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Lam T, Saso A, Torres Ortiz A, Hatcher J, Woodman M, Chandran S, Thistlethwayte R, Best T, Johnson M, Wagstaffe H, Mai A, Buckland M, Gilmour K, Goldblatt D, Grandjean L. Socioeconomic and Demographic Risk Factors for SARS-CoV-2 Seropositivity Among Healthcare Workers in a UK Hospital: A Prospective Cohort Study. Clin Infect Dis 2024; 78:594-602. [PMID: 37647517 PMCID: PMC10954340 DOI: 10.1093/cid/ciad522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/26/2023] [Accepted: 08/29/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND To protect healthcare workers (HCWs) from the consequences of disease due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), it is necessary to understand the risk factors that drive exposure and infection within hospitals. Insufficient consideration of key socioeconomic variables is a limitation of existing studies that can lead to bias and residual confounding of proposed risk factors for infection. METHODS The Co-STARs study prospectively enrolled 3679 HCWs between April 2020 and September 2020. We used multivariate logistic regression to comprehensively characterize the demographic, occupational, socioeconomic, and environmental risk factors for SARS-CoV-2 seropositivity. RESULTS After adjusting for key confounders, relative household overcrowding (odds ratio [OR], 1.4 [95% confidence interval {CI}, 1.1-1.9]; P = .006), Black, Black British, Caribbean, or African ethnicity (OR, 1.7 [95% CI, 1.2-2.3]; P = .003), increasing age (ages 50-60 years: OR, 1.8 [95% CI, 1.3-2.4]; P < .001), lack of access to sick pay (OR, 1.8 [95% CI, 1.3-2.4]; P < .001). CONCLUSIONS Socioeconomic and demographic factors outside the hospital were the main drivers of infection and exposure to SARS-CoV-2 during the first wave of the pandemic in an urban pediatric referral hospital. Overcrowding and out-of-hospital SARS-CoV-2 contact are less amenable to intervention. However, lack of access to sick pay among externally contracted staff is more easily rectifiable. Our findings suggest that providing easier access to sick pay would lead to a decrease in SARS-CoV-2 transmission and potentially that of other infectious diseases in hospital settings. CLINICAL TRIALS REGISTRATION NCT04380896.
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Affiliation(s)
- Tanya Lam
- Department of Infectious Diseases, Great Ormond Street Hospital, London, United Kingdom
| | - Anja Saso
- Department of Infectious Diseases, Great Ormond Street Hospital, London, United Kingdom
- Department of Tropical and Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Medical Research Council Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Arturo Torres Ortiz
- Department of Infectious Diseases, Imperial College London, London, United Kingdom
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, United Kingdom
| | - James Hatcher
- Department of Microbiology, Great Ormond Street Hospital, London, United Kingdom
| | - Marc Woodman
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, United Kingdom
| | - Shruthi Chandran
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, United Kingdom
| | | | - Timothy Best
- Department of Microbiology, Great Ormond Street Hospital, London, United Kingdom
| | - Marina Johnson
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, United Kingdom
| | - Helen Wagstaffe
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, United Kingdom
| | - Annabelle Mai
- Clinical Immunology, Camelia Botnar Laboratories, Great Ormond Street Hospital, London, United Kingdom
| | - Matthew Buckland
- Clinical Immunology, Camelia Botnar Laboratories, Great Ormond Street Hospital, London, United Kingdom
| | - Kimberly Gilmour
- Clinical Immunology, Camelia Botnar Laboratories, Great Ormond Street Hospital, London, United Kingdom
| | - David Goldblatt
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, United Kingdom
| | - Louis Grandjean
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, United Kingdom
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Recanatini C, GeurtsvanKessel CH, Pas SD, Broens EM, Maas M, van Mansfeld R, Mutsaers-van Oudheusden AJG, van Rijen M, Schippers EF, Stegeman A, Tami A, Veldkamp KE, Visser H, Voss A, Wegdam-Blans MCA, Wertheim HFL, Wever PC, Koopmans MPG, Kluytmans JAJW, Kluytmans-van den Bergh MFQ. Seroprevalence of SARS-CoV-2 antibodies among healthcare workers in Dutch hospitals after the 2020 first wave: a multicentre cross-sectional study with prospective follow-up. Antimicrob Resist Infect Control 2023; 12:137. [PMID: 38031155 PMCID: PMC10688070 DOI: 10.1186/s13756-023-01324-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 10/22/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND We aimed to estimate the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence and describe its determinants and associated symptoms among unvaccinated healthcare workers (HCWs) after the first wave of the pandemic. METHODS HCWs from 13 Dutch hospitals were screened for antibodies against the spike protein of SARS-CoV-2 in June-July 2020 and after three months. Participants completed a retrospective questionnaire on determinants for occupational and community exposure to SARS-CoV-2 and symptoms suggestive of COVID-19 experienced since January 2020. The seroprevalence was calculated per baseline characteristic and symptom at baseline and after follow-up. Adjusted odds ratios (aOR) for seropositivity were determined using logistic regression. RESULTS Among 2328 HCWs, 323 (13.9%) were seropositive at enrolment, 49 of whom (15%) reported no previous symptoms suggestive of COVID-19. During follow-up, only 1% of the tested participants seroconverted. Seroprevalence was higher in younger HCWs compared to the mid-age category (aOR 1.53, 95% CI 1.07-2.18). Nurses (aOR 2.21, 95% CI 1.34-3.64) and administrative staff (aOR 1.87, 95% CI 1.02-3.43) had a higher seroprevalence than physicians. The highest seroprevalence was observed in HCWs in the emergency department (ED) (aOR 1.79, 95% CI 1.10-2.91), the lowest in HCWs in the intensive, high, or medium care units (aOR 0.47, 95% CI 0.31-0.71). Chronic respiratory disease, smoking, and having a dog were independently associated with a lower seroprevalence, while HCWs with diabetes mellitus had a higher seroprevalence. In a multivariable model containing all self-reported symptoms since January 2020, altered smell and taste, fever, general malaise/fatigue, and muscle aches were positively associated with developing antibodies, while sore throat and chills were negatively associated. CONCLUSIONS The SARS-CoV-2 seroprevalence in unvaccinated HCWs of 13 Dutch hospitals was 14% in June-July 2020 and remained stable after three months. A higher seroprevalence was observed in the ED and among nurses, administrative and young staff, and those with diabetes mellitus, while a lower seroprevalence was found in HCWs in intensive, high, or medium care, and those with self-reported lung disease, smokers, and dog owners. A history of altered smell or taste, fever, muscle aches and fatigue were independently associated with the presence of SARS-CoV-2 antibodies in unvaccinated HCWs.
