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.
| | - Eric B Bass
- Department of Health Policy and Management, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; Department of Epidemiology, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Edbert B Hsu
- Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
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8
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Standiford TC, Farlow JL, Brenner MJ, Blank R, Rajajee V, Baldwin NR, Chinn SB, Cusac JA, De Cardenas J, Malloy KM, McDonough KL, Napolitano LM, Sjoding MW, Stoneman EK, Washer LL, Park PK. COVID-19 Transmission to Health Care Personnel During Tracheostomy Under a Multidisciplinary Safety Protocol. Am J Crit Care 2022; 31:452-460. [PMID: 35953441 DOI: 10.4037/ajcc2022538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Tracheostomies are highly aerosolizing procedures yet are often indicated in patients with COVID-19 who require prolonged intubation. Robust investigations of the safety of tracheostomy protocols and provider adherence and evaluations are limited. OBJECTIVES To determine the rate of COVID-19 infection of health care personnel involved in COVID-19 tracheostomies under a multidisciplinary safety protocol and to investigate health care personnel's attitudes and suggested areas for improvement concerning the protocol. METHODS All health care personnel involved in tracheostomies in COVID-19-positive patients from April 9 through July 11, 2020, were sent a 22-item electronic survey. RESULTS Among 107 health care personnel (80.5%) who responded to the survey, 5 reported a positive COVID-19 test result (n = 2) or symptoms of COVID-19 (n = 3) within 21 days of the tracheostomy. Respondents reported 100% adherence to use of adequate personal protective equipment. Most (91%) were familiar with the tracheostomy protocol and felt safe (92%) while performing tracheostomy. Suggested improvements included creating dedicated tracheostomy teams and increasing provider choices surrounding personal protective equipment. CONCLUSIONS Multidisciplinary engagement in the development and implementation of a COVID-19 tracheostomy protocol is associated with acceptable safety for all members of the care team.
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Affiliation(s)
- Taylor C Standiford
- Taylor C. Standiford is a second-year resident, Department of Otolaryngology-Head & Neck Surgery, University of California, San Francisco
| | - Janice L Farlow
- Janice L. Farlow is a head and neck surgical oncology fellow, Department of Otolaryngology-Head & Neck Surgery, The Ohio State University, Columbus
| | - Michael J Brenner
- Michael J. Brenner is an associate professor, Department of Otolaryngology-Head & Neck Surgery, University of Michigan, Ann Arbor
| | - Ross Blank
- Ross Blank is an assistant professor, Department of Anesthesiology, University of Michigan, Ann Arbor
| | - Venkatakrishna Rajajee
- Venkata-krishna Rajajee is a professor, Department of Neurosurgery, University of Michigan, Ann Arbor
| | - Noel R Baldwin
- Noel R. Baldwin is a registered nurse, Critical Care Medicine Unit, University of Michigan, Ann Arbor
| | - Steven B Chinn
- Steven B. Chinn is an assistant professor, Department of Otolaryngology-Head & Neck Surgery, University of Michigan, Ann Arbor
| | - Jessica A Cusac
- Jessica A. Cusac is a respiratory therapist, clinical specialist, University Hospital/Cardiovascular Center, University of Michigan, Ann Arbor
| | - Jose De Cardenas
- Jose De Cardenas is an associate professor, Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Michigan, Ann Arbor
| | - Kelly M Malloy
- Kelly M. Malloy is an associate professor, Department of Otolaryngology-Head & Neck Surgery, University of Michigan, Ann Arbor
| | - Kelli L McDonough
- Kelli L. McDonough is a clinical research project manager, Department of Surgery, University of Michigan, Ann Arbor
| | - Lena M Napolitano
- Lena M. Napolitano is a professor, Department of Surgery, University of Michigan, Ann Arbor
| | - Michael W Sjoding
- Michael W. Sjoding is an assistant professor, Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Michigan, Ann Arbor
| | - Emily K Stoneman
- Emily K. Stoneman is an associate professor, Division of Infectious Disease, Department of Medicine, University of Michigan, Ann Arbor
| | - Laraine L Washer
- Laraine L. Washer is a professor, Division of Infectious Disease, Department of Medicine, University of Michigan, Ann Arbor
| | - Pauline K Park
- Pauline K. Park is a professor, Department of Surgery, University of Michigan, Ann Arbor
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9
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Bhatia R, Sledge I, Baral S. Missing science: A scoping study of COVID-19 epidemiological data in the United States. PLoS One 2022; 17:e0248793. [PMID: 36223335 PMCID: PMC9555641 DOI: 10.1371/journal.pone.0248793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 09/12/2022] [Indexed: 11/06/2022] Open
Abstract
Systematic approaches to epidemiologic data collection are critical for informing pandemic responses, providing information for the targeting and timing of mitigations, for judging the efficacy and efficiency of alternative response strategies, and for conducting real-world impact assessments. Here, we report on a scoping study to assess the completeness of epidemiological data available for COVID-19 pandemic management in the United States, enumerating authoritative US government estimates of parameters of infectious transmission, infection severity, and disease burden and characterizing the extent and scope of US public health affiliated epidemiological investigations published through November 2021. While we found authoritative estimates for most expected transmission and disease severity parameters, some were lacking, and others had significant uncertainties. Moreover, most transmission parameters were not validated domestically or re-assessed over the course of the pandemic. Publicly available disease surveillance measures did grow appreciably in scope and resolution over time; however, their resolution with regards to specific populations and exposure settings remained limited. We identified 283 published epidemiological reports authored by investigators affiliated with U.S. governmental public health entities. Most reported on descriptive studies. Published analytic studies did not appear to fully respond to knowledge gaps or to provide systematic evidence to support, evaluate or tailor community mitigation strategies. The existence of epidemiological data gaps 18 months after the declaration of the COVID-19 pandemic underscores the need for more timely standardization of data collection practices and for anticipatory research priorities and protocols for emerging infectious disease epidemics.
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Affiliation(s)
- Rajiv Bhatia
- Primary Care and Population Health, Stanford University, Stanford, CA, United States of America
- * E-mail:
| | | | - Stefan Baral
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, United States of America
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10
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Zhang X, Saade E, Noguez JH, Schmotzer C. SARS-CoV-2 Seroprevalence Among First Responders in Northeastern Ohio, 2020. Public Health Rep 2022; 138:140-148. [PMID: 36114657 PMCID: PMC9692179 DOI: 10.1177/00333549221119143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Objectives: First responders, including firefighters, emergency medical technicians (EMTs), paramedics, and law enforcement officers, are working on the front lines to fight the COVID-19 pandemic and facing an increased risk of infection. This study assessed the seroprevalence of SARS-CoV-2 infection among first responders in northeastern Ohio. Methods: A survey and immunoglobulin G antibody test against SARS-CoV-2 nucleocapsid protein were offered to University Hospitals Health System–affiliated first-responder departments during May to September 2020. The survey contained questions about demographic characteristics and history of SARS-CoV-2 infection. A total of 3080 first responders with diverse job assignments from more than 400 fire and police departments participated in the study. Results: Of 3080 participants, 73 (2.4%) were seropositive and 26 (0.8%) had previously positive real-time polymerase chain reaction results. Asymptomatic infection accounted for 46.6% (34 of 73) of seropositivity. By occupation, rates of seropositivity were highest among administration/support staff (3.8%), followed by paramedics (3.0%), EMTs (2.6%), firefighters (2.2%), and law enforcement officers (0.8%). Work-associated exposure rates to COVID-19 patients were: paramedics (48.2%), firefighters (37.1%), EMTs (32.3%), law enforcement officers (7.7%), and administration/support staff (4.4%). Self-reported community exposure was positively correlated with self-reported work-associated exposure rate (correlation coefficient = 0.99). Neither self-reported community nor work-associated exposure was correlated with SARS-CoV-2 seroprevalence. We found no significant difference in seroprevalence among sex/gender or age groups; however, Black participants had a higher positivity rate than participants of other racial groups despite reporting lower exposure. Conclusions: Despite the high work-associated exposure rate to SARS-CoV-2 infection, first responders with various roles demonstrated seroprevalence no higher than their administrative/supportive colleagues, which suggests infection control measures are effective in preventing work-related infection.
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Affiliation(s)
- Xiaochun Zhang
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
- Case Western Reserve University, School of Medicine, Cleveland, OH, USA
| | - Elie Saade
- Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
- Case Western Reserve University, School of Medicine, Cleveland, OH, USA
| | - Jaime H. Noguez
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
- Case Western Reserve University, School of Medicine, Cleveland, OH, USA
| | - Christine Schmotzer
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
- Case Western Reserve University, School of Medicine, Cleveland, OH, USA
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11
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Pray IW, Grajewski B, Morris C, Modji K, DeJonge P, McCoy K, Tomasallo C, DeSalvo T, Westergaard RP, Meiman J. Measuring Work-related Risk of Coronavirus Disease 2019 (COVID-19): Comparison of COVID-19 Incidence by Occupation and Industry-Wisconsin, September 2020 to May 2021. Clin Infect Dis 2022; 76:e163-e171. [PMID: 35924351 PMCID: PMC9384654 DOI: 10.1093/cid/ciac586] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/01/2022] [Accepted: 07/13/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Work-related exposures play an important role in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission, yet few studies have compared SARS-CoV-2 expsoure risk across occupations and industries. METHODS During September 2020 to May 2021, the Wisconsin Department of Health Services collected occupation and industry data as part of routine coronavirus disease 2019 (COVID-19) case investigations. Adults aged 18-64 years with confirmed or probable COVID-19 in Wisconsin were assigned standardized occupation and industry codes. Cumulative incidence rates were weighted for non-response and calculated using full-time equivalent (FTE) workforce denominators from the 2020 American Community Survey. RESULTS An estimated 11.6% of workers (347 013 of 2.98 million) in Wisconsin, ages 18-64 years, had COVID-19 from September 2020 to May 2021. The highest incidence by occupation (per 100 FTE) occurred among personal care and services workers (22.1), healthcare practitioners and support staff (20.7), and protective services workers (20.7). High-risk sub-groups included nursing assistants and personal care aides (28.8), childcare workers (25.8), food and beverage service workers (25.3), personal appearance workers (24.4), and law enforcement workers (24.1). By industry, incidence was highest in healthcare (18.6); the highest risk sub-sectors were nursing care facilities (30.5) and warehousing (28.5). CONCLUSIONS This analysis represents one of the most complete examinations to date of COVID-19 incidence by occupation and industry. Our approach demonstrates the value of standardized occupational data collection by public health and may be a model for improved occupational surveillance elsewhere. Workers at higher risk of SARS-CoV-2 exposure may benefit from targeted workplace COVID-19 vaccination and mitigation efforts.
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Affiliation(s)
- Ian W Pray
- Corresponding author: Ian Pray, Centers for Disease Control and Prevention, Wisconsin Department of Health Services, 1 W. Wilson St, Madison, WI 53703 ()
| | | | - Collin Morris
- Wisconsin Department of Health Services, Madison, Wisconsin,School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Komi Modji
- Wisconsin Department of Health Services, Madison, Wisconsin,School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Peter DeJonge
- Wisconsin Department of Health Services, Madison, Wisconsin,Epidemic Intelligence Service, CDC
| | - Katherine McCoy
- Wisconsin Department of Health Services, Madison, Wisconsin,School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Carrie Tomasallo
- Wisconsin Department of Health Services, Madison, Wisconsin,School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Traci DeSalvo
- Wisconsin Department of Health Services, Madison, Wisconsin
| | - Ryan P Westergaard
- Wisconsin Department of Health Services, Madison, Wisconsin,School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
| | - Jonathan Meiman
- Wisconsin Department of Health Services, Madison, Wisconsin,School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin
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12
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Azami M, Moradi Y, Moradkhani A, Aghaei A. SARS-CoV-2 seroprevalence around the world: an updated systematic review and meta-analysis. Eur J Med Res 2022; 27:81. [PMID: 35655237 PMCID: PMC9160514 DOI: 10.1186/s40001-022-00710-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/16/2022] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Covid-19 has been one of the major concerns around the world in the last 2 years. One of the challenges of this disease has been to determine its prevalence. Conflicting results of the serology test in Covid explored the need for an updated meta-analysis on this issue. Thus, this systematic review aimed to estimate the prevalence of global SARS-CoV-2 serology in different populations and geographical areas. METHODS To identify studies evaluating the seroprevalence of SARS-CoV-2, a comprehensive literature search was performed from international databases, including Medline (PubMed), Web of Sciences, Scopus, EMBASE, and CINHAL. RESULTS In this meta-analysis, the results showed that SARS-CoV-2 seroprevalence is between 3 and 15% worldwide. In Eastern Mediterranean, the pooled estimate of seroprevalence SARS-CoV-2 was 15% (CI 95% 5-29%), and in Africa, the pooled estimate was 6% (CI 95% 1-13%). In America, the pooled estimate was 8% (CI 95% 6-11%), and in Europe, the pooled estimate was 5% (CI 95% 4-6%). Also the last region, Western Pacific, the pooled estimate was 3% (CI 95% 2-4%). Besides, we analyzed three of these areas separately. This analysis estimated the prevalence in subgroups such as study population, diagnostic methods, sampling methods, time, perspective, and type of the study. CONCLUSION The present meta-analysis showed that the seroprevalence of SARS-CoV-2 has been between 3 and 15% worldwide. Even considering the low estimate of this rate and the increasing vaccination in the world, many people are still susceptible to SARS-CoV-2.
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Affiliation(s)
- Mobin Azami
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Yousef Moradi
- Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Science, Sanandaj, Iran
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Asra Moradkhani
- Student Research Committee, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Abbas Aghaei
- Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Science, Sanandaj, Iran.
