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Niekrens V, Kunz B, Werner M, Valenza G, Seggewies C, Bogdan C, Esse J. Analysis of the effectiveness of hygiene measures and COVID-19 vaccination at a tertiary-care university hospital during the first two years of the SARS-CoV-2 pandemic. Heliyon 2024; 10:e30311. [PMID: 38726181 PMCID: PMC11079082 DOI: 10.1016/j.heliyon.2024.e30311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 04/23/2024] [Accepted: 04/23/2024] [Indexed: 05/12/2024] Open
Abstract
Objective Assessment of the effectiveness of protective measures at a tertiary-care hospital during the SARS-CoV-2 infection waves to provide advice for future pandemics. Design Retrospective cohort study among hospital staff using in-house surveillance data. Setting University Hospital Erlangen (UKER), a tertiary-care provider in Bavaria, Germany. Methods We outline the preventive measures introduced at UKER and retrospectively assess their effectiveness using anonymized monitoring data that were collected during the SARS-CoV-2 pandemic from February 2020 to the end of January 2022. Analysed data includes the incidence of SARS-CoV-2 infections among employees, the frequency of high-risk contacts with infected patients or staff members and breakthrough infections considering the context of exposure. Results The cumulative incidence of SARS-CoV-2 infections among UKER employees was higher before, but lower after the vaccination campaign when compared to the general population. Healthcare workers (HCW), notably physicians and nurses, were especially at risk of infection compared to other UKER employees with less direct patient contact (OR 1.36 [95% CI 1.18-1.57 p < 0.001]). Breakthrough infections mostly occurred after exposure during private life, i.e. in situations without protective equipment. The frequency of high-risk contacts during direct patient care remained stable after SARS-CoV-2 vaccination. Prior to vaccination, 5.2% of HCW with direct patient care tested positive for SARS-CoV-2 within 14 days. After vaccination until the onset of the Omicron wave, conversion rate dropped to 0%. Conclusions This study provides real-world data on the effectiveness of vaccination, contact tracing, personal protective equipment and general hygiene measures during the SARS-CoV-2 pandemic. Based on our findings, we recommend a protective approach combining all these preventive measures.
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Affiliation(s)
- Valentin Niekrens
- Mikrobiologisches Institut - Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Wasserturmstraße 3/5, D-91054, Erlangen, Germany
| | - Bernd Kunz
- Mikrobiologisches Institut - Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Wasserturmstraße 3/5, D-91054, Erlangen, Germany
| | - Markus Werner
- Mikrobiologisches Institut - Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Wasserturmstraße 3/5, D-91054, Erlangen, Germany
| | - Giuseppe Valenza
- Mikrobiologisches Institut - Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Wasserturmstraße 3/5, D-91054, Erlangen, Germany
| | - Christof Seggewies
- Medical Informatics and Communication Center, Universitätsklinikum Erlangen, Glückstraße 11, D-91054, Erlangen, Germany
| | - Christian Bogdan
- Mikrobiologisches Institut - Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Wasserturmstraße 3/5, D-91054, Erlangen, Germany
- FAU Profile Center Immunomedicine, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Schlossplatz 1, D-91054, Erlangen, Germany
| | - Jan Esse
- Mikrobiologisches Institut - Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Wasserturmstraße 3/5, D-91054, Erlangen, Germany
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Kribi S, Touré F, Mendes A, Sanou S, Some A, Aminou AM, Belarbi E, Griessel R, Hema A, Kabore F, Pitzinger P, Strydom A, Vietor AC, Traoré K, Zongo A, Anoh EA, Grossegesse M, Hofmann N, Ouangraoua S, Poda A, Kagone T, Schubert G, Eckmanns T, Venter M, Leendertz F, Akoua-Koffi C, Tomczyk S. Multicountry study of SARS-CoV-2 and associated risk factors among healthcare workers in Côte d'Ivoire, Burkina Faso and South Africa. Trans R Soc Trop Med Hyg 2022; 117:179-188. [PMID: 36153637 PMCID: PMC9619424 DOI: 10.1093/trstmh/trac089] [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] [Received: 05/16/2022] [Revised: 08/22/2022] [Accepted: 09/02/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Reports on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread across Africa have varied, including among healthcare workers (HCWs). This study assessed the comparative SARS-CoV-2 burden and associated risk factors among HCWs in three African countries. METHODS A multicentre study was conducted at regional healthcare facilities in Côte d'Ivoire (CIV), Burkina Faso (BF) and South Africa (SA) from February to May 2021. HCWs provided blood samples for SARS-CoV-2 serology and nasopharyngeal/oropharyngeal swabs for testing of acute infection by polymerase chain reaction and completed a questionnaire. Factors associated with seropositivity were assessed with logistic regression. RESULTS Among 719 HCWs, SARS-CoV-2 seroprevalence was 34.6% (95% confidence interval 31.2 to 38.2), ranging from 19.2% in CIV to 45.7% in BF. A total of 20 of 523 (3.8%) were positive for acute SARS-CoV-2 infection. Female HCWs had higher odds of SARS-CoV-2 seropositivity compared with males, and nursing staff, allied health professionals, non-caregiver personnel and administration had higher odds compared with physicians. HCWs also reported infection prevention and control (IPC) gaps, including 38.7% and 29% having access to respirators and IPC training, respectively, in the last year. CONCLUSIONS This study was a unique comparative HCW SARS-CoV-2 investigation in Africa. Seroprevalence estimates varied, highlighting distinctive population/facility-level factors affecting COVID-19 burden and the importance of established IPC programmes to protect HCWs and patients.