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Affiliation(s)
- Claudia Recanatini
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | | | - Suzan D Pas
- Microvida Laboratory for Medical Microbiology, Bravis Hospital, Roosendaal, The Netherlands
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Els M Broens
- Department Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Martje Maas
- Department of Internal Medicine, Bernhoven Hospital, Uden, The Netherlands
| | - Rosa van Mansfeld
- Department of Medical Microbiology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Miranda van Rijen
- Department of Infection Control, Amphia Hospital, Breda, The Netherlands
| | - Emile F Schippers
- Department of Internal Medicine, Haga Hospital, The Hague, The Netherlands
| | - Arjan Stegeman
- Department of Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Adriana Tami
- Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Karin Ellen Veldkamp
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Hannah Visser
- Department of Internal Medicine, Beatrix Hospital, Gorinchem, The Netherlands
| | - Andreas Voss
- Department of Medical Microbiology and Infectious Diseases, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
- Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marjolijn C A Wegdam-Blans
- Catharina Hospital, Eindhoven, The Netherlands
- Hospital St. Jans Gasthuis, Weert, The Netherlands
- Department of Medical Microbiology, Stichting PAMM, Veldhoven, The Netherlands
| | - Heiman F L Wertheim
- Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Peter C Wever
- Department of Medical Microbiology and Infection Control, Jeroen Bosch Hospital, 's Hertogenbosch, The Netherlands
| | - Marion P G Koopmans
- Viroscience Department, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jan A J W Kluytmans
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Infection Control, Amphia Hospital, Breda, The Netherlands
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Marjolein F Q Kluytmans-van den Bergh
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Infection Control, Amphia Hospital, Breda, The Netherlands
- Amphia Academy Infectious Disease Foundation, Amphia Hospital, Breda, The Netherlands
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3
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Majiya H, Aliyu-Paiko M, Balogu VT, Musa DA, Salihu IM, Kawu AA, Bashir IY, Sani AR, Baba J, Muhammad AT, Jibril FL, Bala E, Obaje NG, Aliyu YB, Muhammad RG, Mohammed H, Gimba UN, Uthman A, Liman HM, Alhaji SA, James JK, Makusidi MM, Isah MD, Abdullahi I, Ndagi U, Waziri B, Bisallah CI, Dadi-Mamud NJ, Ibrahim K, Adamu AK. Seroprevalence of SARS-CoV-2 in Niger State: Pilot Cross-Sectional Study. JMIRx Med 2023; 4:e29587. [PMID: 37855218 PMCID: PMC10595504 DOI: 10.2196/29587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 02/22/2023] [Accepted: 06/08/2023] [Indexed: 10/20/2023]
Abstract
Background The COVID-19 pandemic caused by SARS-CoV-2 is causing ongoing human and socioeconomic losses. Objective To know how far the virus has spread in Niger State, Nigeria, a pilot study was carried out to determine the SARS-CoV-2 seroprevalence, patterns, dynamics, and risk factors in the state. Methods A cross-sectional study design and clustered, stratified random sampling strategy were used to select 185 test participants across the state. SARS-CoV-2 IgG and IgM rapid test kits (colloidal gold immunochromatography lateral flow system) were used to determine the presence or absence of antibodies to the virus in the blood of sampled participants across Niger State from June 26 to 30, 2020. The test kits were validated using the blood samples of some of the Nigeria Center for Disease Control-confirmed positive and negative COVID-19 cases in the state. SARS-CoV-2 IgG and IgM test results were entered into the Epi Info questionnaire administered simultaneously with each test. Epi Info was then used to calculate the arithmetic mean and percentage, odds ratio, χ2 statistic, and regression at a 95% CI of the data generated. Results The seroprevalence of SARS-CoV-2 in Niger State was found to be 25.4% (47/185) and 2.2% (4/185) for the positive IgG and IgM results, respectively. Seroprevalence among age groups, genders, and occupations varied widely. The COVID-19 asymptomatic rate in the state was found to be 46.8% (22/47). The risk analyses showed that the chances of infection are almost the same for both urban and rural dwellers in the state. However, health care workers, those who experienced flulike symptoms, and those who had contact with a person who traveled out of Nigeria in the last 6 months (February to June 2020) were at double the risk of being infected with the virus. More than half (101/185, 54.6%) of the participants in this study did not practice social distancing at any time since the pandemic started. Participants' knowledge, attitudes, and practices regarding COVID-19 are also discussed. Conclusions The observed Niger State SARS-CoV-2 seroprevalence and infection patterns meansuggest that the virus has widely spread, far more SARS-CoV-2 infections have occurred than the reported cases, and there is a high asymptomatic COVID-19 rate across the state.
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Affiliation(s)
- Hussaini Majiya
- Department of Microbiology, Ibrahim Badamasi Babangida University, Lapai, Nigeria
- Center for Applied Sciences and Technology Research, Ibrahim Badamasi Babangida University, Lapai, Nigeria
- Trans-Saharan Disease Research Center, Ibrahim Badamasi Babangida University, Lapai, Nigeria
| | - Mohammed Aliyu-Paiko
- Center for Applied Sciences and Technology Research, Ibrahim Badamasi Babangida University, Lapai, Nigeria
- Trans-Saharan Disease Research Center, Ibrahim Badamasi Babangida University, Lapai, Nigeria
- Department of Biochemistry, Ibrahim Badamasi Babangida University, Lapai, Nigeria
| | - Vincent Tochukwu Balogu
- Department of Microbiology, Ibrahim Badamasi Babangida University, Lapai, Nigeria
- Center for Applied Sciences and Technology Research, Ibrahim Badamasi Babangida University, Lapai, Nigeria
| | - Dickson Achimugu Musa
- Center for Applied Sciences and Technology Research, Ibrahim Badamasi Babangida University, Lapai, Nigeria
- Trans-Saharan Disease Research Center, Ibrahim Badamasi Babangida University, Lapai, Nigeria
- Department of Biochemistry, Ibrahim Badamasi Babangida University, Lapai, Nigeria
| | - Ibrahim Maikudi Salihu
- Center for Applied Sciences and Technology Research, Ibrahim Badamasi Babangida University, Lapai, Nigeria
- Department of Biology, Ibrahim Badamasi Babangida University, Lapai, Nigeria
| | - Abdullahi Abubakar Kawu
- Center for Applied Sciences and Technology Research, Ibrahim Badamasi Babangida University, Lapai, Nigeria
- Trans-Saharan Disease Research Center, Ibrahim Badamasi Babangida University, Lapai, Nigeria
- Department of Computer Science, Ibrahim Badamasi Babangida University, Lapai, Nigeria
| | - Ishaku Yakubu Bashir
- Center for Applied Sciences and Technology Research, Ibrahim Badamasi Babangida University, Lapai, Nigeria
- Department of Geography, Ibrahim Badamasi Babangida University, Lapai, Nigeria
| | - Aishat Rabiu Sani
- Department of Microbiology, Ibrahim Badamasi Babangida University, Lapai, Nigeria
- Center for Applied Sciences and Technology Research, Ibrahim Badamasi Babangida University, Lapai, Nigeria
- Trans-Saharan Disease Research Center, Ibrahim Badamasi Babangida University, Lapai, Nigeria
| | - John Baba
- Department of Microbiology, Ibrahim Badamasi Babangida University, Lapai, Nigeria
- Center for Applied Sciences and Technology Research, Ibrahim Badamasi Babangida University, Lapai, Nigeria
| | - Amina Tako Muhammad
- Center for Applied Sciences and Technology Research, Ibrahim Badamasi Babangida University, Lapai, Nigeria
- Department of Mathematics, Ibrahim Badamasi Babangida University, Lapai, Nigeria
| | - Fatimah Ladidi Jibril
- Department of Microbiology, Ibrahim Badamasi Babangida University, Lapai, Nigeria
- Center for Applied Sciences and Technology Research, Ibrahim Badamasi Babangida University, Lapai, Nigeria
| | - Ezekiel Bala
- Department of Microbiology, Ibrahim Badamasi Babangida University, Lapai, Nigeria
- Center for Applied Sciences and Technology Research, Ibrahim Badamasi Babangida University, Lapai, Nigeria
| | - Nuhu George Obaje
- Center for Applied Sciences and Technology Research, Ibrahim Badamasi Babangida University, Lapai, Nigeria
| | - Yahaya Badeggi Aliyu
- Center for Applied Sciences and Technology Research, Ibrahim Badamasi Babangida University, Lapai, Nigeria
- Department of Mathematics, Ibrahim Badamasi Babangida University, Lapai, Nigeria
| | - Ramatu Gogo Muhammad
- Department of Microbiology, Ibrahim Badamasi Babangida University, Lapai, Nigeria