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
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13
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Kunstler B, Newton S, Hill H, Ferguson J, Hore P, Mitchell BG, Dempsey K, Stewardson AJ, Friedman D, Cole K, Sim MR, Ferguson B, Burns P, King N, McGloughlin S, Dicks M, McCarthy S, Tam B, Hazelton B, McGurgan C, McDonald S, Turner T. P2/N95 respirators & surgical masks to prevent SARS-CoV-2 infection: Effectiveness & adverse effects. Infect Dis Health 2022; 27:81-95. [PMID: 35151628 PMCID: PMC8769935 DOI: 10.1016/j.idh.2022.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/03/2022] [Accepted: 01/05/2022] [Indexed: 12/19/2022]
Abstract
BACKGROUND Millions of people have acquired and died from SARS-CoV-2 infection during the COVID-19 pandemic. Healthcare workers (HCWs) are required to wear personal protective equipment (PPE), including surgical masks and P2/N95 respirators, to prevent infection while treating patients. However, the comparative effectiveness of respirators and masks in preventing SARS-CoV-2 infection and the likelihood of experiencing adverse events (AEs) with wear are unclear. METHODS Searches were carried out in PubMed, Europe PMC and the Cochrane COVID-19 Study Register to 14 June 2021. A systematic review of comparative epidemiological studies examining SARS-CoV-2 infection or AE incidence in HCWs wearing P2/N95 (or equivalent) respirators and surgical masks was performed. Article screening, risk of bias assessment and data extraction were duplicated. Meta-analysis of extracted data was carried out in RevMan. RESULTS Twenty-one studies were included, with most having high risk of bias. There was no statistically significant difference in respirator or surgical mask effectiveness in preventing SARS-CoV-2 infection (OR 0.85, [95%CI 0.72, 1.01]). Healthcare workers experienced significantly more headaches (OR 2.62, [95%CI 1.18, 5.81]), respiratory distress (OR 4.21, [95%CI 1.46, 12.13]), facial irritation (OR 1.80, [95%CI 1.03, 3.14]) and pressure-related injuries (OR 4.39, [95%CI 2.37, 8.15]) when wearing respirators compared to surgical masks. CONCLUSION The existing epidemiological evidence does not enable definitive assessment of the effectiveness of respirators compared to surgical masks in preventing infection. Healthcare workers wearing respirators may be more likely to experience AEs. Effective mitigation strategies are important to ensure the uptake and correct use of respirators by HCWs.
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Affiliation(s)
- Breanne Kunstler
- BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, 8 Scenic Boulevard, Clayton, Melbourne, VIC, 3800, Australia.
| | - Skye Newton
- Adelaide Health Technology Assessment (AHTA), School of Public Health, University of Adelaide, Australia
| | - Hayley Hill
- Adelaide Health Technology Assessment (AHTA), School of Public Health, University of Adelaide, Australia
| | - John Ferguson
- Division of Medicine, John Hunter Hospital, Newcastle Regional Mail Centre, NSW, 2310, Australia
| | - Phillipa Hore
- Department of Anaesthesia and Acute Pain Medicine, St Vincent's Hospital, Victoria Parade, Fitzroy, VIC, 3065, Australia
| | - Brett G. Mitchell
- The University of Newcastle, School of Nursing and Midwifery, Level 9, 77a Holden St, Gosford Hospital, Gosford, NSW, Australia, 2250
| | - Kathy Dempsey
- The Clinical Excellence Commission, 1 Reserve Road, St Leonards, NSW, Australia, 2065
| | - Andrew J. Stewardson
- Department of Infectious Diseases, The Alfred and Central Clinical School, Monash University, 85 Commercial Rd, Melbourne, VIC, Australia, 3004
| | - Deborah Friedman
- Deputy Chief Health Officer, Victorian Department of Health Melbourne, VIC, Australia, 3004
| | - Kate Cole
- Cole Health Pty Ltd, Balmain, NSW, Australia, 2041
| | - Malcolm R. Sim
- Monash Centre for Occupational & Environmental Health (MonCOEH), School of Public Health & Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, 553 St Kilda Rd, Melbourne, VIC, Australia, 3004
| | - Bridget Ferguson
- Central Queensland University, School of Nursing, Midwifery and Social Sciences; 554-700 Yaamba Rd, Norman Gardens, QLD, 4701, Australia
| | - Penelope Burns
- Academic Unit of General Practice, ANU Medical School, The Australian National University, Building 4, Hospital Road, Garran, ACT, 2605, Australia
| | - Nicole King
- North Shore Private Hospital, 3 Westbourne St, St Leonard's, 2065, Australia
| | - Steven McGloughlin
- Alfred Health and School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, VIC, Australia, 3004
| | - Melanie Dicks
- Ernst & Young, 121 Marcus Clarke Street, Canberra, ACT, Australia, 2601
| | - Sally McCarthy
- Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Barry Tam
- Health Infrastructure NSW, 60 Day Road, Cheltenham, NSW, 2119, Australia
| | - Briony Hazelton
- PathWest Laboratory Medicine, QEII Medical Centre, Hospital Avenue, Nedlands, WA, Australia, 6009
| | - Cherylynn McGurgan
- Royal Melbourne Hospital Emergency Department, 300 Grattan Street, Parkville, VIC, Australia, 3050
| | - Steve McDonald
- Cochrane Australia, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Tari Turner
- Cochrane Australia, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
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14
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Gudipati S, Lee M, Scott M, Yaphe S, Huisting J, Yared N, Brar I, Markowitz N. The seroprevalence of COVID-19 in patients living with HIV in metropolitan Detroit. Int J STD AIDS 2022; 33:554-558. [PMID: 35333100 PMCID: PMC8958285 DOI: 10.1177/09564624221076629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background COVID-19, a novel respiratory illness caused by SARS-CoV-2, has become a global pandemic. As of December 2020, 4.8% of the 941 people living with HIV in our Ryan White clinic have tested polymerase chain reaction positive for SARS-CoV-2. The aim of our study was to estimate the seroprevalence of COVID-19 in our Ryan White people living with HIV, irrespective of known past infection. Methods We conducted a cross-sectional study that recruited people living with HIV in the Ryan White program at Henry Ford Hospital in Detroit, Michigan, from September 2020 through May 2021. All Ryan White patients were offered participation during clinic visits. After informed consent, patients completed a survey, and had blood sampled for SARS-CoV-2 antibody testing. Results Of the 529 individuals who completed the written survey, 504 participants were tested for SARS-CoV-2 antibody and 52 people living with HIV were COVID-19 immunoglobulin (Ig) G positive resulting in a seroprevalence of 10.3%. Among 36 persons with PCR-confirmed COVID-19, 52.8% were IgG negative. Inclusion of PCR positive but IgG-negative people living with HIV yields a COVID-19 infection prevalence of 14.1%. Conclusions These findings suggest that passive public health-based antibody surveillance in people living with HIV significantly underestimates past infection.
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Affiliation(s)
- Smitha Gudipati
- Department of Infectious Disease, 24016Henry Ford Hospital, Detroit, MI, USA
| | - Monica Lee
- Department of Infectious Disease, 24016Henry Ford Hospital, Detroit, MI, USA
| | - Megan Scott
- Department of Infectious Disease, 24016Henry Ford Hospital, Detroit, MI, USA
| | - Sean Yaphe
- Department of Infectious Disease, 24016Henry Ford Hospital, Detroit, MI, USA
| | - Joanne Huisting
- Department of Infectious Disease, 24016Henry Ford Hospital, Detroit, MI, USA
| | - Nicholas Yared
- Department of Infectious Disease, 24016Henry Ford Hospital, Detroit, MI, USA
| | - Indira Brar
- Department of Infectious Disease, 24016Henry Ford Hospital, Detroit, MI, USA
| | - Norman Markowitz
- Department of Infectious Disease, 24016Henry Ford Hospital, Detroit, MI, USA
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15
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Martin CA, Pan D, Melbourne C, Teece L, Aujayeb A, Baggaley RF, Bryant L, Carr S, Gregary B, Gupta A, Guyatt AL, John C, McManus IC, Nazareth J, Nellums LB, Reza R, Simpson S, Tobin MD, Woolf K, Zingwe S, Khunti K, Abrams KR, Gray LJ, Pareek M. Risk factors associated with SARS-CoV-2 infection in a multiethnic cohort of United Kingdom healthcare workers (UK-REACH): A cross-sectional analysis. PLoS Med 2022; 19:e1004015. [PMID: 35617423 PMCID: PMC9187071 DOI: 10.1371/journal.pmed.1004015] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 06/10/2022] [Accepted: 05/09/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Healthcare workers (HCWs), particularly those from ethnic minority groups, have been shown to be at disproportionately higher risk of infection with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) compared to the general population. However, there is insufficient evidence on how demographic and occupational factors influence infection risk among ethnic minority HCWs. METHODS AND FINDINGS We conducted a cross-sectional analysis using data from the baseline questionnaire of the United Kingdom Research study into Ethnicity and Coronavirus Disease 2019 (COVID-19) Outcomes in Healthcare workers (UK-REACH) cohort study, administered between December 2020 and March 2021. We used logistic regression to examine associations of demographic, household, and occupational risk factors with SARS-CoV-2 infection (defined by polymerase chain reaction (PCR), serology, or suspected COVID-19) in a diverse group of HCWs. The primary exposure of interest was self-reported ethnicity. Among 10,772 HCWs who worked during the first UK national lockdown in March 2020, the median age was 45 (interquartile range [IQR] 35 to 54), 75.1% were female and 29.6% were from ethnic minority groups. A total of 2,496 (23.2%) reported previous SARS-CoV-2 infection. The fully adjusted model contained the following dependent variables: demographic factors (age, sex, ethnicity, migration status, deprivation, religiosity), household factors (living with key workers, shared spaces in accommodation, number of people in household), health factors (presence/absence of diabetes or immunosuppression, smoking history, shielding status, SARS-CoV-2 vaccination status), the extent of social mixing outside of the household, and occupational factors (job role, the area in which a participant worked, use of public transport to work, exposure to confirmed suspected COVID-19 patients, personal protective equipment [PPE] access, aerosol generating procedure exposure, night shift pattern, and the UK region of workplace). After adjustment, demographic and household factors associated with increased odds of infection included younger age, living with other key workers, and higher religiosity. Important occupational risk factors associated with increased odds of infection included attending to a higher number of COVID-19 positive patients (aOR 2.59, 95% CI 2.11 to 3.18 for ≥21 patients per week versus none), working in a nursing or midwifery role (1.30, 1.11 to 1.53, compared to doctors), reporting a lack of access to PPE (1.29, 1.17 to 1.43), and working in an ambulance (2.00, 1.56 to 2.58) or hospital inpatient setting (1.55, 1.38 to 1.75). Those who worked in intensive care units were less likely to have been infected (0.76, 0.64 to 0.92) than those who did not. Black HCWs were more likely to have been infected than their White colleagues, an effect which attenuated after adjustment for other known risk factors. This study is limited by self-selection bias and the cross sectional nature of the study means we cannot infer the direction of causality. CONCLUSIONS We identified key sociodemographic and occupational risk factors associated with SARS-CoV-2 infection among UK HCWs, and have determined factors that might contribute to a disproportionate odds of infection in HCWs from Black ethnic groups. These findings demonstrate the importance of social and occupational factors in driving ethnic disparities in COVID-19 outcomes, and should inform policies, including targeted vaccination strategies and risk assessments aimed at protecting HCWs in future waves of the COVID-19 pandemic. TRIAL REGISTRATION The study was prospectively registered at ISRCTN (reference number: ISRCTN11811602).
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Affiliation(s)
- Christopher A. Martin
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Daniel Pan
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Carl Melbourne
- Genetic Epidemiology Research Group, Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Lucy Teece
- Biostatistics Research Group, Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Avinash Aujayeb
- Respiratory Department, Northumbria Specialist Emergency Care Hospital, United Kingdom
| | - Rebecca F. Baggaley
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom
| | - Luke Bryant
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom
| | - Sue Carr
- Department of Nephrology, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
- General Medical Council, London, United Kingdom
| | - Bindu Gregary
- Lancashire Clinical Research Facility, Royal Preston Hospital, United Kingdom
| | - Amit Gupta
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - Anna L. Guyatt
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Catherine John
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - I Chris McManus
- University College London Medical School, London, United Kingdom
| | - Joshua Nazareth
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - Laura B. Nellums
- Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Rubina Reza
- Centre for Research & Development, Derbyshire Healthcare NHS Foundation Trust, Derby, United Kingdom
| | - Sandra Simpson
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, United Kingdom
| | - Martin D. Tobin
- Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Katherine Woolf
- University College London Medical School, London, United Kingdom
| | - Stephen Zingwe
- Research and Development Department, Berkshire Healthcare NHS Foundation Trust, Bracknell, United Kingdom
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, United Kingdom
| | - Keith R. Abrams
- Department of Statistics, University of Warwick, United Kingdom
| | - Laura J. Gray
- Biostatistics Research Group, Department of Health Sciences, University of Leicester, Leicester, United Kingdom
| | - Manish Pareek
- Department of Respiratory Sciences, University of Leicester, Leicester, United Kingdom
- Department of Infection and HIV Medicine, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
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Carazo S, Laliberté D, Villeneuve J, Martin R, Deshaies P, Denis G, Adib G, Tissot F, Dionne M, De Serres G. Characterization and evolution of infection control practices among severe acute respiratory coronavirus virus 2 (SARS-CoV-2)-infected healthcare workers in acute-care hospitals and long-term care facilities in Québec, Canada, Spring 2020. Infect Control Hosp Epidemiol 2022; 43:481-489. [PMID: 33853702 PMCID: PMC8111200 DOI: 10.1017/ice.2021.160] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/18/2021] [Accepted: 03/12/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES In this study, we aimed to (1) estimate the severe acute respiratory coronavirus 2 (SARS-CoV-2) infection rate and the secondary attack rate among healthcare workers (HCWs) in Québec, the most affected province of Canada during the first wave; (2) describe the evolution of work-related exposures and infection prevention and control (IPC) practices in infected HCWs; and (3) compare the exposures and practices between acute-care hospitals (ACHs) and long-term care facilities (LTCFs). DESIGN Survey of cases. PARTICIPANTS The study included Québec HCWs from private and public institutions with laboratory-confirmed coronavirus disease 2019 (COVID-19) diagnosed between March 1 and June 14, 2020. HCWs aged ≥18 years who worked during the exposure period and survived their illness were eligible for the survey. METHODS After obtaining consent, 4,542 HCWs completed a standardized questionnaire. COVID-19 rates and proportions of exposures and practices were estimated and compared between ACHs and LTCFs. RESULTS HCWs represented 13,726 (25%) of 54,005 reported COVID-19 cases in Québec and had an 11-times greater rate of COVID-19 than non-HCWs. Their secondary household attack rate was 30%. Most affected occupations were healthcare support workers, nurses and nurse assistants working in LTCFs (45%) and ACHs (30%). Compared to ACHs, HCWs in LTCFs had less training, higher staff mobility between working sites, similar PPE use, and better self-reported compliance with at-work physical distancing. Suboptimal IPC practices declined over time but were still present at the end of the first wave. CONCLUSION Québec HCWs and their families were severely affected during the first wave of COVID-19. Insufficient pandemic preparedness and suboptimal IPC practices likely contributed to high transmission in both LTCFs and ACHs.