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Affiliation(s)
- Sarah Kribi
- Corresponding author: Tel: +4915203088440; E-mail: ; Present address: Seestraße 10, Berlin 13353, Germany
| | | | - Adriano Mendes
- Department of Medical Virology, University of Pretoria, Private Bag x 20 Hatfield 0028, South Africa
| | - Soufiane Sanou
- Le Centre Muraz, Ave Mamadou Konate, Bobo-Dioulasso, Burkina Faso
| | - Arsène Some
- Le Centre Muraz, Ave Mamadou Konate, Bobo-Dioulasso, Burkina Faso
| | - Abdoul M Aminou
- Centre Hospitalier Universitaire Bouaké, Laboratoire de Bactériologie et Virologie 01, 01 BP 1174 Bouaké, Bouaké, Côte d'Ivoire
| | - Essia Belarbi
- Robert Koch Institut P3 Seestraße 10, Berlin 13353, Germany
| | - Rosemary Griessel
- Department of Medical Microbiology, University of Pretoria, Private Bag x 20 Hatfield 0028, South Africa,Department of Medical Microbiology, Tshwane Academic Division, National Health Laboratory Service, Pretoria 0001, South Africa
| | - Arsène Hema
- Centre Hospitalier Sourô Sanou, Service d'épidemiologie, Ave Ponty, Bobo-Dioulasso, Burkina Faso
| | - Firmin Kabore
- Le Centre Muraz, Ave Mamadou Konate, Bobo-Dioulasso, Burkina Faso
| | - Paul Pitzinger
- Robert Koch Institut P3 Seestraße 10, Berlin 13353, Germany
| | - Amy Strydom
- Department of Medical Virology, University of Pretoria, Private Bag x 20 Hatfield 0028, South Africa
| | | | - Korotimi Traoré
- Le Centre Muraz, Ave Mamadou Konate, Bobo-Dioulasso, Burkina Faso
| | - Arsène Zongo
- Le Centre Muraz, Ave Mamadou Konate, Bobo-Dioulasso, Burkina Faso
| | - Etilé A Anoh
- Centre Hospitalier Universitaire Bouaké, Laboratoire de Bactériologie et Virologie 01, 01 BP 1174 Bouaké, Bouaké, Côte d'Ivoire
| | | | | | | | - Armel Poda
- Centre Hospitalier Sourô Sanou, Service d'épidemiologie, Ave Ponty, Bobo-Dioulasso, Burkina Faso
| | - Thérèse Kagone
- Le Centre Muraz, Ave Mamadou Konate, Bobo-Dioulasso, Burkina Faso
| | - Grit Schubert
- Robert Koch Institut P3 Seestraße 10, Berlin 13353, Germany
| | - Tim Eckmanns
- Robert Koch Institut P3 Seestraße 10, Berlin 13353, Germany
| | - Marietjie Venter
- Department of Medical Virology, University of Pretoria, Private Bag x 20 Hatfield 0028, South Africa
| | | | - Chantal Akoua-Koffi
- Centre Hospitalier Universitaire Bouaké, Laboratoire de Bactériologie et Virologie 01, 01 BP 1174 Bouaké, Bouaké, Côte d'Ivoire
| | - Sara Tomczyk
- Robert Koch Institut P3 Seestraße 10, Berlin 13353, Germany
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El Moussaoui M, Maes N, Hong SL, Lambert N, Gofflot S, Dellot P, Belhadj Y, Huynen P, Hayette MP, Meex C, Bontems S, Defêche J, Godderis L, Molenberghs G, Meuris C, Artesi M, Durkin K, Rahmouni S, Grégoire C, Beguin Y, Moutschen M, Dellicour S, Darcis G. Evaluation of Screening Program and Phylogenetic Analysis of SARS-CoV-2 Infections among Hospital Healthcare Workers in Liège, Belgium. Viruses 2022; 14:v14061302. [PMID: 35746774 PMCID: PMC9227503 DOI: 10.3390/v14061302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 06/03/2022] [Accepted: 06/09/2022] [Indexed: 11/16/2022] Open
Abstract