- Center for Applied Sciences and Technology Research, Ibrahim Badamasi Babangida University, Lapai, Nigeria
| | - Hadiza Mohammed
- Center for Applied Sciences and Technology Research, Ibrahim Badamasi Babangida University, Lapai, Nigeria
- Department of Biochemistry, Ibrahim Badamasi Babangida University, Lapai, Nigeria
| | - Usman Naji Gimba
- Center for Applied Sciences and Technology Research, Ibrahim Badamasi Babangida University, Lapai, Nigeria
- Department of Biology, Ibrahim Badamasi Babangida University, Lapai, Nigeria
| | - Abduljelili Uthman
- Center for Applied Sciences and Technology Research, Ibrahim Badamasi Babangida University, Lapai, Nigeria
- Department of Biochemistry, Ibrahim Badamasi Babangida University, Lapai, Nigeria
| | - Hadiza Muhammad Liman
- Center for Applied Sciences and Technology Research, Ibrahim Badamasi Babangida University, Lapai, Nigeria
- Department of Geography, Ibrahim Badamasi Babangida University, Lapai, Nigeria
| | | | | | | | | | - Ibrahim Abdullahi
- Center for Applied Sciences and Technology Research, Ibrahim Badamasi Babangida University, Lapai, Nigeria
- Department of Computer Science, Ibrahim Badamasi Babangida University, Lapai, Nigeria
| | - Umar Ndagi
- Trans-Saharan Disease Research Center, Ibrahim Badamasi Babangida University, Lapai, Nigeria
- General Hospital, Minna, Nigeria
- Ibrahim Badamasi Babangida Specialised Hospital, Minna, Nigeria
| | - Bala Waziri
- Ibrahim Badamasi Babangida Specialised Hospital, Minna, Nigeria
| | | | - Naomi John Dadi-Mamud
- Center for Applied Sciences and Technology Research, Ibrahim Badamasi Babangida University, Lapai, Nigeria
- Department of Biology, Ibrahim Badamasi Babangida University, Lapai, Nigeria
| | - Kolo Ibrahim
- Department of Microbiology, Ibrahim Badamasi Babangida University, Lapai, Nigeria
- Center for Applied Sciences and Technology Research, Ibrahim Badamasi Babangida University, Lapai, Nigeria
| | - Abu Kasim Adamu
- Center for Applied Sciences and Technology Research, Ibrahim Badamasi Babangida University, Lapai, Nigeria
- Department of Biology, Ibrahim Badamasi Babangida University, Lapai, Nigeria
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Boulos L, Curran JA, Gallant A, Wong H, Johnson C, Delahunty-Pike A, Saxinger L, Chu D, Comeau J, Flynn T, Clegg J, Dye C. Effectiveness of face masks for reducing transmission of SARS-CoV-2: a rapid systematic review. Philos Trans A Math Phys Eng Sci 2023; 381:20230133. [PMID: 37611625 PMCID: PMC10446908 DOI: 10.1098/rsta.2023.0133] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 05/23/2023] [Indexed: 08/25/2023]
Abstract
This rapid systematic review of evidence asks whether (i) wearing a face mask, (ii) one type of mask over another and (iii) mandatory mask policies can reduce the transmission of SARS-CoV-2 infection, either in community-based or healthcare settings. A search of studies published 1 January 2020-27 January 2023 yielded 5185 unique records. Due to a paucity of randomized controlled trials (RCTs), observational studies were included in the analysis. We analysed 35 studies in community settings (three RCTs and 32 observational) and 40 in healthcare settings (one RCT and 39 observational). Ninety-five per cent of studies included were conducted before highly transmissible Omicron variants emerged. Ninety-one per cent of observational studies were at 'critical' risk of bias (ROB) in at least one domain, often failing to separate the effects of masks from concurrent interventions. More studies found that masks (n = 39/47; 83%) and mask mandates (n = 16/18; 89%) reduced infection than found no effect (n = 8/65; 12%) or favoured controls (n = 1/65; 2%). Seven observational studies found that respirators were more protective than surgical masks, while five found no statistically significant difference between the two mask types. Despite the ROB, and allowing for uncertain and variable efficacy, we conclude that wearing masks, wearing higher quality masks (respirators), and mask mandates generally reduced SARS-CoV-2 transmission in these study populations. This article is part of the theme issue 'The effectiveness of non-pharmaceutical interventions on the COVID-19 pandemic: the evidence'.
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Affiliation(s)
- Leah Boulos
- Maritime SPOR SUPPORT Unit, Nova Scotia Health, 5790 University Avenue, Halifax, Nova Scotia B3H 1V7, Canada
- IWK Health Centre, 5980 University Avenue, Halifax, Nova Scotia B3K 6R8, Canada
| | - Janet A. Curran
- IWK Health Centre, 5980 University Avenue, Halifax, Nova Scotia B3K 6R8, Canada
- School of Nursing, Dalhousie University, 6299 South Street, Halifax, Nova Scotia B3H 4R2, Canada
| | - Allyson Gallant
- IWK Health Centre, 5980 University Avenue, Halifax, Nova Scotia B3K 6R8, Canada
- Faculty of Health, Dalhousie University, 6299 South Street, Halifax, Nova Scotia B3H 4R2, Canada
| | - Helen Wong
- IWK Health Centre, 5980 University Avenue, Halifax, Nova Scotia B3K 6R8, Canada
- Faculty of Health, Dalhousie University, 6299 South Street, Halifax, Nova Scotia B3H 4R2, Canada
| | - Catherine Johnson
- IWK Health Centre, 5980 University Avenue, Halifax, Nova Scotia B3K 6R8, Canada
- Department of Health and Rehabilitation Services, Western University, 1151 Richmond Street, London, Ontario N6A 3K7, Canada
| | | | - Lynora Saxinger
- Division of Infectious Diseases, Departments of Medicine and Medical Microbiology and Immunology, University of Alberta, 116 Street & 85 Avenue, Edmonton, Alberta T6G 2R3, Canada
| | - Derek Chu
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4L8, Canada
- Department of Medicine, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4L8, Canada
- The Research Institute of St Joe's Hamilton, St Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, Ontario L8N A46, Canada
| | - Jeannette Comeau
- Division of Infectious Diseases, Dalhousie University, 6299 South Street, Halifax, Nova Scotia B3H 4R2, Canada
| | - Trudy Flynn
- Patient/Public Partner, University of Oxford, 11A Mansfield Road, Oxford OX1 3SZ, UK
| | - Julie Clegg
- Patient/Public Partner, University of Oxford, 11A Mansfield Road, Oxford OX1 3SZ, UK
| | - Christopher Dye
- Department of Biology, University of Oxford, 11A Mansfield Road, Oxford OX1 3SZ, UK
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Hutchinson D, Kunasekaran M, Stone H, Chen X, Quigley A, Moa A, MacIntyre CR. Healthcare Workers' SARS-CoV-2 Infections in Four Hospital Outbreaks during Delta Variant Prevalence in Sydney, Australia. Nurs Res Pract 2023; 2023:1806909. [PMID: 37745813 PMCID: PMC10513866 DOI: 10.1155/2023/1806909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 07/07/2023] [Accepted: 08/29/2023] [Indexed: 09/26/2023] Open
Abstract
Background Healthcare workers (HCWs) are at risk of SARS-CoV-2 infections due to occupational exposure. The use of airborne personal protective equipment (PPE) significantly reduces this risk. In June 2021, an epidemic of the Delta variant began in New South Wales (NSW), Australia. Concurrent PPE guidelines, set by the Clinical Excellence Commission (CEC), restricted the use of respirators. Objective To understand the relationship of PPE guidelines with workplace-acquired HCW SARS-CoV-2 infections in different clinical settings and to examine the relationship between rates of community transmission and workplace-acquired HCW infections during the Delta outbreak in NSW. Methods Total SARS-CoV-2 HCW infections between 13 June and 30 October 2021 (first four months of the Delta wave) were estimated from the government COVID-19 surveillance reports and compared with the surveillance reports of community transmission. In the absence of a detailed reporting of HCW infections, open-source data including news articles, media releases, and epidemiological surveillance reports were also collected. Data were extracted on HCW cases of SARS-CoV-2 from four hospitals, including the number of HCW cases (per NSW Health definition), clinical setting, PPE guidelines, and evidence of increasing local transmission. Results SARS-CoV-2 infections in HCW identified as workplace-acquired infections (n = 177) and those without a known transmission source (n = 532) increased during the period of increasing community transmission (n = 75,014) in NSW. Four hospital COVID-19 clusters affecting 20 HCWs were identified between June and October 2021. HCW clusters occurred in general wards where staff were recommended to wear surgical masks. No workplace-acquired HCW infections were reported in these hospitals from critical care wards, where respirators were recommended during the same outbreak weeks. Conclusions Differences in PPE policy across different wards may leave healthcare staff at risk of SARS-CoV-2 infection. During periods of high community transmission, respirators should be provided to protect hospital staff. Formal reporting of HCW infections should occur.