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Affiliation(s)
- Sara Carazo
- CHU de Québec-Université Laval Research Center, Québec, Québec, Canada
| | - Denis Laliberté
- Department of Social and Preventive Medicine, Laval University, Québec, Québec, Canada
- CIUSSS de la Capitale-Nationale, Québec, Québec, Canada
| | - Jasmin Villeneuve
- Institut National de Santé Publique du Québec, Québec, Québec, Canada
| | - Richard Martin
- Institut National de Santé Publique du Québec, Québec, Québec, Canada
| | | | - Geoffroy Denis
- CIUSSS Centre Sud de Montréal, Montreal, Québec, Canada
- McGill University, Montreal, Québec, Canada
| | - Georges Adib
- Institut National de Santé Publique du Québec, Québec, Québec, Canada
| | - France Tissot
- Institut National de Santé Publique du Québec, Québec, Québec, Canada
| | - Marc Dionne
- CHU de Québec-Université Laval Research Center, Québec, Québec, Canada
| | - Gaston De Serres
- CHU de Québec-Université Laval Research Center, Québec, Québec, Canada
- Department of Social and Preventive Medicine, Laval University, Québec, Québec, Canada
- Institut National de Santé Publique du Québec, Québec, Québec, Canada
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17
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Dávila-Conn V, Soto-Nava M, Caro-Vega YN, Paz-Juárez HE, García-Esparza P, Tapia-Trejo D, Pérez-García M, Belaunzarán-Zamudio PF, Reyes-Terán G, Sierra-Madero JG, Galindo-Fraga A, Ávila-Ríos S. Seroepidemiology of SARS-CoV-2 in healthcare personnel working at the largest tertiary COVID-19 referral hospitals in Mexico City. PLoS One 2022; 17:e0264964. [PMID: 35298500 PMCID: PMC8929624 DOI: 10.1371/journal.pone.0264964] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 02/20/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction We performed a longitudinal SARS-CoV-2 seroepidemiological study in healthcare personnel of the two largest tertiary COVID-19 referral hospitals in Mexico City. Methods All healthcare personnel, including staff physicians, physicians in training, nurses, laboratory technicians, researchers, students, housekeeping, maintenance, security, and administrative staff were invited to voluntarily participate, after written informed consent. Participants answered a computer-assisted self-administered interview and donated blood samples for antibody testing every three weeks from October 2020 to June 2021. Results A total of 883 participants (out of 3639 registered employees) contributed with at least one blood sample. The median age was 36 years (interquartile range: 28–46) and 70% were women. The most common occupations were nurse (28%), physician (24%), and administrative staff (22%). Two hundred and ninety participants (32.8%) had a positive-test result in any of the visits, yielding an overall adjusted prevalence of 33.5% for the whole study-period. Two hundred and thirty-five positive tests were identified at the baseline visit (prevalent cases), the remaining 55 positive tests were incident cases. Prevalent cases showed associations with both occupational (institution 2 vs. 1: adjusted odds ratio [aOR] = 2.24, 95% confidence interval [CI]: 1.54–3.25; laboratory technician vs. physician: aOR = 4.38, 95% CI: 1.75–10.93) and community (municipality of residence Xochimilco vs. Tlalpan: aOR = 2.03, 95% CI: 1.09–3.79) risk-factors. The incidence rate was 3.0 cases per 100 person-months. Incident cases were associated with community-acquired risk, due to contact with suspect/confirmed COVID-19 cases (HR = 2.45, 95% CI: 1.21–5.00). Conclusions We observed that between October 2020 and June 2021, healthcare workers of the two largest tertiary COVID-19 referral centers in Mexico City had similar level of exposure to SARS-CoV-2 than the general population. Most variables associated with exposure in this setting pointed toward community rather than occupational risk. Our observations are consistent with successful occupational medicine programs for SARS-CoV-2 infection control in the participating institutions but suggest the need to strengthen mitigation strategies in the community.
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Affiliation(s)
- Vanessa Dávila-Conn
- Centre for Research in Infectious Diseases, National Institute of Respiratory Diseases, Mexico City, Mexico
| | - Maribel Soto-Nava
- Centre for Research in Infectious Diseases, National Institute of Respiratory Diseases, Mexico City, Mexico
| | - Yanink N. Caro-Vega
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Héctor E. Paz-Juárez
- Centre for Research in Infectious Diseases, National Institute of Respiratory Diseases, Mexico City, Mexico
| | - Pedro García-Esparza
- Centre for Research in Infectious Diseases, National Institute of Respiratory Diseases, Mexico City, Mexico
| | - Daniela Tapia-Trejo
- Centre for Research in Infectious Diseases, National Institute of Respiratory Diseases, Mexico City, Mexico
| | - Marissa Pérez-García
- Centre for Research in Infectious Diseases, National Institute of Respiratory Diseases, Mexico City, Mexico
| | | | - Gustavo Reyes-Terán
- Institutos Nacionales de Salud y Hospitales de Alta Especialidad, Secretaría de Salud de México, Mexico City, Mexico
| | - Juan G. Sierra-Madero
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Arturo Galindo-Fraga
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Santiago Ávila-Ríos
- Centre for Research in Infectious Diseases, National Institute of Respiratory Diseases, Mexico City, Mexico
- * E-mail:
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Patterson PD, Mcilvaine QS, Nong L, Liszka MK, Miller RS, Guyette FX, Martin‐Gill C. Masking by health care and public safety workers in non‐patient care areas to mitigate SARS‐CoV‐2 infection: A systematic review. J Am Coll Emerg Physicians Open 2022; 3:e12699. [PMID: 35356376 PMCID: PMC8957376 DOI: 10.1002/emp2.12699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 02/09/2022] [Accepted: 02/17/2022] [Indexed: 11/07/2022] Open
Abstract
Objectives Methods Results Conclusions
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Affiliation(s)
- P. Daniel Patterson
- School of Medicine Department of Emergency Medicine University of Pittsburgh Pittsburgh Pennsylvania USA
- School of Health and Rehabilitation Sciences, Emergency Medicine Program University of Pittsburgh Pittsburgh Pennsylvania USA
| | - Quentin S. Mcilvaine
- School of Medicine Department of Emergency Medicine University of Pittsburgh Pittsburgh Pennsylvania USA
- School of Health and Rehabilitation Sciences, Emergency Medicine Program University of Pittsburgh Pittsburgh Pennsylvania USA
| | - Lily Nong
- School of Medicine Department of Emergency Medicine University of Pittsburgh Pittsburgh Pennsylvania USA
- School of Health and Rehabilitation Sciences, Emergency Medicine Program University of Pittsburgh Pittsburgh Pennsylvania USA
| | - Mary K. Liszka
- School of Medicine Department of Emergency Medicine University of Pittsburgh Pittsburgh Pennsylvania USA
| | - Rebekah S. Miller
- Health Sciences Library System University of Pittsburgh Pittsburgh Pennsylvania USA
| | - Francis X. Guyette
- School of Medicine Department of Emergency Medicine University of Pittsburgh Pittsburgh Pennsylvania USA
| | - Christian Martin‐Gill
- School of Medicine Department of Emergency Medicine University of Pittsburgh Pittsburgh Pennsylvania USA
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19
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Postvaccination SARS-CoV-2 Infections among Healthcare Professionals: A Real World Evidence Study. Vaccines (Basel) 2022; 10:vaccines10040511. [PMID: 35455260 PMCID: PMC9024651 DOI: 10.3390/vaccines10040511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/14/2022] [Accepted: 03/21/2022] [Indexed: 02/05/2023] Open
Abstract
Due to the COVID-19 pandemic, all countries with a global mobilization started to produce and authorize vaccines, prioritizing healthcare professionals (HCPs) to reduce transmission. The aim of this study was to assess post-vaccination infections’ occurrence among HCPs and their correlation with symptom onset. A retrospective cohort study was carried out in the Campania Region from December 2020 to April 2021. Data were retrieved from the Regional Health Information System of the Campania Region (Sinfonia). The study cohort included subjects that had all received at least one vaccine dose. Risk ratios (RRs) adjusted for age and sex (95% confidence intervals) were performed to assess differences in the prevalence between HCPs who tested positive or negative for COVID-19. Univariate and multivariate logistic regression models were used to evaluate the association between symptoms and vaccination status. Findings revealed that HCPs had a lower risk of contracting COVID-19 after receiving at least one vaccine dose, and this risk decreased with age. Furthermore, not having full vaccination coverage may predict a severe/critical evolution of the disease. This study provides a snapshot of the initial state of the Italian vaccination campaign on HCPs. A surveillance approach using Big Data matched to clinical conditions could offer a real analysis in the categorization of subjects most at risk.
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20
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Russell A, Hsu EB, Fenstermacher KZJ, Ricketts EP, Dashler G, Chen A, Shaw-Saliba K, Caturegli PP, Pekosz A, Rothman RE. Characteristics of SARS-CoV-2 Seropositivity among Emergency Department Healthcare Workers at a Tertiary Care Center in Baltimore. Healthcare (Basel) 2022; 10:healthcare10030576. [PMID: 35327055 PMCID: PMC8953704 DOI: 10.3390/healthcare10030576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 03/14/2022] [Accepted: 03/17/2022] [Indexed: 02/01/2023] Open
Abstract
Early in the COVID-19 pandemic (March−July 2020 in Baltimore), emergency department (ED) healthcare workers (HCWs) were considered to be at greater risk of contracting SARS-CoV-2. Limited data existed, however, on the prevalence of SARS-CoV-2 infection and its impact in this workforce population. We enrolled 191 ED HCWs from a tertiary academic center, administered baseline and weekly surveys, and tested them twice (July and December 2020) for serum antibodies against SARS-CoV-2 spike protein. Approximately 6% (11 of 191, 5.8%) of ED HCWs had spike antibodies in July, a prevalence that doubled by December (21 of 174, 12.1%). A positive PCR test was self-reported by 15 of 21 (71%) seropositive and 6 of 153 (4%) seronegative HCWs (p < 0.001). Of the total 27 HCWs who had antibodies and/or were PCR positive, none required hospitalization, 18 (67%) had a self-perceived COVID-19 illness, and 12 of the 18 reported symptoms. The median number of missed workdays was 8.5 (ranging from 2 to 21). While most seropositive ED HCWs who reported symptoms took work absences, none required hospitalization, indicating that COVID-19’s impact on staffing prior to vaccination was not as great as feared.
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Affiliation(s)
- Anna Russell
- Department of Emergency Medicine, School of Medicine, The Johns Hopkins University, Baltimore, MD 21205, USA; (E.B.H.); (K.Z.J.F.); (E.P.R.); (G.D.); (A.C.); (K.S.-S.); (A.P.); (R.E.R.)
- Correspondence:
| | - Edbert B. Hsu
- Department of Emergency Medicine, School of Medicine, The Johns Hopkins University, Baltimore, MD 21205, USA; (E.B.H.); (K.Z.J.F.); (E.P.R.); (G.D.); (A.C.); (K.S.-S.); (A.P.); (R.E.R.)
| | - Katherine Z. J. Fenstermacher
- Department of Emergency Medicine, School of Medicine, The Johns Hopkins University, Baltimore, MD 21205, USA; (E.B.H.); (K.Z.J.F.); (E.P.R.); (G.D.); (A.C.); (K.S.-S.); (A.P.); (R.E.R.)
| | - Erin P. Ricketts
- Department of Emergency Medicine, School of Medicine, The Johns Hopkins University, Baltimore, MD 21205, USA; (E.B.H.); (K.Z.J.F.); (E.P.R.); (G.D.); (A.C.); (K.S.-S.); (A.P.); (R.E.R.)
| | - Gabriella Dashler
- Department of Emergency Medicine, School of Medicine, The Johns Hopkins University, Baltimore, MD 21205, USA; (E.B.H.); (K.Z.J.F.); (E.P.R.); (G.D.); (A.C.); (K.S.-S.); (A.P.); (R.E.R.)
| | - Allison Chen
- Department of Emergency Medicine, School of Medicine, The Johns Hopkins University, Baltimore, MD 21205, USA; (E.B.H.); (K.Z.J.F.); (E.P.R.); (G.D.); (A.C.); (K.S.-S.); (A.P.); (R.E.R.)
| | - Kathryn Shaw-Saliba
- Department of Emergency Medicine, School of Medicine, The Johns Hopkins University, Baltimore, MD 21205, USA; (E.B.H.); (K.Z.J.F.); (E.P.R.); (G.D.); (A.C.); (K.S.-S.); (A.P.); (R.E.R.)
| | - Patrizio P. Caturegli
- Department of Pathology, School of Medicine, The Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Andrew Pekosz
- Department of Emergency Medicine, School of Medicine, The Johns Hopkins University, Baltimore, MD 21205, USA; (E.B.H.); (K.Z.J.F.); (E.P.R.); (G.D.); (A.C.); (K.S.-S.); (A.P.); (R.E.R.)
- Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Richard E. Rothman
- Department of Emergency Medicine, School of Medicine, The Johns Hopkins University, Baltimore, MD 21205, USA; (E.B.H.); (K.Z.J.F.); (E.P.R.); (G.D.); (A.C.); (K.S.-S.); (A.P.); (R.E.R.)
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Rosenstrom ET, Mele J, Ivy JS, Mayorga ME, Patel MD, Lich KH, Johnson K, Delamater P, Keskinocak P, Boyce R, Smith R, Swann JL. Can vaccine prioritization reduce disparities in COVID-19 burden for historically marginalized populations? PNAS NEXUS 2022; 1:pgab004. [PMID: 36712803 PMCID: PMC9801966 DOI: 10.1093/pnasnexus/pgab004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 11/19/2021] [Accepted: 12/17/2021] [Indexed: 02/01/2023]
Abstract
SARS-CoV-2 vaccination strategies were designed to reduce COVID-19 mortality, morbidity, and health inequities. To assess the impact of vaccination strategies on disparities in COVID-19 burden among historically marginalized populations (HMPs), e.g. Black race and Hispanic ethnicity, we used an agent-based simulation model, populated with census-tract data from North Carolina. We projected COVID-19 deaths, hospitalizations, and cases from 2020 July 1 to 2021 December 31, and estimated racial/ethnic disparities in COVID-19 outcomes. We modeled 2-stage vaccination prioritization scenarios applied to sub-groups including essential workers, older adults (65+), adults with high-risk health conditions, HMPs, or people in low-income tracts. Additionally, we estimated the effects of maximal uptake (100% for HMP vs. 100% for everyone), and distribution to only susceptible people. We found strategies prioritizing essential workers, then older adults led to the largest mortality and case reductions compared to no prioritization. Under baseline uptake scenarios, the age-adjusted mortality for HMPs was higher (e.g. 33.3%-34.1% higher for the Black population and 13.3%-17.0% for the Hispanic population) compared to the White population. The burden on HMPs decreased only when uptake was increased to 100% in HMPs; however, the Black population still had the highest relative mortality rate even when targeted distribution strategies were employed. If prioritization schemes were not paired with increased uptake in HMPs, disparities did not improve. The vaccination strategies publicly outlined were insufficient, exacerbating disparities between racial and ethnic groups. Strategies targeted to increase vaccine uptake among HMPs are needed to ensure equitable distribution and minimize disparities in outcomes.
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Affiliation(s)
- Erik T Rosenstrom
- Department of Industrial and Systems Engineering, North Carolina State University, 915 Partners Way, Campus Box 7906, Raleigh, NC 27606, USA
| | - Jessica Mele
- Department of Industrial and Systems Engineering, North Carolina State University, 915 Partners Way, Campus Box 7906, Raleigh, NC 27606, USA
| | - Julie S Ivy
- Department of Industrial and Systems Engineering, North Carolina State University, 915 Partners Way, Campus Box 7906, Raleigh, NC 27606, USA
| | - Maria E Mayorga
- Department of Industrial and Systems Engineering, North Carolina State University, 915 Partners Way, Campus Box 7906, Raleigh, NC 27606, USA
| | - Mehul D Patel
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Kristen Hassmiller Lich
- Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Karl Johnson
- Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Paul Delamater
- Department of Geography, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Pinar Keskinocak
- Department of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Ross Boyce
- Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Raymond Smith
- Department of Engineering, East Carolina University, Greenville, NC 27834, USA
| | - Julie L Swann
- To whom correspondence should be addressed: NC State University; 915 Partners Way; Campus Box 7906, Raleigh, NC 27695. Tel; +(919-515-6423);
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22
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Mulligan K, Berg AH, Eckstein M, Hori A, Rodriguez A, Sobhani K, Toubat O, Sood N. SARS-CoV-2 seroprevalence among firefighters in Los Angeles, California. Occup Environ Med 2022; 79:315-318. [DOI: 10.1136/oemed-2021-107805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 12/20/2021] [Indexed: 11/04/2022]
Abstract
ObjectiveWe estimate the seroprevalence of SARS-CoV-2 antibodies among a sample of firefighters in the Los Angeles (LA), California fire department in October 2020 and compare demographic and contextual factors for seropositivity.MethodsWe conducted a serological survey of firefighters in LA, California, USA, in October 2020. Individuals were classified as seropositive for SARS-CoV-2 if they tested positive for IgG, IgM or both. We compared demographic and contextual factors for seropositivity.ResultsAll firefighters in LA, California, USA were invited to participate in our study, but only roughly 21% participated. Of 713 participants with valid serological data, 8.8% tested positive for SARS-CoV-2 antibodies, and among the 686 with complete survey data 8.9% tested positive for antibodies. Seropositivity was not associated with gender, age or race/ethnicity. Seropositivity was highest among firefighters who reported working in the vicinity of LA International Airport, which had a known outbreak in July 2020.ConclusionsSeroprevalence among firefighters in our sample was 8.8%, however, we lack a full workplace seroprevalence estimate to compare the relative magnitude against general population seroprevalence (15%). Workplace safety protocols, such as access to personal protective equipment and testing, can mitigate increased risk of infection at work, and may have eliminated differences in disease burden by geography and race/ethnicity in our sample.
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23
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Xu Z, Lin CA, Laffidy M, Fowks L. Perpetuating Health Disparities of Minority Groups: The Role of U.S. Newspapers in the COVID-19 Pandemic. RACE AND SOCIAL PROBLEMS 2022; 14:357-368. [PMID: 35079295 PMCID: PMC8777407 DOI: 10.1007/s12552-021-09354-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 06/13/2023]
Abstract
During the COVID-19 pandemic, news media are expected to play a critical role in reducing health disparities. However, we know little about whether and how disparities in COVID-19 have been covered in national and local U.S. newspapers. This study examined whether minority health gained news attention and whether partisan bias affected related coverage in the early stages of the pandemic. Results indicate that minority groups have been underrepresented in COVID-19 news articles. Left-leaning newspapers were more likely to discuss minorities in COVID-19 news than least biased media. Left-leaning and right-leaning newspapers did not differ in the number of articles mentioning racial/ethnic minorities. COVID-19 news exceeded the average U.S. reading comprehension level and require some college education to understand but did not differ in readability levels among partisan newspapers. Left-leaning newspapers used significantly more medical terms and affiliated scientific facts to describe COVID-19 than right-leaning newspapers. Implications include avoiding potential failures in informing the public (especially the racial/ethnic minorities) essential scientific facts about disease prevention and increasing public trust in health news coverage.
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Affiliation(s)
- Zhan Xu
- School of Communication, Northern Arizona University, 700 S. Knoles Dr, Flagstaff, AZ 86011 USA
| | | | - Mary Laffidy
- University of Illinois at Urbana-Champaign, Champaign, IL USA
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24
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Zuñiga M, Lagomarcino AJ, Muñoz S, Alonso AP, Rodriguez MA, O'Ryan ML. A cross sectional study found differential risks for COVID-19 seropositivity amongst health care professionals in Chile. J Clin Epidemiol 2021; 144:72-83. [PMID: 34965480 PMCID: PMC8710239 DOI: 10.1016/j.jclinepi.2021.12.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 11/11/2021] [Accepted: 12/22/2021] [Indexed: 12/29/2022]
Abstract
Objective Health care workers (HCWs) are at increased risk for SARS-CoV-2 infection, however not all face the same risk. We aimed to determine IgG/IgM prevalence and risk factors associated with seropositivity in Chilean HCWs. Study Design and Setting This was a nationwide, cross-sectional study including a questionnaire and COVID-19 lateral flow IgG/IgM antibody testing. All HCWs in the Chilean public health care system were invited to participate following the country's first wave. Results IgG/IgM positivity in 85,529 HCWs was 7.2%, ranging from 1.6% to 12.4% between regions. Additionally, 9.7% HCWs reported a positive PCR of which 47% were seropositive. Overall, 10,863 (12.7%) HCWs were PCR and/or IgG/IgM positive. Factors independently associated with increased odds ratios (ORs) for seropositivity were: working in a hospital, night shifts, contact with Covid-19, using public transport, male gender, age>45, BMI ≥30, and reporting ≥2 symptoms. Stress and/or mental health disorder and smoking were associated with decreased ORs. These factors remained significant when including PCR positive cases in the model. Conclusions HCWs in the hospital were at highest risk for COVID-19, and several independent risk factors for seropositivity and/or PCR positivity were identified.
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Affiliation(s)
- Marcela Zuñiga
- Healthcare Networks Undersecretariat, Ministry of Health, Monjitas 565, Santiago, Chile
| | - Anne J Lagomarcino
- Office of Innovation, Faculty of Medicine, Universidad de Chile, Av. Independencia 1027, Independencia, Santiago, Chile
| | - Sergio Muñoz
- Department of Public Health - CIGES, Faculty of Medicine, Universidad de La Frontera, Claro Solar 115, Temuco, Chile
| | - Alfredo Peña Alonso
- Management Control and Quality Department, Primary Care Division, Healthcare Networks Undersecretariat, Ministry of Health, Monjitas 565, Santiago, Chile
| | - María Andrea Rodriguez
- Computer Science Department, Universidad de Concepción, Edmundo Larenas 219, Concepción, Chile; Millennium Institute of Foundational Research on Data, Campus San Joaquín, Pontificia Universidad Católica de Chile, Vicuña Mackenna 4860, Macul, Chile
| | - Miguel L O'Ryan
- Microbiology and Mycology Program, Institute of Biomedical Sciences, Faculty of Medicine, Universidad de Chile, Av. Independencia 1027, Independencia, Santiago, Chile; Millennium Institute on Immunology and Immunotherapy, Faculty of Medicine, Universidad de Chile, Av. Independencia 1027, Independencia, Santiago, Chile.
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25
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Brousseau N, Morin L, Ouakki M, Savard P, Quach C, Longtin Y, Cheng MP, Carignan A, Dufresne SF, Leduc JM, Lavallée C, Gauthier N, Bestman-Smith J, Arrieta MJ, Ishak M, Lévesque S, Martin P, De Serres G. SARS-CoV-2 seroprevalence in health care workers from 10 hospitals in Quebec, Canada: a cross-sectional study. CMAJ 2021; 193:E1868-E1877. [PMID: 34903591 PMCID: PMC8677578 DOI: 10.1503/cmaj.202783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has disproportionately affected health care workers. We sought to estimate SARS-CoV-2 seroprevalence among hospital health care workers in Quebec, Canada, after the first wave of the pandemic and to explore factors associated with SARS-CoV-2 seropositivity. METHODS Between July 6 and Sept. 24, 2020, we enrolled health care workers from 10 hospitals, including 8 from a region with a high incidence of COVID-19 (the Montréal area) and 2 from low-incidence regions of Quebec. Eligible health care workers were physicians, nurses, orderlies and cleaning staff working in 4 types of care units (emergency department, intensive care unit, COVID-19 inpatient unit and non-COVID-19 inpatient unit). Participants completed a questionnaire and underwent SARS-CoV-2 serology testing. We identified factors independently associated with higher seroprevalence. RESULTS Among 2056 enrolled health care workers, 241 (11.7%) had positive SARS-CoV-2 serology. Of these, 171 (71.0%) had been previously diagnosed with COVID-19. Seroprevalence varied among hospitals, from 2.4% to 3.7% in low-incidence regions to 17.9% to 32.0% in hospitals with outbreaks involving 5 or more health care workers. Higher seroprevalence was associated with working in a hospital where outbreaks occurred (adjusted prevalence ratio 4.16, 95% confidence interval [CI] 2.63-6.57), being a nurse or nursing assistant (adjusted prevalence ratio 1.34, 95% CI 1.03-1.74) or an orderly (adjusted prevalence ratio 1.49, 95% CI 1.12-1.97), and Black or Hispanic ethnicity (adjusted prevalence ratio 1.41, 95% CI 1.13-1.76). Lower seroprevalence was associated with working in the intensive care unit (adjusted prevalence ratio 0.47, 95% CI 0.30-0.71) or the emergency department (adjusted prevalence ratio 0.61, 95% CI 0.39-0.98). INTERPRETATION Health care workers in Quebec hospitals were at high risk of SARS-CoV-2 infection, particularly in outbreak settings. More work is needed to better understand SARS-CoV-2 transmission dynamics in health care settings.