Healthcare workers (HCWs) are known to be at higher risk of developing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections although whether these risks are equal across all occupational roles is uncertain. Identifying these risk factors and understand SARS-CoV-2 transmission pathways in healthcare settings are of high importance to achieve optimal protection measures. We aimed to investigate the implementation of a voluntary screening program for SARS-CoV-2 infections among hospital HCWs and to elucidate potential transmission pathways though phylogenetic analysis before the vaccination era. HCWs of the University Hospital of Liège, Belgium, were invited to participate in voluntary reverse transcriptase-polymerase chain reaction (RT-PCR) assays performed every week from April to December 2020. Phylogenetic analysis of SARS-CoV-2 genomes were performed for a subgroup of 45 HCWs. 5095 samples were collected from 703 HCWs. 212 test results were positive, 15 were indeterminate, and 4868 returned negative. 156 HCWs (22.2%) tested positive at least once during the study period. All SARS-CoV-2 test results returned negative for 547 HCWs (77.8%). Nurses (p < 0.05), paramedics (p < 0.05), and laboratory staff handling respiratory samples (p < 0.01) were at higher risk for being infected compared to the control non-patient facing group. Our phylogenetic analysis revealed that most positive samples corresponded to independent introduction events into the hospital. Our findings add to the growing evidence of differential risks of being infected among HCWs and support the need to implement appropriate protection measures based on each individual’s risk profile to guarantee the protection of both HCWs and patients. Furthermore, our phylogenetic investigations highlight that most positive samples correspond to distinct introduction events into the hospital.
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Affiliation(s)
- Majdouline El Moussaoui
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liege, Belgium; (P.D.); (Y.B.); (C.M.); (M.M.); (G.D.)
- Correspondence:
| | - Nathalie Maes
- Department of Biostatistics and Medico-Economic Information, University Hospital of Liège, 4000 Liege, Belgium;
| | - Samuel L. Hong
- Department of Microbiology, Immunology and Transplantation, Rega Institute, Katholieke Universiteit Leuven, 3000 Leuven, Belgium; (S.L.H.); (S.D.)
| | - Nicolas Lambert
- Department of Neurology, University Hospital of Liège, 4000 Liege, Belgium;
| | - Stéphanie Gofflot
- Department of Biothèque Hospitalo-Universitaire de Liège (BHUL), University Hospital of Liège, 4000 Liege, Belgium;
| | - Patricia Dellot
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liege, Belgium; (P.D.); (Y.B.); (C.M.); (M.M.); (G.D.)
| | - Yasmine Belhadj
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liege, Belgium; (P.D.); (Y.B.); (C.M.); (M.M.); (G.D.)
| | - Pascale Huynen
- Department of Clinical Microbiology, University Hospital of Liège, 4000 Liege, Belgium; (P.H.); (M.-P.H.); (C.M.); (S.B.); (J.D.)
| | - Marie-Pierre Hayette
- Department of Clinical Microbiology, University Hospital of Liège, 4000 Liege, Belgium; (P.H.); (M.-P.H.); (C.M.); (S.B.); (J.D.)
| | - Cécile Meex
- Department of Clinical Microbiology, University Hospital of Liège, 4000 Liege, Belgium; (P.H.); (M.-P.H.); (C.M.); (S.B.); (J.D.)
| | - Sébastien Bontems
- Department of Clinical Microbiology, University Hospital of Liège, 4000 Liege, Belgium; (P.H.); (M.-P.H.); (C.M.); (S.B.); (J.D.)
| | - Justine Defêche
- Department of Clinical Microbiology, University Hospital of Liège, 4000 Liege, Belgium; (P.H.); (M.-P.H.); (C.M.); (S.B.); (J.D.)