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Affiliation(s)
- Danielle Hutchinson
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Mohana Kunasekaran
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Haley Stone
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Xin Chen
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Ashley Quigley
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Aye Moa
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - C. Raina MacIntyre
- Biosecurity Program, The Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- College of Public Service & Community Solutions, Arizona State University, Tempe, AZ 85004, USA
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Bosserman RE, Farnsworth CW, O’Neil CA, Cass C, Park D, Ballman C, Wallace MA, Struttmann E, Stewart H, Arter O, Peacock K, Fraser VJ, Budge PJ, Olsen MA, Burnham CAD, Babcock HM, Kwon JH. Seroprevalence of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) antibodies among healthcare personnel in the Midwestern United States, September 2020-April 2021. Antimicrob Steward Healthc Epidemiol 2023; 3:e133. [PMID: 37592963 PMCID: PMC10428156 DOI: 10.1017/ash.2022.375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/15/2022] [Accepted: 12/15/2022] [Indexed: 08/19/2023]
Abstract
Objective To determine the prevalence of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) IgG nucleocapsid (N) antibodies among healthcare personnel (HCP) with no prior history of COVID-19 and to identify factors associated with seropositivity. Design Prospective cohort study. Setting An academic, tertiary-care hospital in St. Louis, Missouri. Participants The study included 400 HCP aged ≥18 years who potentially worked with coronavirus disease 2019 (COVID-19) patients and had no known history of COVID-19; 309 of these HCP also completed a follow-up visit 70-160 days after enrollment. Enrollment visits took place between September and December 2020. Follow-up visits took place between December 2020 and April 2021. Methods At each study visit, participants underwent SARS-CoV-2 IgG N-antibody testing using the Abbott SARS-CoV-2 IgG assay and completed a survey providing information about demographics, job characteristics, comorbidities, symptoms, and potential SARS-CoV-2 exposures. Results Participants were predominately women (64%) and white (79%), with median age of 34.5 years (interquartile range [IQR], 30-45). Among the 400 HCP, 18 (4.5%) were seropositive for IgG N-antibodies at enrollment. Also, 34 (11.0%) of 309 were seropositive at follow-up. HCP who reported having a household contact with COVID-19 had greater likelihood of seropositivity at both enrollment and at follow-up. Conclusions In this cohort of HCP during the first wave of the COVID-19 pandemic, ∼1 in 20 had serological evidence of prior, undocumented SARS-CoV-2 infection at enrollment. Having a household contact with COVID-19 was associated with seropositivity.
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Affiliation(s)
- Rachel E. Bosserman
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Christopher W. Farnsworth
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
| | - Caroline A. O’Neil
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Candice Cass
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Daniel Park
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Claire Ballman
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
| | - Meghan A. Wallace
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
| | - Emily Struttmann
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Henry Stewart
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Olivia Arter
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Kate Peacock
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Victoria J. Fraser
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Philip J. Budge
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Margaret A. Olsen
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Carey-Ann D. Burnham
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
| | - Hilary M. Babcock
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Jennie H. Kwon
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
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Schubl SD, Figueroa C, Palma AM, de Assis RR, Jain A, Nakajima R, Jasinskas A, Brabender D, Hosseinian S, Naaseh A, Hernandez Dominguez O, Runge A, Skochko S, Chinn J, Kelsey AJ, Lai KT, Zhao W, Horvath P, Tifrea D, Grigorian A, Gonzales A, Adelsohn S, Zaldivar F, Edwards R, Amin AN, Stamos MJ, Barie PS, Felgner PL, Khan S. Risk factors for SARS-CoV-2 seropositivity in a health care worker population during the early pandemic. BMC Infect Dis 2023; 23:330. [PMID: 37194021 PMCID: PMC10186297 DOI: 10.1186/s12879-023-08284-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 04/27/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND While others have reported severe acute respiratory syndrome-related coronavirus 2(SARS-CoV-2) seroprevalence studies in health care workers (HCWs), we leverage the use of a highly sensitive coronavirus antigen microarray to identify a group of seropositive health care workers who were missed by daily symptom screening that was instituted prior to any epidemiologically significant local outbreak. Given that most health care facilities rely on daily symptom screening as the primary method to identify SARS-CoV-2 among health care workers, here, we aim to determine how demographic, occupational, and clinical variables influence SARS-CoV-2 seropositivity among health care workers. METHODS We designed a cross-sectional survey of HCWs for SARS-CoV-2 seropositivity conducted from May 15th to June 30th 2020 at a 418-bed academic hospital in Orange County, California. From an eligible population of 5,349 HCWs, study participants were recruited in two ways: an open cohort, and a targeted cohort. The open cohort was open to anyone, whereas the targeted cohort that recruited HCWs previously screened for COVID-19 or work in high-risk units. A total of 1,557 HCWs completed the survey and provided specimens, including 1,044 in the open cohort and 513 in the targeted cohort. Demographic, occupational, and clinical variables were surveyed electronically. SARS-CoV-2 seropositivity was assessed using a coronavirus antigen microarray (CoVAM), which measures antibodies against eleven viral antigens to identify prior infection with 98% specificity and 93% sensitivity. RESULTS Among tested HCWs (n = 1,557), SARS-CoV-2 seropositivity was 10.8%, and risk factors included male gender (OR 1.48, 95% CI 1.05-2.06), exposure to COVID-19 outside of work (2.29, 1.14-4.29), working in food or environmental services (4.85, 1.51-14.85), and working in COVID-19 units (ICU: 2.28, 1.29-3.96; ward: 1.59, 1.01-2.48). Amongst 1,103 HCWs not previously screened, seropositivity was 8.0%, and additional risk factors included younger age (1.57, 1.00-2.45) and working in administration (2.69, 1.10-7.10). CONCLUSION SARS-CoV-2 seropositivity is significantly higher than reported case counts even among HCWs who are meticulously screened. Seropositive HCWs missed by screening were more likely to be younger, work outside direct patient care, or have exposure outside of work.
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Affiliation(s)
- Sebastian D Schubl
- Department of Surgery, School of Medicine, University of California Irvine, Irvine, CA, USA
| | - Cesar Figueroa
- Department of Surgery, School of Medicine, University of California Irvine, Irvine, CA, USA
| | - Anton M Palma
- Institute for Clinical and Translational Sciences, University of California Irvine, Irvine, CA, USA
| | - Rafael R de Assis
- Department of Physiology and Biophysics, University of California Irvine, Irvine, CA, USA
| | - Aarti Jain
- Department of Physiology and Biophysics, University of California Irvine, Irvine, CA, USA
| | - Rie Nakajima
- Department of Physiology and Biophysics, University of California Irvine, Irvine, CA, USA
| | - Algimantas Jasinskas
- Department of Physiology and Biophysics, University of California Irvine, Irvine, CA, USA
| | - Danielle Brabender
- Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sina Hosseinian
- School of Medicine, University of California Irvine, Irvine, CA, USA
| | - Ariana Naaseh
- School of Medicine, University of California Irvine, Irvine, CA, USA
| | | | - Ava Runge
- School of Medicine, University of California Irvine, Irvine, CA, USA
| | - Shannon Skochko
- School of Medicine, University of California Irvine, Irvine, CA, USA
| | - Justine Chinn
- School of Medicine, University of California Irvine, Irvine, CA, USA
| | - Adam J Kelsey
- Department of Pharmaceutical Sciences, School of Medicine, University of California Irvine, Irvine, CA, USA
| | - Kieu T Lai
- Department of Pharmaceutical Sciences, School of Medicine, University of California Irvine, Irvine, CA, USA
| | - Weian Zhao
- Department of Pharmaceutical Sciences, School of Medicine, University of California Irvine, Irvine, CA, USA
| | - Peter Horvath
- Institute for Clinical and Translational Sciences, University of California Irvine, Irvine, CA, USA
| | - Delia Tifrea
- Department of Pathology, School of Medicine, University of California Irvine, Irvine, CA, USA
| | - Areg Grigorian
- Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Abran Gonzales
- Department of Surgery, School of Medicine, University of California Irvine, Irvine, CA, USA
| | - Suzanne Adelsohn
- Department of Pathology, School of Medicine, University of California Irvine, Irvine, CA, USA
| | - Frank Zaldivar
- Institute for Clinical and Translational Sciences, University of California Irvine, Irvine, CA, USA
| | - Robert Edwards
- Department of Pathology, School of Medicine, University of California Irvine, Irvine, CA, USA
| | - Alpesh N Amin
- Department of Medicine, School of Medicine, University of California Irvine, Irvine, CA, USA
| | - Michael J Stamos
- School of Medicine, University of California Irvine, Irvine, CA, USA
| | - Philip S Barie
- Department of Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Philip L Felgner
- Department of Physiology and Biophysics, University of California Irvine, Irvine, CA, USA
| | - Saahir Khan
- Division of Infectious Diseases, Department of Medicine, Keck School of Medicine, University of Southern California, 1520 San Pablo St., Los Angeles, CA, 90033, USA.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Valverde-Espinoza N, Barja-Ore J, Rojas MS, Pérez-Silva M, Herrera-Málaga R, Angulo LH, López BR. Personal protective equipment: Analysis of supply among midwives during the COVID-19 pandemic in Peru. Midwifery 2023; 118:103583. [PMID: 36608487 PMCID: PMC9792185 DOI: 10.1016/j.midw.2022.103583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 03/09/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To report the details of provision of personal protective equipment to midwives during the COVID-19 pandemic in Peru METHODS: This is a non-experimental, descriptive, cross-sectional study. An online survey of 679 midwives working at public healthcare centres was conducted via questionnaires. The following aspects were outlined: method of supply and frequency of delivery of personal protective equipment, type of personal protective equipment provided by the institution, and self-purchase. Furthermore, features of the midwives' workplace were described. For statistical analysis, absolute frequencies and relative proportions were used for categorical variables, and mean and standard deviation were used for numerical variables. MEASUREMENTS AND FINDINGS The most important finding of this study is that a large proportion of midwives (66.6%) did not receive new personal protective equipment for each shift; 41.9% of midwives who received personal protective equipment during each shift exclusively provided services in the COVID-19 ward, whereas 27.6% did not. The least received supplies were of N95 respirator masks (41.7%) and disposable isolation suit gown (50.5%). Only a certain proportion of midwives (38.6%) were trained by their own institutions on the use of personal protective equipment. KEY CONCLUSIONS The provision of personal protective equipment to midwives and training on personal protective equipment were insufficient at all workplaces. Therefore, measures must be taken to increase the supply of this material to midwives who are essential workers in reproductive health.