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Affiliation(s)
- Nicholas Brousseau
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que.
| | - Laurianne Morin
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Manale Ouakki
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Patrice Savard
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Caroline Quach
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Yves Longtin
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Matthew P Cheng
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Alex Carignan
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Simon F Dufresne
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Jean-Michel Leduc
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Christian Lavallée
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Nicolas Gauthier
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Julie Bestman-Smith
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Maria-Jesus Arrieta
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Magued Ishak
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Simon Lévesque
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Philippe Martin
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Gaston De Serres
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
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Brousseau N, Morin L, Ouakki M, Savard P, Quach C, Longtin Y, Cheng MP, Carignan A, Dufresne SF, Leduc JM, Lavallée C, Gauthier N, Bestman-Smith J, Arrieta MJ, Ishak M, Lévesque S, Martin P, De Serres G. SARS-CoV-2 seroprevalence in health care workers from 10 hospitals in Quebec, Canada: a cross-sectional study. CMAJ 2021. [PMID: 34903591 DOI: 10.1503/cmaj.202783/tab-related-content] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has disproportionately affected health care workers. We sought to estimate SARS-CoV-2 seroprevalence among hospital health care workers in Quebec, Canada, after the first wave of the pandemic and to explore factors associated with SARS-CoV-2 seropositivity. METHODS Between July 6 and Sept. 24, 2020, we enrolled health care workers from 10 hospitals, including 8 from a region with a high incidence of COVID-19 (the Montréal area) and 2 from low-incidence regions of Quebec. Eligible health care workers were physicians, nurses, orderlies and cleaning staff working in 4 types of care units (emergency department, intensive care unit, COVID-19 inpatient unit and non-COVID-19 inpatient unit). Participants completed a questionnaire and underwent SARS-CoV-2 serology testing. We identified factors independently associated with higher seroprevalence. RESULTS Among 2056 enrolled health care workers, 241 (11.7%) had positive SARS-CoV-2 serology. Of these, 171 (71.0%) had been previously diagnosed with COVID-19. Seroprevalence varied among hospitals, from 2.4% to 3.7% in low-incidence regions to 17.9% to 32.0% in hospitals with outbreaks involving 5 or more health care workers. Higher seroprevalence was associated with working in a hospital where outbreaks occurred (adjusted prevalence ratio 4.16, 95% confidence interval [CI] 2.63-6.57), being a nurse or nursing assistant (adjusted prevalence ratio 1.34, 95% CI 1.03-1.74) or an orderly (adjusted prevalence ratio 1.49, 95% CI 1.12-1.97), and Black or Hispanic ethnicity (adjusted prevalence ratio 1.41, 95% CI 1.13-1.76). Lower seroprevalence was associated with working in the intensive care unit (adjusted prevalence ratio 0.47, 95% CI 0.30-0.71) or the emergency department (adjusted prevalence ratio 0.61, 95% CI 0.39-0.98). INTERPRETATION Health care workers in Quebec hospitals were at high risk of SARS-CoV-2 infection, particularly in outbreak settings. More work is needed to better understand SARS-CoV-2 transmission dynamics in health care settings.
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Affiliation(s)
- Nicholas Brousseau
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que.
| | - Laurianne Morin
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Manale Ouakki
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Patrice Savard
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Caroline Quach
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Yves Longtin
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Matthew P Cheng
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Alex Carignan
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Simon F Dufresne
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Jean-Michel Leduc
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Christian Lavallée
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Nicolas Gauthier
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Julie Bestman-Smith
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Maria-Jesus Arrieta
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Magued Ishak
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Simon Lévesque
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Philippe Martin
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
| | - Gaston De Serres
- Institut national de santé publique du Québec (Brousseau, Ouakki, De Serres), Montréal, Que.; Centre de recherche du CHU de Québec-Université Laval (Brousseau, Morin, De Serres), Québec, Que.; Départements de médecine et de médecine des laboratoires (Savard), Centre Hospitalier de l'Université de Montréal; Centre de recherche du Centre Hospitalier de l'Université de Montréal (Savard); Department of Microbiology, Infectious Diseases & Immunology (Quach), CHU Sainte-Justine, Université de Montréal; Jewish General Hospital (Longtin); Divisions of Infectious Disease and Medical Microbiology (Cheng), McGill University Health Center, Montréal, Que.; CIUSSS de l'Estrie - CHUS (Carignan, Lévesque, Martin); Département de microbiologie et infectiologie (Carignan, Lévesque, Martin), Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Que.; Département de médecine (Dufresne, Lavallée), CIUSSS-de-l'Est-de-l'Île-de-Montréal; CIUSSS du Nord-de-l'Île-de-Montréal (Leduc, Gauthier), Montréal, Que.; Hôpital de l'Enfant-Jésus du CHU de Québec (Bestman-Smith), Québec, Que.; CIUSSS de l'Ouest-de-l'Île-de-Montréal (Arrieta); CIUSSS du Centre-Sud-de-l'île-de-Montréal (Ishak), Montréal, Que
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Evolution of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) seroprevalence among employees of a US academic children's hospital during coronavirus disease 2019 (COVID-19) pandemic. Infect Control Hosp Epidemiol 2021; 43:1647-1655. [PMID: 34852866 PMCID: PMC8668398 DOI: 10.1017/ice.2021.487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: To describe the cumulative seroprevalence of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) antibodies during the coronavirus disease 2019 (COVID-19) pandemic among employees of a large pediatric healthcare system. Design, setting, and participants: Prospective observational cohort study open to adult employees at the Children’s Hospital of Philadelphia, conducted April 20–December 17, 2020. Methods: Employees were recruited starting with high-risk exposure groups, utilizing e-mails, flyers, and announcements at virtual town hall meetings. At baseline, 1 month, 2 months, and 6 months, participants reported occupational and community exposures and gave a blood sample for SARS-CoV-2 antibody measurement by enzyme-linked immunosorbent assays (ELISAs). A post hoc Cox proportional hazards regression model was performed to identify factors associated with increased risk for seropositivity. Results: In total, 1,740 employees were enrolled. At 6 months, the cumulative seroprevalence was 5.3%, which was below estimated community point seroprevalence. Seroprevalence was 5.8% among employees who provided direct care and was 3.4% among employees who did not perform direct patient care. Most participants who were seropositive at baseline remained positive at follow-up assessments. In a post hoc analysis, direct patient care (hazard ratio [HR], 1.95; 95% confidence interval [CI], 1.03–3.68), Black race (HR, 2.70; 95% CI, 1.24–5.87), and exposure to a confirmed case in a nonhealthcare setting (HR, 4.32; 95% CI, 2.71–6.88) were associated with statistically significant increased risk for seropositivity. Conclusions: Employee SARS-CoV-2 seroprevalence rates remained below the point-prevalence rates of the surrounding community. Provision of direct patient care, Black race, and exposure to a confirmed case in a nonhealthcare setting conferred increased risk. These data can inform occupational protection measures to maximize protection of employees within the workplace during future COVID-19 waves or other epidemics.
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Feehan AK, Denstel KD, Katzmarzyk PT, Velasco C, Burton JH, Price-Haywood EG, Seoane L. Community versus individual risk of SARS-CoV-2 infection in two municipalities of Louisiana, USA: An assessment of Area Deprivation Index (ADI) paired with seroprevalence data over time. PLoS One 2021; 16:e0260164. [PMID: 34847149 PMCID: PMC8631658 DOI: 10.1371/journal.pone.0260164] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 11/03/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Determine whether an individual is at greater risk of severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) infection because of their community or their individual risk factors. STUDY DESIGN AND SETTING 4,752 records from two large prevalence studies in New Orleans and Baton Rouge, Louisiana were used to assess whether zip code tabulation areas (ZCTA)-level area deprivation index (ADI) or individual factors accounted for risk of infection. Logistic regression models assessed associations of individual-level demographic and socioeconomic factors and the zip code-level ADI with SARS-CoV-2 infection. RESULTS In the unadjusted model, there were increased odds of infection among participants residing in high versus low ADI (both cities) and high versus mid-level ADI (Baton Rouge only) zip codes. When individual-level covariates were included, the odds of infection remained higher only among Baton Rouge participants who resided in high versus mid-level ADI ZCTAs. Several individual factors contributed to infection risk. After adjustment for ADI, race and age (Baton Rouge) and race, marital status, household size, and comorbidities (New Orleans) were significant. CONCLUSIONS While higher ADI was associated with higher risk of SARS-CoV-2 infection, individual-level participant characteristics accounted for a significant proportion of this association. Additionally, stage of the pandemic may affect individual risk factors for infection.
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Affiliation(s)
- Amy K. Feehan
- Ochsner Clinic Foundation, New Orleans, LA, United States of America
- Ochsner Clinical School, The University of Queensland, New Orleans, LA, United States of America
| | - Kara D. Denstel
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States of America
| | - Peter T. Katzmarzyk
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States of America
| | - Cruz Velasco
- Ochsner Clinic Foundation, New Orleans, LA, United States of America
- Center for Outcomes and Health Services Research, New Orleans, LA, United States of America
| | - Jeffrey H. Burton
- Ochsner Clinic Foundation, New Orleans, LA, United States of America
- Center for Outcomes and Health Services Research, New Orleans, LA, United States of America
| | - Eboni G. Price-Haywood
- Ochsner Clinic Foundation, New Orleans, LA, United States of America
- Ochsner Clinical School, The University of Queensland, New Orleans, LA, United States of America
- Center for Outcomes and Health Services Research, New Orleans, LA, United States of America
| | - Leonardo Seoane
- Ochsner Clinic Foundation, New Orleans, LA, United States of America
- Ochsner Clinical School, The University of Queensland, New Orleans, LA, United States of America
- Louisiana State University Health Sciences Center-Shreveport, Shreveport, LA, United States of America
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Akinbami LJ, Biggerstaff BJ, Chan PA, McGibbon E, Pathela P, Petersen LR. Reinfection with SARS-CoV-2 among previously infected healthcare personnel and first responders. Clin Infect Dis 2021; 75:e201-e207. [PMID: 34791108 PMCID: PMC8767877 DOI: 10.1093/cid/ciab952] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Indexed: 12/22/2022] Open
Abstract
Background SARS-CoV-2 virus testing among first responders and healthcare personnel who participated in a May-August 2020 serosurvey which assessed spike protein antibodies (S1 region) provided an opportunity to assess reinfection. Methods Serology survey data were merged with virus testing results from Rhode Island (March 1, 2020-February 17, 2021) and New York City (March 10-December 14, 2020). Participants with a positive virus test ≥14 days before their serology test were included. Reinfection was defined as a second positive SARS-CoV-2 test result ≥90 days after the first positive test. The association between serostatus and reinfection was assessed with a proportional hazards model adjusting for demographics, exposures, and virus testing frequency. Results Among 1,572 previously infected persons, 40 (2.5%) were reinfected. Reinfection differed by serostatus: 8.4% among seronegative versus 1.9% among seropositive participants (p<0.0001). Most reinfections occurred among Rhode Island nursing home and corrections (RINHC) personnel (n=30) who were most frequently tested (mean 30.3 tests versus 4.6 for other Rhode Island and 2.3 for New York City participants). The adjusted hazard ratio (aHR) for reinfection in seropositive versus seronegative persons was 0.41 (95% CI 0.20, 0.81). Exposure to a household member with COVID-19 before the serosurvey was also protective (aHR 0.34, 95% CI 0.13, 0.89). Conclusions Reinfections were uncommon among previously infected persons over a 9-month period that preceded widespread variant circulation. Seropositivity decreased reinfection risk. Lower reinfection risk associated with exposure to a household member with COVID-19 before the serosurvey may reflect subsequently reduced household transmission among members of previously infected households.
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Affiliation(s)
- Lara J Akinbami
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, USA.,U.S. Public Health Service, Rockville, Maryland, USA
| | - Brad J Biggerstaff
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Philip A Chan
- Rhode Island Department of Health, Providence, Rhode Island, USA
| | - Emily McGibbon
- New York City Department of Health and Mental Hygiene, Queens, New York, USA
| | - Preeti Pathela
- New York City Department of Health and Mental Hygiene, Queens, New York, USA
| | - Lyle R Petersen
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
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Lynch JB, Davitkov P, Anderson DJ, Bhimraj A, Cheng VCC, Guzman-Cottrill J, Dhindsa J, Duggal A, Jain MK, Lee GM, Liang SY, McGeer A, Varghese J, Lavergne V, Murad MH, Mustafa RA, Sultan S, Falck-Ytter Y, Morgan RL. Infectious Diseases Society of America Guidelines on Infection Prevention for Healthcare Personnel Caring for Patients with Suspected or Known COVID-19. Clin Infect Dis 2021:ciab953. [PMID: 34791102 PMCID: PMC8767890 DOI: 10.1093/cid/ciab953] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Since its emergence in late 2019, SARS-CoV-2 continues to pose a risk to healthcare personnel (HCP) and patients in healthcare settings. Although all clinical interactions likely carry some risk of transmission, human actions like coughing and care activities like aerosol-generating procedures likely have a higher risk of transmission. The rapid emergence and global spread of SARS-CoV-2 continues to create significant challenges in healthcare facilities, particularly with shortages of personal protective equipment (PPE) used by HCP. Evidence-based recommendations for what PPE to use in conventional, contingency, and crisis standards of care continue to be needed. Where evidence is lacking, the development of specific research questions can help direct funders and investigators. OBJECTIVE Develop evidence-based rapid guidelines intended to support HCP in their decisions about infection prevention when caring for patients with suspected or known COVID-19. METHODS IDSA formed a multidisciplinary guideline panel including frontline clinicians, infectious disease specialists, experts in infection control, and guideline methodologists with representation from the disciplines of public health, medical microbiology, pediatrics, critical care medicine and gastroenterology. The process followed a rapid recommendation checklist. The panel prioritized questions and outcomes. Then a systematic review of the peer-reviewed and grey literature was conducted. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the certainty of evidence and make recommendations. RESULTS The IDSA guideline panel agreed on eight recommendations, including two updated recommendations and one new recommendation added since the first version of the guideline. Narrative summaries of other interventions undergoing evaluations are also included. CONCLUSIONS Using a combination of direct and indirect evidence, the panel was able to provide recommendations for eight specific questions on the use of PPE for HCP providing care for patients with suspected or known COVID-19. Where evidence was lacking, attempts were made to provide potential avenues for investigation. There remain significant gaps in the understanding of the transmission dynamics of SARS-CoV-2 and PPE recommendations may need to be modified in response to new evidence. These recommendations should serve as a minimum for PPE use in healthcare facilities and do not preclude decisions based on local risk assessments or requirements of local health jurisdictions or other regulatory bodies.