| | - Lode Godderis
- Centre for Environment and Health, Department of Public Health and Primary Care, Katholieke Universiteit Leuven, 3000 Leuven, Belgium;
| | - Geert Molenberghs
- Institute for Biostatistics and Statistical Bioinformatics, Katholieke Universiteit Leuven, 3000 Leuven, Belgium;
| | - Christelle Meuris
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liege, Belgium; (P.D.); (Y.B.); (C.M.); (M.M.); (G.D.)
| | - Maria Artesi
- Laboratory of Human Genetics, GIGA-Institute, University of Liège, 4000 Liege, Belgium; (M.A.); (K.D.)
| | - Keith Durkin
- Laboratory of Human Genetics, GIGA-Institute, University of Liège, 4000 Liege, Belgium; (M.A.); (K.D.)
| | - Souad Rahmouni
- Laboratory of Animal Genomics, GIGA-Medical Genomics, GIGA-Institute, University of Liège, 4000 Liege, Belgium;
| | - Céline Grégoire
- Department of Haematology, University Hospital of Liège, 4000 Liege, Belgium; (C.G.); (Y.B.)
| | - Yves Beguin
- Department of Haematology, University Hospital of Liège, 4000 Liege, Belgium; (C.G.); (Y.B.)
| | - Michel Moutschen
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liege, Belgium; (P.D.); (Y.B.); (C.M.); (M.M.); (G.D.)
| | - Simon Dellicour
- Department of Microbiology, Immunology and Transplantation, Rega Institute, Katholieke Universiteit Leuven, 3000 Leuven, Belgium; (S.L.H.); (S.D.)
- Spatial Epidemiology Lab, Université Libre de Bruxelles, 1000 Brussels, Belgium
| | - Gilles Darcis
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liege, Belgium; (P.D.); (Y.B.); (C.M.); (M.M.); (G.D.)
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Hildebrandt A, Hökelekli O, Uflacker L, Rudolf H, Paulussen M, Gatermann SG. Seroprevalence of SARS-CoV-2 Antibodies in Employees of Three Hospitals of a Secondary Care Hospital Network in Germany and an Associated Fire Brigade: Results of a Repeated Cross-Sectional Surveillance Study Over 1 Year. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042402. [PMID: 35206589 PMCID: PMC8878380 DOI: 10.3390/ijerph19042402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/06/2022] [Accepted: 02/15/2022] [Indexed: 02/06/2023]
Abstract
Healthcare workers (HCWs) are playing a vital role in the current SARS-CoV-2 pandemic. This study investigated how infection spreads within three local hospitals and an associated fire brigade in Germany by testing employees for the presence of SARS-CoV-2 IgG antibodies over one year. The three observational periods corresponded to the initial three pandemic waves: first wave: June–September 2020, second wave: October 2020–January 2021, and third wave: February–June 2021. We analysed 3285 serum samples of 1842 employees, which represents 65.7% of all employees. Altogether, 13.2% employees were seropositive: 194/1411 HCWs (13.7%) and 49/431 non-HCWs (11.4%) with a clear increase of seroprevalence from the first (1.1%) to the second (13.2%) and third (29.3%) pandemic wave. HCWs presumably had an additional occupational risk for infection in the second and third wave due to an increase of infection pressure with more COVID-19 patients treated, showing possible weak points in the recommended infection prevention strategy.