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Boomsma C, Poplausky D, Jasper JM, MacRae MC, Tang AM, Byhoff E, Wurcel AG, Doron S, Subbaraman R. Sources of exposure and risk among employees infected with severe acute respiratory coronavirus virus 2 (SARS-CoV-2) in a large, urban, tertiary-care hospital in the United States. Antimicrob Steward Healthc Epidemiol 2023; 3:e20. [PMID: 36819772 PMCID: PMC9936511 DOI: 10.1017/ash.2022.366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/23/2022] [Accepted: 11/29/2022] [Indexed: 02/03/2023]
Abstract
Objective Hospital employees are at risk of SARS-CoV-2 infection through transmission in 3 settings: (1) the community, (2) within the hospital from patient care, and (3) within the hospital from other employees. We evaluated probable sources of infection among hospital employees based on reported exposures before infection. Design A structured survey was distributed to participants to evaluate presumed COVID-19 exposures (ie, close contacts with people with known or probable COVID-19) and mask usage. Participants were stratified into high, medium, low, and unknown risk categories based on exposure characteristics and personal protective equipment. Setting Tertiary-care hospital in Boston, Massachusetts. Participants Hospital employees with a positive SARS-CoV-2 PCR test result between March 2020 and January 2021. During this period, 573 employees tested positive, of whom 187 (31.5%) participated. Results We did not detect a statistically significant difference in the proportion of employees who reported any exposure (ie, close contacts at any risk level) in the community compared with any exposure in the hospital, from either patients or employees. In total, 131 participants (70.0%) reported no known high-risk exposure (ie, unmasked close contacts) in any setting. Among those who could identify a high-risk exposure, employees were more likely to have had a high-risk exposure in the community than in both hospital settings combined (odds ratio, 1.89; P = .03). Conclusions Hospital employees experienced exposure risks in both community and hospital settings. Most employees were unable to identify high-risk exposures prior to infection. When respondents identified high-risk exposures, they were more likely to have occurred in the community.
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Affiliation(s)
| | - Dina Poplausky
- Tufts University School of Medicine, Boston, Massachusetts
| | | | | | - Alice M. Tang
- Department of Public Health and Community Medicine and Center for Global Public Health, Tufts University School of Medicine, Boston, Massachusetts
| | - Elena Byhoff
- Department of Medicine, Tufts Medical Center, Boston, Massachusetts
| | - Alysse G. Wurcel
- Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts
| | - Shira Doron
- Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts
| | - Ramnath Subbaraman
- Department of Public Health and Community Medicine and Center for Global Public Health, Tufts University School of Medicine, Boston, Massachusetts
- Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts
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11
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Dudeja M, Shaikh A, Islam F, Alvi Y, Ahmad M, Kashyap V, Singh V, Rahman A, Panda M, Shree N, Nandy S, Jain V. Assessment of potential risk factors for COVID-19 among health care workers in a health care setting in Delhi, India -a cohort study. PLoS One 2023; 18:e0265290. [PMID: 36662835 PMCID: PMC9858779 DOI: 10.1371/journal.pone.0265290] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 11/28/2022] [Indexed: 01/21/2023] Open
Abstract
INTRODUCTION Healthcare workers (HCW) are most vulnerable to contracting COVID-19 infection. Understanding the extent of human-to-human transmission of the COVID-19 infection among HCWs is critical in managing this infection and for policy making. We did this study to estimate new infection by seroconversion among HCWs in recent contact with COVID-19 and predict the risk factors for infection. METHODS A cohort study was conducted at a tertiary care COVID-19 hospital in New Delhi during the first and second waves of the COVID-19 pandemic. All HCWs working in the hospital during the study period who came in recent contact with the patients were our study population. The data was collected by a detailed face-to-face interview, serological assessment for anti- COVID-19 antibodies at baseline and end line, and daily symptoms. Potential risk factors for seroprevalence and seroconversion were analyzed by logistic regression keeping the significance at p<0.05. RESULTS A total of 192 HCWs were recruited in this study, out of which 119 (62.0%) were seropositive. Almost all were wearing Personal protective equipment (PPE) and following Infection prevention and control (IPC) measures during their recent contact with a COVID-19 patient. Seroconversion was observed among 36.7% of HCWs, while 64.0% had a serial rise in the titer of antibodies during the follow-up period. Seropositivity was negatively associated with being a doctor (odds ratio [OR] 0.35, 95% Confidence Interval [CI] 0.18-0.71), having COVID-19 symptoms (OR 0.21, 95% CI 0.05-0.82), having comorbidities (OR 0.14, 95% CI 0.03-0.67), and received IPC training (OR 0.25, 95% CI 0.07-0.86), while positively associated with partial (OR 3.30, 95% CI 1.26-8.69), as well as complete vaccination for COVID-19 (OR 2.43, 95% CI 1.12-5.27). Seroconversion was positively associated with doctor as a profession (OR 13.04, 95% CI 3.39-50.25) and with partially (OR 4.35, 95% CI 1.07-17.65), as well as fully vaccinated for COVID-19 (OR 6.08, 95% CI 1.73-21.4). No significant association was observed between adherence to any IPC measures and PPE adopted by the HCW during the recent contact with COVID-19 patients and seroconversion. CONCLUSION Almost all the HCW practiced IPC measures in these settings. High seropositivity and seroconversion are most likely due to concurrent vaccination against COVID-19 rather than recent exposure to COVID-19 patients. Further studies using anti-N antibodies serology may help us find the reason for the seropositivity and seroconversion among HCWs.