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Affiliation(s)
- John B Lynch
- Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington
| | - Perica Davitkov
- VA Northeast Ohio Healthcare System, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Deverick J Anderson
- Duke Center for Antimicrobial Stewardship and Infection Prevention, Duke University School of Medicine, Durham, North Carolina
| | - Adarsh Bhimraj
- Department of Infectious Diseases, Cleveland Clinic, Cleveland, Ohio
| | - Vincent Chi-Chung Cheng
- Queen Mary Hospital, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Judith Guzman-Cottrill
- Department of Pediatrics, Division of Infectious Diseases, Oregon Health and Science University, Portland, Oregon
| | | | - Abhijit Duggal
- Department of Critical Care, Cleveland Clinic, Cleveland, Ohio
| | - Mamta K Jain
- Department of Internal Medicine, Division of Infectious Diseases, UT Southwestern Medical Center, Dallas, Texas
| | - Grace M Lee
- Department of Pediatrics-Infectious Disease, Stanford University School of Medicine, Stanford, California
| | - Stephen Y Liang
- Division of Infectious Diseases and Emergency Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Allison McGeer
- Department of Microbiology, Sinai Health System, University of Toronto, Toronto, Ontario
| | - Jamie Varghese
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario
| | - Valery Lavergne
- Department of Pathology and Laboratory Medicine, Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - M Hassan Murad
- Division of Preventive Medicine, Mayo Clinic, Rochester, Minnesota
| | - Reem A Mustafa
- Division of Nephrology and Hypertension, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
| | - Shahnaz Sultan
- Division of Gastroenterology, Hepatology, and Nutrition, University of Minnesota, Minneapolis VA Health Care System, Minneapolis, Minnesota
| | - Yngve Falck-Ytter
- VA Northeast Ohio Healthcare System, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Rebecca L Morgan
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario
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Lier M, Nessler S, Stadelmann C, Pressler M, Saager L, Moerer O, Roessler M, Meissner K, Winkler MS. High class filtering facepiece (FFP) are fundamental and effective in protection of emergency health care workers: an observational cohort study in a German community. Scand J Trauma Resusc Emerg Med 2021; 29:155. [PMID: 34717713 PMCID: PMC8556778 DOI: 10.1186/s13049-021-00969-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 10/12/2021] [Indexed: 11/30/2022] Open
Abstract
Background Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a highly contagious airborne virus inducing pandemic coronavirus disease 2019 (COVID-19). This is most relevant for medical staff working under harmful conditions in emergencies often dealing with patients and an undefined SARS-CoV-2 status. We aimed to measure the effect of high-class filtering facepieces (FFP) in emergency medical service (EMS) staff by analyzing seroprevalence and history of positive polymerase chain reaction (PCR) for SARS-CoV-2. Method This observational cohort study included workers in EMS, who were compared with hospital staff (HS) and staff, which was not directly involved in patient care (NPC). All direct patient contacts of EMS workers were protected by FFP2/N95 (filtering face piece protection class 2/non-oil-based particulates filter efficiency 95%) masks, whereas HS was protected by FFP2/N95 exclusively when a patient had a proven or suspected SARS-CoV-2 infection. NPC was not protected by higher FFP. The seroprevalence of SARS-CoV-2 antibodies was analyzed by immunoassay by end of 12/2020 together with the history of a positive PCR. In addition, a self-assessment was performed regarding the quantity of SARS-CoV-2 positive contacts, about flu symptoms and personal belief of previous COVID-19 infections. Results The period in which contact to SARS-CoV-2 positive patients has been possible was 10 months (March to December 2020)—with 54,681 patient contacts documented for EMS—either emergencies (n = 33,241) or transportation services (n = 21,440). Seven hundred-thirty (n = 730) participants were included into the study (n = EMS: 325, HS: 322 and NPC: 83). The analysis of the survey showed that the exposure to patients with an unknown and consecutive positive SARS-CoV-2 result was significantly higher for EMS when compared to HS (EMS 55% vs. HS 30%, p = 0.01). The incidence of a SARS-CoV-2 infection in our cohort was 1.2% (EMS), 2.2% (HS) and 2.4% (NPC) within the three groups (ns) and lowest in EMS. Furthermore, the belief of previous COVID-19 was significant higher in EMS (19% vs. 10%), Conclusion The consistent use of FFP2/N95 in EMS is able to prevent work-related SARS-CoV-2 infections in emergency situations. The significance of physical airway protection in exposed medical staff is still relevant especially under the aspect of new viral variants and unclear effectiveness of new vaccines. Graphical Abstract ![]()
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Affiliation(s)
- Martin Lier
- Department of Anesthesiology, Emergency and Intensive Care Medicine, University Medical Centre Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.
| | - Stefan Nessler
- Institute for Neuropathology, University Medical Centre Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Christine Stadelmann
- Institute for Neuropathology, University Medical Centre Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Meike Pressler
- Department of Anesthesiology, Emergency and Intensive Care Medicine, University Medical Centre Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Leif Saager
- Department of Anesthesiology, Emergency and Intensive Care Medicine, University Medical Centre Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Onnen Moerer
- Department of Anesthesiology, Emergency and Intensive Care Medicine, University Medical Centre Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Markus Roessler
- Department of Anesthesiology, Emergency and Intensive Care Medicine, University Medical Centre Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Konrad Meissner
- Department of Anesthesiology, Emergency and Intensive Care Medicine, University Medical Centre Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Martin S Winkler
- Department of Anesthesiology, Emergency and Intensive Care Medicine, University Medical Centre Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
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Montague BT, Wipperman MF, Hooper AT, Hamon SC, Crow R, Elemo F, Hersh L, Langdon S, Hamilton JD, O'Brien MP, Simões EAF. Anti-SARS-CoV-2 IgA Identifies Asymptomatic Infection in First Responders. J Infect Dis 2021; 225:578-586. [PMID: 34636907 PMCID: PMC8549282 DOI: 10.1093/infdis/jiab524] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 10/08/2021] [Indexed: 11/22/2022] Open
Abstract
Background IgA is an important component of the early immune response to SARS-CoV-2. Prior serosurveys in high-risk groups employing IgG testing alone have provided discordant estimates. The potential added benefit of IgA in serosurveys has not been established. Methods Longitudinal serosurvey of first responders (police, emergency medical service providers, fire fighters, and other staff) employing three serologic tests: anti-spike IgA, anti-spike IgG, and anti-nucleocapsid IgG correlated with surveys assessing occupational and non-occupational risk, exposure to COVID-19 and illnesses consistent with COVID-19. Results Twelve percent of first responders in Colorado at baseline and 22% at follow-up were assessed as having SARS-CoV-2 infection. Five percent at baseline and 6% at follow-up were seropositive only for IgA. Among those IgA positive only at baseline, the majority 69% had a positive antibody at follow-up. 45% of those infected at baseline and 33% at follow-up were asymptomatic. At all time points, the estimated cumulative incidence in our study was higher than that in the general population. Conclusions First responders are at high risk of infection with SARS-CoV-2. IgA testing identified a significant portion of cases missed by IgG testing and its use as part of serologic surveys may improve retrospective identification of asymptomatic infection.
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Affiliation(s)
| | | | | | | | - Rowena Crow
- University of Colorado School of Medicine, Aurora, CO USA
| | - Femi Elemo
- Regeneron Pharmaceuticals, Tarrytown, NY USA
| | - Lisa Hersh
- Regeneron Pharmaceuticals, Tarrytown, NY USA
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Popova AY, Tarasenko AA, Smolensky VY, Egorova SA, Smirnov VS, Dashkevich AM, Svetogor TN, Glinskaya IN, Skuranovich AL, Milichkina AM, Dronina AM, Samoilovich EO, Khamitova IV, Semeiko GV, Amvrosyeva TV, Shmeleva NP, Rubanik LV, Esmanchik OP, Karaban IA, Drobyshevskaya VG, Sadovnikova GV, Shilovich MV, Podushkina EA, Kireichuk VV, Petrova OA, Bondarenko SV, Salazhkova IF, Tkach LM, Shepelevich LP, Autukhova NL, Ivanov VM, Babilo AS, Navyshnaya MV, Belyaev NN, Zueva EV, Volosar LA, Verbov VN, Likhachev IV, Zagorskaya TO, Morozova NF, Korobova ZR, Gubanova AV, Totolian AA. Herd immunity to SARS-CoV-2 among the population of the Republic of Belarus amid the COVID-19 pandemic. RUSSIAN JOURNAL OF INFECTION AND IMMUNITY 2021. [DOI: 10.15789/2220-7619-hit-1798] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Objective was to investigate the SARS-CoV-2 collective immunity status of the population of Belarus within the context of the COVID-19 pandemic. Materials and methods. The work was carried out according to the methodology for assessing SARS-CoV-2 population immunity, developed by Rospotrebnadzor Russia and the Ministry of Health of Belarus with the participation of the St. Petersburg Pasteur Institute, taking into account WHO recommendations. The Bioethics Committee of Belarus and the local ethics committee of the St. Petersburg Pasteur Institute approved the study. Selection of participants was carried out using a questionnaire method and online technology (internet, cloud server). Volunteers were randomized into seven age groups (years of age): 1–17; 18–29; 30–39; 40–49; 50–59; 60–69; and 70+. Regional randomization ensured proportional representation of volunteers from each region, and no more than 30 people were included from one enterprise. In accordance with manufacturer instructions, blood plasma samples were analyzed for: IgG antibodies (Abs) to the SARS-CoV-2 nucleocapsid (Nc) using a quantitative ELISA test system; and IgG Abs to the receptor binding domain (RBD) of the SARS-CoV-2 S (spike) surface glycoprotein using a qualitative ELISA test system. Statistical processing was carried out using Excel 2010 and other software. Statistical differences were designated as significant when p 0.05, unless otherwise indicated. Results. The level of seroprevalence, in terms of Abs to Nc among the Belarusian population, was 38.4% (95% CI 37.6–45.4). The highest Ab levels were found among individuals in older age groups (50-70+ years old). The lowest were found in children 1–17 years old and in young people 18–39 years old The distribution of seroprevalence across Belarusian regions was relatively homogeneous, with the exception of the Minsk Region, where a statistically significant decrease in the indicator was noted. In terms of profession, the largest share of seropositive individuals was found among transportation workers; the smallest was found in business. The moderate COVID-19 incidence has not led to a dramatic increase in the number of contacts. The base reproduction number (R0) was 1.3. In the Republic of Belarus, there was a moderate level of asymptomatic COVID-19 among seropositive individuals (45.3% [95% CI 44.0–46.7]). This form of infection was observed most often among children aged 1–17 years old (65.0% [95% CI 61.3–68.6]). In parallel with seroprevalence assessment, SARS-CoV-2 vaccination was carried out. We used two vaccines: Gam-COVID-Vac (also known as Sputnik V, developed by Gamaleya National Center for Epidemiology and Microbiology, Russia); and BBIBP-CorV (Sinopharm, PRC). Vaccination against SARS-CoV-2 was accompanied by an increase in the level of anti-RBD Abs (95% [95% CI 94.7–96.7]). Taking into account the vaccination of a subset of the population with BBIBP-CorV, the overall herd immunity, inferred from the analyzed indicators (presence of anti-Nc or anti-RBD Abs), was 47.1% (95% CI 46.3–48.0). Conclusion. COVID-19 in Belarus was characterized by a moderately pronounced course of the epidemic process. The threshold level of herd immunity to SARS-CoV-2 has not yet been reached, as a result of which the conditions for progression of the epidemic remain.
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Kraus CK. Mask effectiveness against viral illnesses in health care professionals. J Am Coll Emerg Physicians Open 2021; 2:e12583. [PMID: 34746924 PMCID: PMC8549016 DOI: 10.1002/emp2.12583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 10/06/2021] [Accepted: 10/06/2021] [Indexed: 11/06/2022] Open
Affiliation(s)
- Chadd K. Kraus
- Department of Emergency MedicineGeisinger Medical CenterDanvillePennsylvaniaUSA
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He S, Hecimovic A, Matijasevic V, Mai HT, Heslop L, Foster J, Alexander KE, Pal N, Alexandrou E, Davidson PM, Frost SA. Prevalence of SARS-CoV-2 antibodies among nurses: A systematic review and meta-analysis. J Clin Nurs 2021; 31:1557-1569. [PMID: 34570947 PMCID: PMC8661824 DOI: 10.1111/jocn.16009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/10/2021] [Accepted: 08/05/2021] [Indexed: 12/12/2022]
Abstract
Aims and Objectives This systematic review and meta‐analysis reports the seroprevalence of SARS‐CoV‐2 antibodies among nurses. Background With a growing body of literature reporting the positive serology for SARS‐CoV‐2 antibodies among healthcare workers, it remains unclear whether staff at the point of direct patient care are more prone to developing and transmitting the virus. Given nurses make up the majority of the global health workforce, outbreaks among these workers could severely undermine a health system’s capability to manage the pandemic. We aimed to summarise and report the seroprevalence of SARS‐CoV‐2 antibodies among nurses globally. Design Systematic review and meta‐analyses. Methods This systematic review was developed, undertaken and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guideline. We searched the electronic medical literature databases: MEDLINE; CINAHL; and EMBASE for studies reporting the seroprevalence of SARS‐CoV‐2 antibodies among nursing staff. Studies that reported nursing specific data were included in this review. Study quality was evaluated using the Joanna Briggs Institute checklist for studies reporting prevalence data. Studies were stratified according to the World Health Organisation region classifications, and results were presented using forest plots and summary prevalence and variance was estimated using a random effects model. Results Our electronic search identified 1687 potential studies, of which 1148 were screened for eligibility after duplicates were removed, and 51 of the studies were included in our meta‐analysis. The overall seroprevalence of SARS‐CoV‐2 antibodies among nurses was estimated to be 8.1% (95% CI 6.9%–9.4%) among the 60,571 participants included in the studies. Seropositivity was highest in the African region (48.2%, 95% CI 39.2%–57.3%), followed by the European region (10.3%, 95% CI 8.0%–12.5%), the Region of the Americas (8.4%, 95% CI 6.0%–10.7%), the South‐East Asia region (3.0%, 95% CI 0.00%–6.5%) and the Western Pacific region (0.5%, 95% CI 0.0%–1.0%). Pooled estimates were unable to be calculated in the Eastern Mediterranean region due to insufficient studies. Conclusion The seroprevalence of SARS‐CoV‐2 antibodies among nurses is comparable to other healthcare workers, and possibly similar to the general population. Early adoption and adherence to personal protective equipment and social distancing measures could explain these similarities, meaning the majority of staff contracted the virus through community transmission and not in a healthcare setting. Relevance to clinical practice Fear and uncertainty have been features of this pandemic, including among nurses. This meta‐analysis should provide some comfort to nurses that risks are similar to community exposure when adequate PPE is available and there is an adherence to infection control measures.