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Affiliation(s)
- Anke Hildebrandt
- St. Vincenz Hospital, Department of Internal Medicine I, 45711 Datteln, Germany
- Institute of Medical Microbiology, University Hospital Münster, 48149 Münster, Germany
| | - Oktay Hökelekli
- St. Vincenz Hospital, Department of Internal Medicine I, 45711 Datteln, Germany
| | - Lutz Uflacker
- St. Vincenz Hospital, Department of Internal Medicine I, 45711 Datteln, Germany
| | - Henrik Rudolf
- Institute for Biostatistics and Informatics in Medicine and Ageing Research, University Medical Center Rostock, 18057 Rostock, Germany
| | - Michael Paulussen
- Vestische Kinder- und Jugendklinik, Witten/Herdecke University, 45711 Datteln, Germany
| | - Sören G Gatermann
- National Reference Center for Multidrug-Resistant Gram-Negative Bacteria, Ruhr University Bochum, 44801 Bochum, Germany
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Tomczyk S, Hönning A, Hermes J, Grossegesse M, Hofmann N, Michel J, Neumann M, Nitsche A, Hoppe B, Eckmanns T, Schmidt-Traub H, Zappel K. Longitudinal SARS-CoV-2 seroepidemiological investigation among healthcare workers at a tertiary care hospital in Germany. BMC Infect Dis 2022; 22:80. [PMID: 35073863 PMCID: PMC8784861 DOI: 10.1186/s12879-022-07057-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 01/11/2022] [Indexed: 01/27/2023] Open
Abstract
Background SARS-CoV-2 cases in Germany increased in early March 2020. By April 2020, cases among health care workers (HCW) were detected across departments at a tertiary care hospital in Berlin, prompting a longitudinal investigation to assess HCW SARS-CoV-2 serostatus with an improved testing strategy and associated risk factors. Methods In May/June and December 2020, HCWs voluntarily provided blood for serology and nasopharyngeal/oropharyngeal (NP/OP) samples for real-time polymerase chain reaction (PCR) and completed a questionnaire. A four-tiered SARS-CoV-2 serological testing strategy including two different enzyme-linked immunosorbent assays (ELISA) and biological neutralization test (NT) was used. ELISA-NT correlation was assessed using Pearson’s correlation coefficient. Sociodemographic and occupational factors associated with seropositivity were assessed with multivariate logistic regression. Results In May/June, 18/1477 (1.2%) HCWs were SARS-CoV-2 seropositive, followed by 56/1223 (4.6%) in December. Among those tested in both, all seropositive in May/June remained seropositive by ELISA and positive by NT after 6 months. ELISA ratios correlated well with NT titres in May/June (R = 0.79) but less so in December (R = 0.41). Those seropositive reporting a past SARS-CoV-2 positive PCR result increased from 44.4% in May/June to 85.7% in December. HCWs with higher occupational risk (based on profession and working site), nurses, males, and those self-reporting COVID-19-like symptoms had significantly higher odds of seropositivity. Conclusions This investigation provides insight into the burden of HCW infection in this local outbreak context and the antibody dynamics over time with an improved robust testing strategy. It also highlights the continued need for effective infection control measures particularly among HCWs with higher occupational risk. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07057-3.
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Szajek K, Fleisch F, Hutter S, Risch M, Bechmann T, Luyckx VA, Güsewell S, Hirzel C, Cusini A, Group AS. Healthcare institutions' recommendation regarding the use of FFP-2 masks and SARS-CoV-2 seropositivity among healthcare workers: a multicenter longitudinal cohort study. Antimicrob Resist Infect Control 2022; 11:6. [PMID: 35012679 PMCID: PMC8744038 DOI: 10.1186/s13756-021-01047-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 12/24/2021] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Health care workers (HCW) are heavily exposed to SARS-CoV-2 from the beginning of the pandemic. We aimed to analyze risk factors for SARS-CoV-2 seroconversion among HCW with a special emphasis on the respective healthcare institutions' recommendation regarding the use of FFP-2 masks. METHODS We recruited HCW from 13 health care institutions (HCI) with different mask policies (type IIR surgical face masks vs. FFP-2 masks) in Southeastern Switzerland (canton of Grisons). Sera of participants were analyzed for the presence of SARS-CoV-2 antibodies 6 months apart, after the first and during the second pandemic wave using an electro-chemiluminescence immunoassay (ECLIA, Roche Diagnostics). We captured risk factors for SARS-CoV-2 infection by using an online questionnaire at both time points. The effects of individual COVID-19 exposure, regional incidence and FFP-2 mask policy on the probability of seroconversion were evaluated with univariable and multivariable logistic regression. RESULTS SARS-CoV-2 antibodies were detected in 99 of 2794 (3.5%) HCW at baseline and in 376 of 2315 (16.2%) participants 6 months later. In multivariable analyses the strongest association for seroconversion was exposure to a household member with known COVID-19 (aOR: 19.82, 95% CI 8.11-48.43, p < 0.001 at baseline and aOR: 8.68, 95% CI 6.13-12.29, p < 0.001 at follow-up). Significant occupational risk factors at baseline included exposure to COVID-19 patients (aOR: 2.79, 95% CI 1.28-6.09, p = 0.010) and to SARS-CoV-2 infected co-workers (aOR: 2.50, 95% CI 1.52-4.12, p < 0.001). At follow up 6 months later, non-occupational exposure to SARS-CoV-2 infected individuals (aOR: 2.54, 95% CI 1.66-3.89 p < 0.001) and the local COVID-19 incidence of the corresponding HCI (aOR: 1.98, 95% CI 1.30-3.02, p = 0.001) were associated with seroconversion. The healthcare institutions' mask policy (surgical masks during usual exposure vs. general use of FFP-2 masks) did not affect seroconversion rates of HCW during the first and the second pandemic wave. CONCLUSION Contact with SARS-CoV-2 infected household members was the most important risk factor for seroconversion among HCW. The strongest occupational risk factor was exposure to COVID-19 patients. During this pandemic, with heavy non-occupational exposure to SARS-CoV-2, the mask policy of HCIs did not affect the seroconversion rate of HCWs.