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Affiliation(s)
- Mridu Dudeja
- Department of Microbiology, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Aqsa Shaikh
- Department of Community Medicine, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Farzana Islam
- Department of Community Medicine, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Yasir Alvi
- Department of Community Medicine, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Mohammad Ahmad
- World Health Organization, Country Office, New Delhi, India
| | - Varun Kashyap
- Department of Community Medicine, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Vishal Singh
- Zonal AEFI Coordinator, Ministry of Health and Family Welfare, Government of India, New Delhi, India
| | - Anisur Rahman
- World Health Organization, Country Office, New Delhi, India
| | - Meely Panda
- Department of Community and Family Medicine, All India Institute of Medical Science, Telangana, India
| | - Neetu Shree
- Department of Microbiology, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Shyamasree Nandy
- Department of Community Medicine, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Vineet Jain
- Department of Medicine, Hamdard Institute of Medical Sciences and Research, New Delhi, India
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Mansour Ghanaie R, Jamee M, Khodaei H, Shirvani A, Amirali A, Karimi A, Fallah F, Azimi L, Armin S, Fahimzad SA, Rafiei Tabatabaei S, Gholinegad Z, Rajabnejad M, Moemeni M, Kazemi Aghdam M, Noripour S, Mansour Ghanaie M, Tariverdi M, Soroush M, Masomi M, Shahraki F, Torkaman-Nejad S, Vaghefi SS, Shirvani F, Alebouyeh M. Assessment of early and post COVID-19 vaccination antibody response in healthcare workers: a multicentre cross-sectional study on inactivated, mRNA and vector-based vaccines. Epidemiol Infect 2023; 151:e12. [PMID: 36688340 DOI: 10.1017/S0950268822001984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
In this multicentre study, we compared the status of antibody production in healthcare personnel (HCP) before and after vaccination using different brands of COVID-19 vaccines between March 2021 and September 2021. Out of a total of 962 HCP enrolled in our study, the antibody against the S1 domain of SARS-CoV-2 was detected in 48.3%, 95.5% and 96.2% of them before, after the first and the second doses of the vaccines, respectively. Our results showed post-vaccination infection in 3.7% and 5.9% of the individuals after the first and second doses of vaccines, respectively. The infection was significantly lower in HCP who presented higher antibody titres before the vaccination. Although types of vaccines did not show a significant difference in the infection rate, a lower infection rate was recorded for AstraZeneca after the second vaccination course. This rate was equal among individuals receiving a second dose of Sinopharm and Sputnik. Vaccine-related side effects were more frequent among AstraZeneca recipients after the first dose and among Sputnik recipients after the second dose. In conclusion, our results showed diversity among different brands of COVID-19 vaccines; however, it seems that two doses of the vaccines could induce an antibody response in most of HCP. The induced immunity could persist for 3-5 months after the second vaccination course.
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Vangeti S, Periasamy S, Sun P, Balinsky CA, Mahajan AS, Kuzmina NA, Soares-Schanoski A, Cooper E, Beckett C, Marayag J, Marrone A, Nunez E, Ge Y, Porter CK, Goforth CW, Lizewski SE, Lizewski R, Jani V, Sugiharto VA, Schilling M, Yu XB, Marjanovic N, George MC, Bukreyev A, Sealfon SC, Letizia AG, Ramos I. Serum Fc-Mediated Monocyte Phagocytosis Activity Is Stable for Several Months after SARS-CoV-2 Asymptomatic and Mildly Symptomatic Infection. Microbiol Spectr 2022; 10:e0183722. [PMID: 36374040 DOI: 10.1128/spectrum.01837-22] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We investigated the temporal profile of multiple components of the serological response after asymptomatic or mildly symptomatic SARS-CoV-2 infection, in a cohort of 67 previously SARS-CoV-2 naive young adults, up to 8.5 months after infection. We found a significant decrease of spike IgG and neutralization antibody titers from early (11 to 56 days) to late (4 to 8.5 months) time points postinfection. Over the study period, S1-specific IgG levels declined significantly faster than that of the S2-specific IgG. Further, serum antibodies from PCR-confirmed participants cross-recognized S2, but not S1, of the betacoronaviruses HKU1 and OC43, suggesting a greater degree of cross-reactivity of S2 among betacoronaviruses. Antibody-Dependent Natural Killer cell Activation (ADNKA) was detected at the early time point but significantly decreased at the late time point. Induction of serum Antibody-Dependent Monocyte Phagocytosis (ADMP) was detected in all the infected participants, and its levels remained stable over time. Additionally, a reduced percentage of participants had detectable neutralizing activity against the Beta (50%), Gamma (61 to 67%), and Delta (90 to 94%) variants, both early and late postinfection, compared to the ancestral strain (100%). Antibody binding to S1 and RBD of Beta, Gamma, Delta (1.7 to 2.3-fold decrease), and Omicron (10 to 16-fold decrease) variants was also significantly reduced compared to the ancestral SARS-CoV-2 strain. Overall, we found variable temporal profiles of specific components and functionality of the serological response to SARS-CoV-2 in young adults, which is characterized by lasting, but decreased, neutralizing activity and antibody binding to S1, stable ADMP activity, and relatively stable S2-specific IgG levels. IMPORTANCE Adaptive immunity mediated by antibodies is important for controlling SARS-CoV-2 infection. While vaccines against COVID-19 are currently widely distributed, a high proportion of the global population is still unvaccinated. Therefore, understanding the dynamics and maintenance of the naive humoral immune response to SARS-CoV-2 is of great importance. In addition, long-term responses after asymptomatic infection are not well-characterized, given the challenges in identifying such cases. Here, we investigated the longitudinal humoral profile in a well-characterized cohort of young adults with documented asymptomatic or mildly symptomatic SARS-CoV-2 infection. By analyzing samples collected preinfection, early after infection and during late convalescence, we found that, while neutralizing activity decreased over time, high levels of serum S2 IgG and Antibody-Dependent Monocyte Phagocytosis (ADMP) activity were maintained up to 8.5 months after infection. This suggests that a subset of antibodies with specific functions could contribute to long-term protection against SARS-CoV-2 in convalescent unvaccinated individuals.
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Sheng WH, Chang HC, Chang SY, Hsieh MJ, Chen YC, Wu YY, Pan SC, Wang JT, Chen YC. SARS-CoV-2 infection among healthcare workers whom already received booster vaccination during epidemic outbreak of omicron variant in Taiwan. J Formos Med Assoc 2022; 122:376-383. [PMID: 36564300 PMCID: PMC9755014 DOI: 10.1016/j.jfma.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/22/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND/PURPOSE Healthcare workers (HCWs) are at risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection due to occupational exposure. We aim to investigate the prevalence and risk factors of SARS-CoV-2 infection among HCWs during epidemic outbreak of omicron variant in Taiwan. METHODS Sequential reserved serum samples collected from our previous study during December 2021 and July 2022 were tested for antibodies against SARS-CoV-2 nucleocapsid protein (NP). Diagnosis of SARS-CoV-2 infection was defined as positive either of anti-SARS-CoV-2 nucleoprotein, rapid antigen test or polymerase chain reaction. Retrospective chart review and a questionnaire were used to access the symptoms and risk factors for SARS-CoV-2 infection. RESULTS Totally 300 participants (69.3% female) with a median age of 37.9 years were enrolled. A significant increase incidence of SARS-CoV-2 infection was found before and during community outbreak (11.91 versus 230.93 per 100,000 person-days, P < 0.001), which was a trend paralleling that observed in the general population. For 61 SARS-CoV-2 infected participants, nine (14.8%) were asymptomatic. Multivariate analysis revealed recent contact with a SARS-CoV-2 infected household (odds ratio [OR], 7.01; 95% confidence interval [95% CI], 3.70-13.30; P < 0.001) and co-existed underlying autoimmune diseases (OR, 4.46; 95% CI, 1.28-15.51; P = 0.019) were significant risk factors associated with acquisition of SARS-CoV-2 infection among HCWs. CONCLUSION Community factors, such as closely contact with SARS-CoV-2 infected individuals and underlying immune suppression status, were significant factors for acquisition of SARS-CoV-2 infection among HCWs. We suggest the application of appropriate infection control measures for HCWs should be maintained to reduce risk of SARS-CoV-2 infection.