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Affiliation(s)
- Steven He
- South Western Sydney Nursing and Midwifery Research, Ingham Institute of Applied Medical Research, Sydney, New South Wales, Australia.,Western Sydney University, Sydney, New South Wales, Australia
| | - Anthony Hecimovic
- South Western Sydney Nursing and Midwifery Research, Ingham Institute of Applied Medical Research, Sydney, New South Wales, Australia.,South Western Sydney Local Health District Primary and Community Health, Sydney, New South Wales, Australia
| | - Vesna Matijasevic
- South Western Sydney Nursing and Midwifery Research, Ingham Institute of Applied Medical Research, Sydney, New South Wales, Australia.,South Western Sydney Local Health District Primary and Community Health, Sydney, New South Wales, Australia
| | - Ha Thi Mai
- South Western Sydney Nursing and Midwifery Research, Ingham Institute of Applied Medical Research, Sydney, New South Wales, Australia.,Western Sydney University, Sydney, New South Wales, Australia
| | - Linda Heslop
- Ken Merten Library, Liverpool Hospital, Sydney, New South Wales, Australia
| | - Jann Foster
- South Western Sydney Nursing and Midwifery Research, Ingham Institute of Applied Medical Research, Sydney, New South Wales, Australia.,Western Sydney University, Sydney, New South Wales, Australia.,NSW Centre for Evidence Based Health Care: A JBI Affiliated Group, Sydney, New South Wales, Australia
| | - Kate E Alexander
- South Western Sydney Local Health District Public Health Unit, Sydney, New South Wales, Australia
| | - Naru Pal
- South Western Sydney Local Health District Public Health Unit, Sydney, New South Wales, Australia
| | - Evan Alexandrou
- South Western Sydney Nursing and Midwifery Research, Ingham Institute of Applied Medical Research, Sydney, New South Wales, Australia.,Western Sydney University, Sydney, New South Wales, Australia.,Department of Intensive Care, Liverpool Hospital, Sydney, New South Wales, Australia.,Griffith University, Brisbane, Queensland, Australia
| | | | - Steven A Frost
- South Western Sydney Nursing and Midwifery Research, Ingham Institute of Applied Medical Research, Sydney, New South Wales, Australia.,Western Sydney University, Sydney, New South Wales, Australia.,Department of Intensive Care, Liverpool Hospital, Sydney, New South Wales, Australia
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Chou R, Dana T, Jungbauer R. Update Alert 6: Masks for Prevention of Respiratory Virus Infections, Including SARS-CoV-2, in Health Care and Community Settings. Ann Intern Med 2021; 174:W68. [PMID: 34251900 PMCID: PMC8280537 DOI: 10.7326/l21-0393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Roger Chou
- Pacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, Oregon
| | - Tracy Dana
- Pacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, Oregon
| | - Rebecca Jungbauer
- Pacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, Oregon
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Vieira V, Tang IW, Bartell S, Zahn M, Fedoruk MJ. SARS-CoV-2 antibody seroprevalence among firefighters in Orange County, California. Occup Environ Med 2021; 78:789-792. [PMID: 34433659 DOI: 10.1136/oemed-2021-107461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 08/03/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We conducted serological SARS-CoV-2 antibody testing from October to November 2020 to estimate the SARS-CoV-2 seroprevalence among firefighters/paramedics in Orange County (OC), California. METHODS OC firefighters employed at the time of the surveillance activity were invited to participate in a voluntary survey that collected demographic, occupational and previous COVID-19 testing data, and a SARS-CoV-2 immunoglobulin (Ig)G antibody blood test. We collected venous blood samples using mobile phlebotomy teams that travelled to individual fire stations, in coordination with an annual tuberculosis testing campaign for firefighters employed by OC Fire Authority (OCFA), and independently for firefighters employed by cities. We estimated seroprevalence and assessed several potential predictors of seropositivity. RESULTS The seroprevalence was 5.3% among 923 OCFA personnel tested, with 92.2% participating. Among firefighters self-reporting a previous positive COVID-19 antibody or PCR test result, twenty-one (37%) did not have positive IgG tests in the current serosurvey. There were no statistically significant differences in demographic characteristics between cases and non-cases. Work city was a significant predictor of case status (p=0.015). Seroprevalence (4.8%) was similar when aggregated across seven city fire departments (42%-65% participation). In total, 1486°C fire personnel were tested. CONCLUSION Using a strong serosurvey design and large firefighter cohort, we observed a SARS-CoV-2 IgG seroprevalence of 5.3%. The seroprevalence among OC firefighters in October 2020 was lower than the general county population estimated seroprevalence (11.5%) in August. The difference may be due in part to safety measures taken by OC fire departments at the start of the pandemic, as well as differences in antibody test methods and/or duration of antibody response.
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Affiliation(s)
- Verónica Vieira
- Department of Environmental and Occupational Health, University of California Irvine Susan and Henry Samueli College of Health Sciences, Irvine, California, USA .,University of California Irvine Center for Occupational and Environmental Health, Irvine, California, USA
| | - Ian W Tang
- Department of Environmental and Occupational Health, University of California Irvine Susan and Henry Samueli College of Health Sciences, Irvine, California, USA
| | - Scott Bartell
- Department of Environmental and Occupational Health, University of California Irvine Susan and Henry Samueli College of Health Sciences, Irvine, California, USA.,University of California Irvine Center for Occupational and Environmental Health, Irvine, California, USA
| | - Matthew Zahn
- Orange County Health Care Agency, Santa Ana, California, USA
| | - Marion Joseph Fedoruk
- Department of Environmental and Occupational Health, University of California Irvine Susan and Henry Samueli College of Health Sciences, Irvine, California, USA.,University of California Irvine Center for Occupational and Environmental Health, Irvine, California, USA
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Akinbami LJ, Petersen LR, Sami S, Vuong N, Lukacs SL, Mackey L, Atas J, LaFleur BJ. Coronavirus Disease 2019 Symptoms and Severe Acute Respiratory Syndrome Coronavirus 2 Antibody Positivity in a Large Survey of First Responders and Healthcare Personnel, May-July 2020. Clin Infect Dis 2021; 73:e822-e825. [PMID: 33515250 PMCID: PMC7929062 DOI: 10.1093/cid/ciab080] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Indexed: 12/02/2022] Open
Abstract
A SARS-CoV-2 serosurvey among first responder/healthcare personnel showed that loss of taste/smell was most predictive of seropositivity; percent seropositivity increased with number of COVID-19 symptoms. However, 22.9% with nine symptoms were seronegative, and 8.3% with no symptoms were seropositive. These findings demonstrate limitations of symptom-based surveillance and importance of testing.
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Affiliation(s)
- Lara J Akinbami
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, USA.,US Public Health Service, Rockville, Maryland, USA
| | - Lyle R Petersen
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Samira Sami
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Nga Vuong
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Susan L Lukacs
- National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland, USA.,US Public Health Service, Rockville, Maryland, USA
| | - Lisa Mackey
- National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado, USA
| | - Jenny Atas
- Region 2 South Healthcare Coalition, Detroit, Michigan, USA
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Escandón K, Rasmussen AL, Bogoch II, Murray EJ, Escandón K, Popescu SV, Kindrachuk J. COVID-19 false dichotomies and a comprehensive review of the evidence regarding public health, COVID-19 symptomatology, SARS-CoV-2 transmission, mask wearing, and reinfection. BMC Infect Dis 2021; 21:710. [PMID: 34315427 PMCID: PMC8314268 DOI: 10.1186/s12879-021-06357-4] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 06/24/2021] [Indexed: 02/07/2023] Open
Abstract
Scientists across disciplines, policymakers, and journalists have voiced frustration at the unprecedented polarization and misinformation around coronavirus disease 2019 (COVID-19) pandemic. Several false dichotomies have been used to polarize debates while oversimplifying complex issues. In this comprehensive narrative review, we deconstruct six common COVID-19 false dichotomies, address the evidence on these topics, identify insights relevant to effective pandemic responses, and highlight knowledge gaps and uncertainties. The topics of this review are: 1) Health and lives vs. economy and livelihoods, 2) Indefinite lockdown vs. unlimited reopening, 3) Symptomatic vs. asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, 4) Droplet vs. aerosol transmission of SARS-CoV-2, 5) Masks for all vs. no masking, and 6) SARS-CoV-2 reinfection vs. no reinfection. We discuss the importance of multidisciplinary integration (health, social, and physical sciences), multilayered approaches to reducing risk ("Emmentaler cheese model"), harm reduction, smart masking, relaxation of interventions, and context-sensitive policymaking for COVID-19 response plans. We also address the challenges in understanding the broad clinical presentation of COVID-19, SARS-CoV-2 transmission, and SARS-CoV-2 reinfection. These key issues of science and public health policy have been presented as false dichotomies during the pandemic. However, they are hardly binary, simple, or uniform, and therefore should not be framed as polar extremes. We urge a nuanced understanding of the science and caution against black-or-white messaging, all-or-nothing guidance, and one-size-fits-all approaches. There is a need for meaningful public health communication and science-informed policies that recognize shades of gray, uncertainties, local context, and social determinants of health.
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Affiliation(s)
- Kevin Escandón
- School of Medicine, Universidad del Valle, Cali, Colombia.
| | - Angela L Rasmussen
- Vaccine and Infectious Disease Organization, University of Saskatchewan, Saskatoon, Canada
- Georgetown Center for Global Health Science and Security, Georgetown University, Washington, DC, USA
| | - Isaac I Bogoch
- Division of Infectious Diseases, University of Toronto, Toronto General Hospital, Toronto, Canada
| | - Eleanor J Murray
- Department of Epidemiology, Boston University School of Public Health, Boston, USA
| | - Karina Escandón
- Department of Anthropology, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Saskia V Popescu
- Georgetown Center for Global Health Science and Security, Georgetown University, Washington, DC, USA
- Schar School of Policy and Government, George Mason University, Fairfax, VA, USA
| | - Jason Kindrachuk
- Vaccine and Infectious Disease Organization, University of Saskatchewan, Saskatoon, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Canada
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Colomb-Cotinat M, Poujol I, Monluc S, Vaux S, Olivier C, Le Vu S, Floret N, Golliot F, Berger-Carbonne A. Burden of COVID-19 on workers in hospital settings: The French situation during the first wave of the pandemic. Infect Dis Now 2021; 51:560-563. [PMID: 34245939 PMCID: PMC8262402 DOI: 10.1016/j.idnow.2021.06.308] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/11/2021] [Accepted: 06/29/2021] [Indexed: 11/28/2022]
Abstract
We launched a survey in April 2020 to assess the number and proportion of hospital workers infected during the first wave of the COVID-19 pandemic in France, and to assess the attributable mortality. All French hospital settings (HS) were invited to declare new cases and attributable deaths by occupation category each week. Between March 1 and June 28, 2020, participating HS accounted for 69.5% of the total number of HS workers in France, and declared 31,088 infected workers; 16 died from the infection. We estimated that 3.43% (95% CI: 3.42–3.45) of French workers in HS, and 3.97% (95% CI: 3.95–3.99) of healthcare workers were infected during the first wave. Workers in regions with a cumulative rate of hospitalized COVID-19 patients equal or above the national rate, HS other than tertiary hospitals, or occupations with frequent patient contacts were particularly impacted. Targeted prevention campaigns should be elaborated.
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Affiliation(s)
- M Colomb-Cotinat
- Santé publique France, Direction des maladies infectieuses, Saint-Maurice, France.
| | - I Poujol
- Santé publique France, Direction des maladies infectieuses, Saint-Maurice, France
| | - S Monluc
- Santé publique France, Direction des maladies infectieuses, Saint-Maurice, France
| | - S Vaux
- Santé publique France, Direction des maladies infectieuses, Saint-Maurice, France
| | - C Olivier
- Groupe d'étude sur le risque d'exposition des soignants aux agents infectieux (GERES), Paris, France
| | - S Le Vu
- Santé publique France, Direction des maladies infectieuses, Saint-Maurice, France
| | - N Floret
- CPias Bourgogne-Franche-Comté, Besançon, France
| | - F Golliot
- Santé publique France, Direction des régions, Saint-Maurice, France
| | - A Berger-Carbonne
- Santé publique France, Direction des maladies infectieuses, Saint-Maurice, France
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Stemen D, Ge M, Hwang D, Qaddoumi B, Roden M, Nanda N, Ference E. Frame to Improve the Fit of N95 Filtering Face Mask Respirators. J Occup Environ Med 2021; 63:e362-e366. [PMID: 33852548 PMCID: PMC8168670 DOI: 10.1097/jom.0000000000002223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE Test a device that can improve upon the seal of filtering face mask respirators (FFRs). METHODS A 3-D prototype for a fit improvement frame (FIF) was created and quantitative fit testing was performed for FFRs with and without the FIF. RESULTS Thirty eight volunteers underwent fit testing. The overall fit pass rate was 100% for the 3M model 1860 masks, 50% for the 3M model 8511 masks, 13% for the BYD CARE model DE2322, and 7% for the Honeywell DC300N95. When using the FIF the overall passing rate increase to 87% for the DE2322 + FIF (P < 0.01) and for the DC300N95 + FIF the passing rate increase to 73% (P < 0.01). CONCLUSION The FIF is effective in improving the mask fit of a common flat fold N95 masks and potentially other N95 masks.