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Affiliation(s)
- Katarzyna Szajek
- Department of Internal Medicine, Cantonal Hospital of Grisons, Chur, Switzerland
| | - Felix Fleisch
- Division of Infectious Diseases, Cantonal Hospital of Grisons, 7000, Chur, Switzerland
| | - Sandra Hutter
- Central Laboratory, Cantonal Hospital of Grisons, Chur, Switzerland
| | - Martin Risch
- Central Laboratory, Cantonal Hospital of Grisons, Chur, Switzerland
| | - Theresa Bechmann
- Division for Information and Communication Technology, Cantonal Hospital of Grisons, Chur, Switzerland
| | - Valerie A Luyckx
- Division of Nephrology, Cantonal Hospital of Grisons, Chur, Switzerland
| | - Sabine Güsewell
- Clinical Trials Unit, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland
| | - Cédric Hirzel
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital and University of Bern, Bern, Switzerland
| | - Alexia Cusini
- Division of Infectious Diseases, Cantonal Hospital of Grisons, 7000, Chur, Switzerland.
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Sharma P, Chawla R, Basu S, Saxena S, Mariam W, Bharti PK, Rao S, Tanwar N, Rahman A, Ahmad M. Seroprevalence of SARS-CoV-2 and Risk Assessment Among Healthcare Workers at a Dedicated Tertiary Care COVID-19 Hospital in Delhi, India: A Cohort Study. Cureus 2021; 13:e20805. [PMID: 35145765 PMCID: PMC8810309 DOI: 10.7759/cureus.20805] [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] [Accepted: 12/28/2021] [Indexed: 11/05/2022] Open
Abstract
Background Healthcare workers (HCWs) have a substantially higher risk of Covid-19 infection but there is a paucity of information on the risk factors of disease transmission in high-burden real-world settings. The study objective was to determine the seroprevalence of SARS-CoV-2 among healthcare workers in a high-burden Covid-19 setting and to estimate the incidence and identify the risk factors of infection. Methods This was a prospective observational cohort study amongst doctors and nurses working at a dedicated Covid-19 tertiary care government hospital in Delhi, India. A baseline blood sample (2-3ml) was collected from all the participants to test for the presence of total SARS-CoV-2 antibodies. The HCWs that were seronegative (non-reactive) at baseline were followed-up for ≥21≤28 days with the collection of a second blood sample to assess for the incidence of SARS-CoV-2 infection. Results A total of 321 (51.3%, 95% C.I 47.4, 55.3) HCWs were detected with SARS-CoV-2 antibodies on baseline examination. The seroprevalence, when adjusted for assay characteristics, was 54.5% (95% C.I 50.3, 58.6). On bivariate analysis, SARS-CoV-2 antibody positivity lacked statistically significant association with either age, sex, occupation, cumulative duty duration, and smoking status. The incidence of seroconversion in the baseline seronegative cohort on follow-up after 21-28 days was observed in 35 (14.9%) HCWs (n=245). Furthermore, the self-reported adherence to infection prevention and control measures did not show a statistically significant association with antibody positivity in the HCWs, neither at baseline nor on follow-up. Conclusions The high risk of SARS-CoV-2 transmission in HCWs may be substantially reduced by adherence to Infection Prevention Control (IPC) and protective measures.