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Affiliation(s)
- Wang-Huei Sheng
- Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan,School of Medicine, National Taiwan University College of Medicine, Taipei City, Taiwan,Corresponding author. Department of Internal Medicine, National Taiwan University Hospital, 7, Chung Shan South Road, Taipei City, 10002, Taiwan. Fax: +886 2 23710615
| | - Hao-Chun Chang
- Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu County, Taiwan
| | - Sui-Yuan Chang
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan,Department of Laboratory Medicine, National Taiwan University Hospital, Taipei City, Taiwan
| | - Ming-Ju Hsieh
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan,Occupational Safety and Health Office, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Cheng Chen
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yu-Yun Wu
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Sung-Ching Pan
- Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan,Infection Control Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Jann-Tay Wang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan,School of Medicine, National Taiwan University College of Medicine, Taipei City, Taiwan
| | - Yee-Chun Chen
- Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan,Infection Control Center, National Taiwan University Hospital, Taipei, Taiwan
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15
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Freedman ND, Brown L, Newman LM, Jones JM, Benoit TJ, Averhoff F, Bu X, Bayrak K, Lu A, Coffey B, Jackson L, Chanock SJ, Kerlavage AR. COVID-19 SeroHub, an online repository of SARS-CoV-2 seroprevalence studies in the United States. Sci Data 2022; 9:727. [DOI: 10.1038/s41597-022-01830-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 11/09/2022] [Indexed: 11/28/2022] Open
Abstract
AbstractSeroprevalence studies provide useful information about the proportion of the population either vaccinated against SARS-CoV-2, previously infected with the virus, or both. Numerous studies have been conducted in the United States, but differ substantially by dates of enrollment, target population, geographic location, age distribution, and assays used. This can make it challenging to identify and synthesize available seroprevalence data by geographic region or to compare infection-induced versus combined infection- and vaccination-induced seroprevalence. To facilitate public access and understanding, the National Institutes of Health and the Centers for Disease Control and Prevention developed the COVID-19 Seroprevalence Studies Hub (COVID-19 SeroHub, https://covid19serohub.nih.gov/), a data repository in which seroprevalence studies are systematically identified, extracted using a standard format, and summarized through an interactive interface. Within COVID-19 SeroHub, users can explore and download data from 178 studies as of September 1, 2022. Tools allow users to filter results and visualize trends over time, geography, population, age, and antigen target. Because COVID-19 remains an ongoing pandemic, we will continue to identify and include future studies.
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16
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Messing K, Chadoin M, Blanchette-Luong V. Should data on gender and ethnicity inform ergonomics interventions? Lessons from four case studies. Ergonomics 2022; 65:1567-1577. [PMID: 35531647 DOI: 10.1080/00140139.2022.2074098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 04/30/2022] [Indexed: 06/14/2023]
Abstract
Ergonomists intervene to improve work for all workers and adapt jobs to a range of worker characteristics. But their mandate rarely includes explicit attention to the distribution of worker demographics, to divisions among workers, or to discrimination on the basis of sex/gender or racialisation. A decades-long collaboration between ergonomists and the women's committees of three union confederations in Québec, Canada led to several instances where ergonomists had to confront situations involving sexism or racism, not foreseen during their training. This article will explore four problematic situations and suggest solutions, including paying more attention to teamwork, considering gender during ergonomics training, and developing a code of practice for ergonomics interventions.Practitioner summary: Workplace inequities related to sex/gender, racialisation and other sources of social inequity can affect job performance and workers' health. As such, do ergonomists need to consider them during an intervention? How? We analyse four situations encountered during interventions and suggest more attention to understanding workplace dynamics and promoting team function.
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Affiliation(s)
- Karen Messing
- Department of Biological Sciences, Université du Québec à Montréal, Montréal, Canada
- CINBIOSE Research Centre, Université du Québec à Montréal, Montréal, Canada
| | - Martin Chadoin
- CINBIOSE Research Centre, Université du Québec à Montréal, Montréal, Canada
- School of Management, Université du Québec à Montréal, Montréal, Canada
| | - Vanessa Blanchette-Luong
- CINBIOSE Research Centre, Université du Québec à Montréal, Montréal, Canada
- Psychology Department, Université du Québec à Montréal, Montréal, Canada
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17
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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18
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Socan M, Prosenc K, Kukec A, Zaletel-Kragelj L, Remec T, Grmek-Kosnik I. Determinants of seropositivity for SARS-CoV-2 in hospital staff in the second wave of the pandemic in Slovenia. Int J Occup Med Environ Health 2022; 35:571-584. [PMID: 35856815 PMCID: PMC10464744 DOI: 10.13075/ijomeh.1896.01932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 03/30/2022] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVES The pandemic caused by the novel coronavirus (SARS-CoV-2) affected a disproportionately high percentage of healthcare workers (HCWs). The aim of the study was to assess the seroprevalence of SARS-CoV-2-specific IgG antibodies in nurses and clinicians working in 2 Slovenian regional hospitals, and to identify the factors associated with seropositivity. MATERIAL AND METHODS The study was designed as a crosssectional study. Clinicians and nurses were invited to participate in November-December 2020. The respondents (813, 65.8%) completed a questionnaire and consented to provide 10 ml of blood for determining the presence of SARS-CoV-2 IgG antibodies. RESULTS The authors observed a seroprevalence rate of 20.4%. The results of the univariate analysis proved that the age of a nurse or clinician was the factor most strongly associated with seropositivity - in fact, the youngest nurses and clinicians were 8.33 times more likely to be seropositive than those in the oldest age group (p = 0.041). Being in contact with a family/household member who was SARS-CoV-2-positive was also a very important factor. In the work-related factors group, being in the contact with a SARS-CoV-2-positive colleague (OR = 2.35, p = 0.026) or being in contact with a COVID-19 patient (OR = 1.96, p = 0.004) correlated with seropositivity. In the primary work location/department group, the only significant association appeared among those working in surgical, ENT or ophthalmology departments. The results of the multivariate analysis further supported the thesis that the age of nurses and clinicians was the factor most strongly associated with seropositivity. The youngest nurses and clinicians were 12.5 times more likely to be seropositive than those in the oldest age group (p = 0.024). Being in contact with a SARS-CoV-2-positive family/household member remained the second most important factor. CONCLUSIONS A significant number of clinicians and nurses working in secondary healthcare were infected in the first 9 months of the pandemic. Int J Occup Med Environ Health. 2022;35(5):571-84.