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Affiliation(s)
- Daniel Stemen
- Department of Respiratory and Interventional Pulmonology, Keck Medical Center of the University of Southern California (Mr Stemen); Caruso Department of Otolaryngology-Head and Neck Surgery (Dr Ge, Dr Ference); Department of Radiology (Dr Hwang); Department of Biomedical Engineering, Viterbi School of Engineering of the University of Southern California (Dr Hwang); Tetra Bio Distributed (Mr Qaddoumi, Dr Roden; Section of Infectious Disease, Department of Medicine (Dr Nanda), Keck School of Medicine of the University of Southern California, Los Angeles, California
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Laeyendecker O, Hsieh YH, Rothman RE, Dashler G, Kickler T, Fernandez RE, Clarke W, Patel EU, Tobian AAR, Kelen GD, Quinn TC. Demographic and clinical correlates of acute and convalescent SARS-CoV-2 infection among patients of a U.S. emergency department. Am J Emerg Med 2021; 48:261-268. [PMID: 34015609 PMCID: PMC8086378 DOI: 10.1016/j.ajem.2021.04.081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/21/2021] [Accepted: 04/26/2021] [Indexed: 11/14/2022] Open
Abstract
Background Emergency Departments (EDs) have served as critical surveillance sites for infectious diseases. We sought to determine the prevalence and temporal trends of acute (by PCR) and convalescent (by antibody [Ab]) SARS-CoV-2 infection during the earliest phase of the pandemic among patients in an urban ED in Baltimore City. Methods We tested remnant blood samples from 3255 unique ED patients, collected between March 16th and May 31st 2020 for SARS-CoV-2 Ab. PCR for acute SARS-CoV-2 infection from nasopharyngeal swabs was obtained on any patients based on clinical suspicion. Hospital records were abstracted and factors associated with SARS-CoV-2 infection were assessed. Results Of 3255 ED patients, 8.2% (95%CI: 7.3%, 9.2%) individuals had evidence of SARS-CoV-2 infection; 155 PCR+, 78 Ab+, and 35 who were both PCR+ and Ab+. Prevalence of disease increased throughout the study period, ranging from 3.2% (95%CI: 1.8%, 5.2%) PCR+ and 0.6% (95%CI: 0.1%, 1.8%) Ab+ in March, to 6.2% (95%CI: 5.1%, 7.4%) PCR+ and 4.2% (95%CI: 3.3%, 5.3%) Ab+ in May. The highest SARS-CoV-2 prevalence was found in Hispanic individuals who made up 8.4% (95%CI: 7.4%, 9.4%) of individuals screened, but 35% (95%CI: 29%, 41%) of infections (PCR and/or Ab+). Demographic and clinical factors independently associated with acute infection included Hispanic ethnicity, loss of smell or taste, subjective fever, cough, muscle ache and fever. Factors independently associated with convalescent infection were Hispanic ethnicity and low oxygen saturation. Conclusions The burden of COVID-19 in Baltimore City increased dramatically over the 11-week study period and was disproportionately higher among Hispanic individuals. ED-based surveillance methods are important for identifying both acute and convalescent SARS-CoV-2 infections and provides important information regarding demographic and clinical correlates of disease in the local community.
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Affiliation(s)
- Oliver Laeyendecker
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Baltimore, MD, United States of America; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
| | - Yu-Hsiang Hsieh
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Richard E Rothman
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Gaby Dashler
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Thomas Kickler
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Reinaldo E Fernandez
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - William Clarke
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Eshan U Patel
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Aaron A R Tobian
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Gabor D Kelen
- Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Thomas C Quinn
- Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Baltimore, MD, United States of America; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
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Chou R, Dana T, Jungbauer R, Weeks C. Update Alert 5: Masks for Prevention of Respiratory Virus Infections, Including SARS-CoV-2, in Health Care and Community Settings. Ann Intern Med 2021; 174:W47. [PMID: 33683928 PMCID: PMC7974711 DOI: 10.7326/l21-0116] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Roger Chou
- Pacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, Oregon
| | - Tracy Dana
- Pacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, Oregon
| | - Rebecca Jungbauer
- Pacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, Oregon
| | - Chandler Weeks
- Pacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, Oregon
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Chou R, Dana T, Selph S, Totten AM, Buckley DI, Fu R. Update Alert 7: Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers. Ann Intern Med 2021; 174:W45-W46. [PMID: 33556273 PMCID: PMC7893536 DOI: 10.7326/l21-0034] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Roger Chou
- Pacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, Oregon
| | - Tracy Dana
- Pacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, Oregon
| | - Shelley Selph
- Pacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, Oregon
| | - Annette M Totten
- Pacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, Oregon
| | - David I Buckley
- Pacific Northwest Evidence-based Practice Center and School of Public Health, Oregon Health & Science University-Portland State University, Portland, Oregon
| | - Rongwei Fu
- Pacific Northwest Evidence-based Practice Center and School of Public Health, Oregon Health & Science University-Portland State University, Portland, Oregon
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Amit S, Beni SA, Biber A, Grinberg A, Leshem E, Regev-Yochay G. Postvaccination COVID-19 among Healthcare Workers, Israel. Emerg Infect Dis 2021; 27:1220-1222. [PMID: 33522478 PMCID: PMC8007324 DOI: 10.3201/eid2704.210016] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Coronavirus disease (COVID-19) symptoms can be mistaken for vaccine-related side effects during initial days after immunization. Among 4,081 vaccinated healthcare workers in Israel, 22 (0.54%) developed COVID-19 from 1-10 days (median 3.5 days) after immunization. Clinicians should not dismiss postvaccination symptoms as vaccine-related and should promptly test for COVID-19.
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Akinbami LJ, Chan PA, Vuong N, Sami S, Lewis D, Sheridan PE, Lukacs SL, Mackey L, Grohskopf LA, Patel A, Petersen LR. Severe Acute Respiratory Syndrome Coronavirus 2 Seropositivity among Healthcare Personnel in Hospitals and Nursing Homes, Rhode Island, USA, July-August 2020. Emerg Infect Dis 2021; 27:823-834. [PMID: 33622481 PMCID: PMC7920685 DOI: 10.3201/eid2703.204508] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Healthcare personnel are recognized to be at higher risk for infection with severe acute respiratory syndrome coronavirus 2. We conducted a serologic survey in 15 hospitals and 56 nursing homes across Rhode Island, USA, during July 17–August 28, 2020. Overall seropositivity among 9,863 healthcare personnel was 4.6% (95% CI 4.2%–5.0%) but varied 4-fold between hospital personnel (3.1%, 95% CI 2.7%–3.5%) and nursing home personnel (13.1%, 95% CI 11.5%–14.9%). Within nursing homes, prevalence was highest among personnel working in coronavirus disease units (24.1%; 95% CI 20.6%–27.8%). Adjusted analysis showed that in hospitals, nurses and receptionists/medical assistants had a higher likelihood of seropositivity than physicians. In nursing homes, nursing assistants and social workers/case managers had higher likelihoods of seropositivity than occupational/physical/speech therapists. Nursing home personnel in all occupations had elevated seropositivity compared with hospital counterparts. Additional mitigation strategies are needed to protect nursing home personnel from infection, regardless of occupation.
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Sabourin KR, Schultz J, Romero J, Lamb MM, Larremore D, Morrison TE, Frazer-Abel A, Zimmer S, Kedl RM, Jaenisch T, Rochford R. Risk Factors of SARS-CoV-2 Antibodies in Arapahoe County First Responders-The COVID-19 Arapahoe SErosurveillance Study (CASES) Project. J Occup Environ Med 2021; 63:191-198. [PMID: 33298759 PMCID: PMC7934329 DOI: 10.1097/jom.0000000000002099] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVES Define the seroprevalence and risk factors for SARS-CoV-2 antibodies in Arapahoe County, Colorado first responders (eg, law enforcement, human services, fire departments). METHODS Two hundred sixty four first responders were enrolled June to July 2020. SARS-CoV-2 seropositivity was defined as detection of immunoglobulin G (IgG) antibodies to both spike receptor binding domain and nucleocapsid in venous blood by validated enzyme-linked immunosorbent assay. We compared risk factors for being seropositive versus seronegative. RESULTS 4% (11/264) were SARS-CoV-2 seropositive. Seropositive participants were significantly more likely to have lung disease (% seropositive, % seronegative; P-value) (36%, 8%; P = 0.01), prior SARS-CoV-2/COVID-19 testing (36%, 8%; P ≤ 0.01), a prior positive result (18%, less than 1%), and to believe they previously had COVID-19 (64%, 15%; P < 0.01). Only 15% of those believing they had COVID-19 had anti-SARS-CoV-2 antibodies. CONCLUSIONS Human services employees and individuals with lung disease are at SARS-CoV-2 exposure risk. Few individuals believed they had COVID-19 had prior exposure.
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Affiliation(s)
- Katherine R Sabourin
- Department of Immunology and Microbiology (Dr Sabourin, Dr Schultz, Dr Morrison, Dr Kedl, Dr Rochford); Department of Epidemiology, Colorado School of Public Health (Dr Lamb, Dr Jaenisch); Department of Computer Science, College of Engineering and Applied Science (Dr Larremore); BioFrontiers Institute (Dr Larremore), University of Colorado Boulder; Department of Rheumatology (Dr Frazer-Abel); Department of Infectious Disease (Mr Romero, Dr Zimmer), School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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Chou R, Dana T, Jungbauer R, Weeks C. Update Alert 4: Masks for Prevention of Respiratory Virus Infections, Including SARS-CoV-2, in Health Care and Community Settings. Ann Intern Med 2021; 174:W24. [PMID: 33370171 PMCID: PMC7774035 DOI: 10.7326/l20-1429] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Roger Chou
- Pacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, Oregon
| | - Tracy Dana
- Pacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, Oregon
| | - Rebecca Jungbauer
- Pacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, Oregon
| | - Chandler Weeks
- Pacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, Oregon
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Sami S, Akinbami LJ, Petersen LR, Crawley A, Lukacs SL, Weiss D, Henseler RA, Vuong N, Mackey L, Patel A, Grohskopf LA, Morgenthau BM, Daskalakis D, Pathela P. Prevalence of SARS-CoV-2 Antibodies in First Responders and Public Safety Personnel, New York City, New York, USA, May-July 2020. Emerg Infect Dis 2021; 27:796-804. [PMID: 33493106 PMCID: PMC7920688 DOI: 10.3201/eid2703.204340] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
We conducted a serologic survey in public service agencies in New York City, New York, USA, during May–July 2020 to determine prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among first responders. Of 22,647 participants, 22.5% tested positive for SARS-CoV-2–specific antibodies. Seroprevalence for police and firefighters was similar to overall seroprevalence; seroprevalence was highest in correctional staff (39.2%) and emergency medical technicians (38.3%) and lowest in laboratory technicians (10.1%) and medicolegal death investigators (10.8%). Adjusted analyses demonstrated association between seropositivity and exposure to SARS-CoV-2–positive household members (adjusted odds ratio [aOR] 3.52 [95% CI 3.19–3.87]), non-Hispanic Black race or ethnicity (aOR 1.50 [95% CI 1.33–1.68]), and severe obesity (aOR 1.31 [95% CI 1.05–1.65]). Consistent glove use (aOR 1.19 [95% CI 1.06–1.33]) increased likelihood of seropositivity; use of other personal protective equipment had no association. Infection control measures, including vaccination, should be prioritized for frontline workers.
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Ioannidis JPA. Precision shielding for COVID-19: metrics of assessment and feasibility of deployment. BMJ Glob Health 2021; 6:e004614. [PMID: 33514595 PMCID: PMC7849322 DOI: 10.1136/bmjgh-2020-004614] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/06/2021] [Accepted: 01/07/2021] [Indexed: 12/12/2022] Open
Abstract
The ability to preferentially protect high-risk groups in COVID-19 is hotly debated. Here, the aim is to present simple metrics of such precision shielding of people at high risk of death after infection by SARS-CoV-2; demonstrate how they can estimated; and examine whether precision shielding was successfully achieved in the first COVID-19 wave. The shielding ratio, S, is defined as the ratio of prevalence of infection among people in a high-risk group versus among people in a low-risk group. The contrasted risk groups examined here are according to age (≥70 vs <70 years), and institutionalised (nursing home) setting. For age-related precision shielding, data were used from large seroprevalence studies with separate prevalence data for elderly versus non-elderly and with at least 1000 assessed people≥70 years old. For setting-related precision shielding, data were analysed from 10 countries where information was available on numbers of nursing home residents, proportion of nursing home residents among COVID-19 deaths and overall population infection fatality rate (IFR). Across 17 seroprevalence studies, the shielding ratio S for elderly versus non-elderly varied between 0.4 (substantial shielding) and 1.6 (substantial inverse protection, that is, low-risk people being protected more than high-risk people). Five studies in the USA all yielded S=0.4-0.8, consistent with some shielding being achieved, while two studies in China yielded S=1.5-1.6, consistent with inverse protection. Assuming 25% IFR among nursing home residents, S values for nursing home residents ranged from 0.07 to 3.1. The best shielding was seen in South Korea (S=0.07) and modest shielding was achieved in Israel, Slovenia, Germany and Denmark. No shielding was achieved in Hungary and Sweden. In Belgium (S=1.9), the UK (S=2.2) and Spain (S=3.1), nursing home residents were far more frequently infected than the rest of the population. In conclusion, the experience from the first wave of COVID-19 suggests that different locations and settings varied markedly in the extent to which they protected high-risk groups. Both effective precision shielding and detrimental inverse protection can happen in real-life circumstances. COVID-19 interventions should seek to achieve maximal precision shielding.
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Affiliation(s)
- John P A Ioannidis
- Department of Medicine and Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, USA
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