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Dehnen D, Dehnen K, Trilling M, Fiedler M, Drexler J, Goralski M, Le-Trilling VTK, Schöler L, Jöckel KH, Heßbrügge M. Discrepancy between frequent occurrence of COVID-19-like symptoms and low seroconversion rates among healthcare workers. J Med Virol 2021; 94:951-957. [PMID: 34633099 PMCID: PMC8661860 DOI: 10.1002/jmv.27385] [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: 06/11/2021] [Revised: 09/20/2021] [Accepted: 10/06/2021] [Indexed: 11/09/2022]
Abstract
During the first wave of the pandemic, we compared the occurrence of subjectively experienced COVID‐19‐like symptoms and true severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) seroconversion rates among medical personnel in general practices. This cross‐sectional study determined the SARS‐CoV‐2‐specific immunoglobulin G (IgG) antibody status of medical staff from 100 outpatient practices in Germany. Study cohort characteristics and COVID‐19‐like symptoms were obtained by questionnaires. The initial screening for SARS‐CoV‐2‐recognizing antibodies was performed using a commercial chemiluminescence microparticle immunoassay. Positive results were controlled with another approved test. Samples with discrepant results were subjected to a third IgG‐binding assay and a neutralization test. A total of 861 participants were included, 1.7% (n = 15) of whom tested positive for SARS‐CoV‐specific IgG in the initial screening test. In 46.6% (n = 7) of positive cases, test results were confirmed by an independent test. In the eight samples with discrepant results, neither spike‐specific antibodies nor in vitro neutralizing capacity were detectable, resulting in a genuine seroprevalence rate of 0.8%. 794 participants completed the questionnaire. Intriguingly, a total of 53.7% (n = 426) of them stated episodes of COVID‐19‐like symptoms. Except for smell and taste dysfunction, there were no significant differences between the groups with and without laboratory‐confirmed SARS‐CoV‐2 seroconversion. Our results demonstrated that only 0.8% of participants acquired SARS‐CoV‐2 even though 53.7% of participants reportedly experienced COVID‐19‐like symptoms. Thus, even among medical staff, self‐diagnosis based on subjectively experienced symptoms does not have a relevant predictive value.
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Affiliation(s)
- Dorothea Dehnen
- Institute of Family Practice, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Katja Dehnen
- Institute of Family Practice, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Mirko Trilling
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Melanie Fiedler
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Julia Drexler
- Institute of Family Practice, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Marcel Goralski
- Institute of Family Practice, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | | | - Lara Schöler
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology (IMIBE), University Hospital Essen, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Martina Heßbrügge
- Institute of Family Practice, Medical Faculty, University of Duisburg-Essen, Essen, Germany
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9
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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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10
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König J, Chung S, Ertl V, Doering BK, Comtesse H, Unterhitzenberger J, Barke A. The German Translation of the Stress and Anxiety to Viral Epidemics-9 (SAVE-9) Scale: Results from Healthcare Workers during the Second Wave of COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9377. [PMID: 34501967 PMCID: PMC8431413 DOI: 10.3390/ijerph18179377] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/01/2021] [Accepted: 09/02/2021] [Indexed: 02/07/2023]
Abstract
Healthcare workers (HCW) are among those most directly affected by the COVID-19 pandemic. Most research with this group has used ad hoc measures, which limits comparability across samples. The Stress and Anxiety to Viral Epidemics-9 scale (SAVE-9) is a nine-item scale first developed in Korea, and has since been translated into several languages. We report on data collected from 484 German HCW between November 2020 and March 2021, during the "second wave" of coronavirus infections. We conducted item analysis, confirmatory factor analysis on the previously found factor solutions of the SAVE-9, examined correlations with established measures of depression, generalized anxiety, and insomnia, and compared scores between different groups of HCW. The psychometric properties of the German SAVE-9 were satisfactory and comparable to previous findings from Korea and Russia. Correlations with mental health measures were positive, as expected. We found some significant differences between groups of HCW on the SAVE-9 which were consistent with the literature but did not appear on the other mental health measures. This suggests that the SAVE-9 taps into specifically work-related stress, which may make it a helpful instrument in this research area.
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Affiliation(s)
- Julia König
- Department of Clinical and Biological Psychology, Catholic University of Eichstaett-Ingolstadt, Ostenstraße 25, 85072 Eichstaett, Germany; (V.E.); (B.K.D.); (H.C.); (J.U.); (A.B.)
| | - Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea
| | - Verena Ertl
- Department of Clinical and Biological Psychology, Catholic University of Eichstaett-Ingolstadt, Ostenstraße 25, 85072 Eichstaett, Germany; (V.E.); (B.K.D.); (H.C.); (J.U.); (A.B.)
| | - Bettina K. Doering
- Department of Clinical and Biological Psychology, Catholic University of Eichstaett-Ingolstadt, Ostenstraße 25, 85072 Eichstaett, Germany; (V.E.); (B.K.D.); (H.C.); (J.U.); (A.B.)
| | - Hannah Comtesse
- Department of Clinical and Biological Psychology, Catholic University of Eichstaett-Ingolstadt, Ostenstraße 25, 85072 Eichstaett, Germany; (V.E.); (B.K.D.); (H.C.); (J.U.); (A.B.)
| | - Johanna Unterhitzenberger
- Department of Clinical and Biological Psychology, Catholic University of Eichstaett-Ingolstadt, Ostenstraße 25, 85072 Eichstaett, Germany; (V.E.); (B.K.D.); (H.C.); (J.U.); (A.B.)
| | - Antonia Barke
- Department of Clinical and Biological Psychology, Catholic University of Eichstaett-Ingolstadt, Ostenstraße 25, 85072 Eichstaett, Germany; (V.E.); (B.K.D.); (H.C.); (J.U.); (A.B.)
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11
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Larribère L, Gordejeva J, Kuhnhenn L, Kurscheidt M, Pobiruchin M, Vladimirova D, Martin M, Roser M, Schramm W, Martens UM, Eigenbrod T. Assessment of SARS-CoV-2 Infection among Healthcare Workers of a German COVID-19 Treatment Center. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7057. [PMID: 34281000 PMCID: PMC8297119 DOI: 10.3390/ijerph18137057] [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] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 06/28/2021] [Indexed: 12/11/2022]
Abstract
To date, more than 160 million people have been infected with COVID-19 worldwide. In the present study, we investigated the history of SARS-CoV-2 infection among 3067 healthcare workers (HCW) in a German COVID-19 treatment center during the early phase of the pandemic (July 2020) based on the seroprevalence of SARS-CoV-2 antibodies and self-reported previous PCR results. The results demonstrate a low prevalence of SARS-CoV-2 infection (n = 107 [3.5%]) with no increased risk for employees with a high level of patient exposure in general or working in COVID-19-confined areas in particular. This suggests that the local hygiene standards implemented in our hospital during the first wave of COVID-19 pandemic were effective in preventing patient-to-HCW transmission. No evidence for highly mobile staff serving as a vector for SARS-CoV-2 transmission could be found. In addition, impairment of smell and/or taste was strongly associated with SARS-CoV-2 history.
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Affiliation(s)
- Lionel Larribère
- Cancer Center Heilbronn-Franken, SLK Clinics Heilbronn GmbH, 74078 Heilbronn, Germany; (D.V.); (U.M.M.)
| | - Jelizaveta Gordejeva
- GECKO Institute for Medicine, Informatics and Economics, Hochschule Heilbronn, 74081 Heilbronn, Germany; (J.G.); (M.K.); (M.P.); (W.S.)
| | - Lisa Kuhnhenn
- Institute of Laboratory Medicine, SLK Clinics Heilbronn GmbH, 74078 Heilbronn, Germany; (L.K.); (M.R.); (T.E.)
| | - Maximilian Kurscheidt
- GECKO Institute for Medicine, Informatics and Economics, Hochschule Heilbronn, 74081 Heilbronn, Germany; (J.G.); (M.K.); (M.P.); (W.S.)
| | - Monika Pobiruchin
- GECKO Institute for Medicine, Informatics and Economics, Hochschule Heilbronn, 74081 Heilbronn, Germany; (J.G.); (M.K.); (M.P.); (W.S.)
| | - Dilyana Vladimirova
- Cancer Center Heilbronn-Franken, SLK Clinics Heilbronn GmbH, 74078 Heilbronn, Germany; (D.V.); (U.M.M.)
| | - Maria Martin
- Institute for Infection Prevention and Clinical Hygiene, SLK Clinics Heilbronn GmbH, 74078 Heilbronn, Germany;
| | - Markus Roser
- Institute of Laboratory Medicine, SLK Clinics Heilbronn GmbH, 74078 Heilbronn, Germany; (L.K.); (M.R.); (T.E.)
| | - Wendelin Schramm
- GECKO Institute for Medicine, Informatics and Economics, Hochschule Heilbronn, 74081 Heilbronn, Germany; (J.G.); (M.K.); (M.P.); (W.S.)
| | - Uwe M. Martens
- Cancer Center Heilbronn-Franken, SLK Clinics Heilbronn GmbH, 74078 Heilbronn, Germany; (D.V.); (U.M.M.)
| | - Tatjana Eigenbrod
- Institute of Laboratory Medicine, SLK Clinics Heilbronn GmbH, 74078 Heilbronn, Germany; (L.K.); (M.R.); (T.E.)
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