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Affiliation(s)
- Maja Socan
- National Institute of Public Health, Ljubljana, Slovenia (Centre for Communicable Diseases)
| | - Katarina Prosenc
- National Laboratory for Health, Food and Environment, Ljubljana, Slovenia (Laboratory for Public Health Virology)
| | - Andreja Kukec
- University of Ljubljana, Ljubljana, Slovenia (Medical Faculty, Chair for Public Health)
| | | | - Tatjana Remec
- Novo Mesto General Hospital, Novo Mesto, Slovenia (Department for Infectious Diseases)
| | - Irena Grmek-Kosnik
- National Laboratory for Health, Food and Environment, Kranj, Slovenia (Laboratory for Human Microbiology)
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19
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Mayer KP, Palakshappa JA, Peltan ID, Andrew JS, Gundel SJ, Ringwood NJ, Mckeehan J, Hope AA, Rogers AJ, Biehl M, Hayden DL, Caldwell E, Mehkri O, Lynch DJ, Burham EL, Hough CL, Jolley SE. Functional, imaging, and respiratory evaluation (FIRE) of patients post-hospitalization for COVID-19: protocol for a pilot observational study. Pilot Feasibility Stud 2022; 8:212. [PMID: 36123599 PMCID: PMC9483889 DOI: 10.1186/s40814-022-01151-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 08/12/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction We describe a protocol for FIRE CORAL, an observational cohort study that examines the recovery from COVID-19 disease following acute hospitalization with an emphasis on functional, imaging, and respiratory evaluation. Methods and analysis FIRE CORAL is a multicenter prospective cohort study of participants recovering from COVID-19 disease with in-person follow-up for functional and pulmonary phenotyping conducted by the National Heart, Lung and Blood Institute (NHLBI) Prevention and Early Treatment of Acute Lung Injury (PETAL) Network. FIRE CORAL will include a subset of participants enrolled in Biology and Longitudinal Epidemiology of PETAL COVID-19 Observational Study (BLUE CORAL), an NHLBI-funded prospective cohort study describing the clinical characteristics, treatments, biology, and outcomes of hospitalized patients with COVID-19 across the PETAL Network. FIRE CORAL consists of a battery of in-person assessments objectively measuring pulmonary function, abnormalities on lung imaging, physical functional status, and biospecimen analyses. Participants will attend and perform initial in-person testing at 3 to 9 months after hospitalization. The primary objective of the study is to determine the feasibility of longitudinal assessments investigating multiple domains of recovery from COVID-19. Secondarily, we will perform descriptive statistics, including the prevalence and characterization of abnormalities on pulmonary function, chest imaging, and functional status. We will also identify potential clinical and biologic factors that predict recovery or the occurrence of persistent impairment of pulmonary function, chest imaging, and functional status. Ethics and dissemination FIRE CORAL is approved via the Vanderbilt University central institutional review board (IRB) and via reliance agreement with the site IRBs. Results will be disseminated via the writing group for the protocol committee and reviewed by the PETAL Network publications committee prior to publication. Data obtained via the study will subsequently be made publicly available via NHLBI’s biorepository. Strengths and limitations of the study Strengths:First US-based multicenter cohort of pulmonary and functional outcomes in patients previously hospitalized for COVID-19 infection Longitudinal biospecimen measurement allowing for biologic phenotyping of abnormalities Geographically diverse cohort allowing for a more generalizable understanding of post-COVID pulmonary sequela
Limitations:Selected cohort given proximity to a participating center Small cohort which may be underpowered to identify small changes in pulmonary function
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Affiliation(s)
- Kirby P Mayer
- Division of Pulmonary and Critical Care Medicine, University of Colorado Anschutz Medical Campus, 12700 East 19th Avenue, Aurora, CO, 80045, USA.,Department of Physical Therapy, University of Kentucky, Lexington, USA
| | - Jessica A Palakshappa
- Division of Pulmonary and Critical Care Medicine, University of Colorado Anschutz Medical Campus, 12700 East 19th Avenue, Aurora, CO, 80045, USA.,Section of Pulmonary, Critical Care, Allergy, and Immunologic Diseases, Wake Forest University School of Medicine, Winston-Salem, USA
| | - Ithan Daniel Peltan
- Division of Pulmonary and Critical Care Medicine, University of Colorado Anschutz Medical Campus, 12700 East 19th Avenue, Aurora, CO, 80045, USA.,Intermountain Healthcare, Salt Lake City, USA
| | - James S Andrew
- Division of Pulmonary and Critical Care Medicine, University of Colorado Anschutz Medical Campus, 12700 East 19th Avenue, Aurora, CO, 80045, USA.,Division of Rheumatology, University of Washington, Seattle, USA
| | - Stephanie J Gundel
- Division of Pulmonary and Critical Care Medicine, University of Colorado Anschutz Medical Campus, 12700 East 19th Avenue, Aurora, CO, 80045, USA.,University of Washington, Seattle, USA
| | - Nancy J Ringwood
- Division of Pulmonary and Critical Care Medicine, University of Colorado Anschutz Medical Campus, 12700 East 19th Avenue, Aurora, CO, 80045, USA.,Massachusetts General Hospital, Boston, USA
| | - Jeffrey Mckeehan
- Division of Pulmonary and Critical Care Medicine, University of Colorado Anschutz Medical Campus, 12700 East 19th Avenue, Aurora, CO, 80045, USA.,Division of Pulmonary and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Aluko A Hope
- Division of Pulmonary and Critical Care Medicine, University of Colorado Anschutz Medical Campus, 12700 East 19th Avenue, Aurora, CO, 80045, USA.,Pulmonary and Critical Care Medicine, Oregon Health and Sciences University, Portland, USA
| | - Angela J Rogers
- Division of Pulmonary and Critical Care Medicine, University of Colorado Anschutz Medical Campus, 12700 East 19th Avenue, Aurora, CO, 80045, USA.,Pulmonary and Critical Care Medicine, Stanford University, Stanford, USA
| | - Michelle Biehl
- Division of Pulmonary and Critical Care Medicine, University of Colorado Anschutz Medical Campus, 12700 East 19th Avenue, Aurora, CO, 80045, USA.,Critical Care Medicine, Cleveland Clinic, Cleveland, USA
| | - Douglas L Hayden
- Division of Pulmonary and Critical Care Medicine, University of Colorado Anschutz Medical Campus, 12700 East 19th Avenue, Aurora, CO, 80045, USA.,Massachusetts General Hospital, Boston, USA
| | - Ellen Caldwell
- Division of Pulmonary and Critical Care Medicine, University of Colorado Anschutz Medical Campus, 12700 East 19th Avenue, Aurora, CO, 80045, USA.,Division of Pulmonary and Critical Care, University of Washington, Seattle, USA
| | - Omar Mehkri
- Division of Pulmonary and Critical Care Medicine, University of Colorado Anschutz Medical Campus, 12700 East 19th Avenue, Aurora, CO, 80045, USA.,Department of Critical Care, Respiratory Institute, Cleveland Clinic, Cleveland, USA
| | - David J Lynch
- Division of Pulmonary and Critical Care Medicine, University of Colorado Anschutz Medical Campus, 12700 East 19th Avenue, Aurora, CO, 80045, USA.,Department of Radiology, National Jewish Health, Denver, USA
| | - Ellen L Burham
- Division of Pulmonary and Critical Care Medicine, University of Colorado Anschutz Medical Campus, 12700 East 19th Avenue, Aurora, CO, 80045, USA.,University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Catherine L Hough
- Division of Pulmonary and Critical Care Medicine, University of Colorado Anschutz Medical Campus, 12700 East 19th Avenue, Aurora, CO, 80045, USA.,Pulmonary and Critical Care Medicine, Oregon Health and Sciences University, Portland, USA
| | - Sarah E Jolley
- Division of Pulmonary and Critical Care Medicine, University of Colorado Anschutz Medical Campus, 12700 East 19th Avenue, Aurora, CO, 80045, USA.
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20
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Waldman SE, Adams JY, Albertson TE, Juárez MM, Myers SL, Atreja A, Batra S, Foster EE, Huynh CV, Liu AY, Lubarsky DA, Ngo VT, Sandrock CE, Taylor SL, Tompkins AM, Cohen SH. Real-world impact of vaccination on coronavirus disease 2019 (COVID-19) incidence in healthcare personnel at an academic medical center. Infect Control Hosp Epidemiol 2022; 43:1194-200. [PMID: 34287111 DOI: 10.1017/ice.2021.336] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVE Coronavirus disease 2019 (COVID-19) vaccination effectiveness in healthcare personnel (HCP) has been established. However, questions remain regarding its performance in high-risk healthcare occupations and work locations. We describe the effect of a COVID-19 HCP vaccination campaign on SARS-CoV-2 infection by timing of vaccination, job type, and work location. METHODS We conducted a retrospective review of COVID-19 vaccination acceptance, incidence of postvaccination COVID-19, hospitalization, and mortality among 16,156 faculty, students, and staff at a large academic medical center. Data were collected 8 weeks prior to the start of phase 1a vaccination of frontline employees and ended 11 weeks after campaign onset. RESULTS The COVID-19 incidence rate among HCP at our institution decreased from 3.2% during the 8 weeks prior to the start of vaccinations to 0.38% by 4 weeks after campaign initiation. COVID-19 risk was reduced among individuals who received a single vaccination (hazard ratio [HR], 0.52; 95% confidence interval [CI], 0.40-0.68; P < .0001) and was further reduced with 2 doses of vaccine (HR, 0.17; 95% CI, 0.09-0.32; P < .0001). By 2 weeks after the second dose, the observed case positivity rate was 0.04%. Among phase 1a HCP, we observed a lower risk of COVID-19 among physicians and a trend toward higher risk for respiratory therapists independent of vaccination status. Rates of infection were similar in a subgroup of nurses when examined by work location. CONCLUSIONS Our findings show the real-world effectiveness of COVID-19 vaccination in HCP. Despite these encouraging results, unvaccinated HCP remain at an elevated risk of infection, highlighting the need for targeted outreach to combat vaccine hesitancy.
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21
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Maier HE, Kuan G, Saborio S, Carrillo FAB, Plazaola M, Barilla C, Sanchez N, Lopez R, Smith M, Kubale J, Ojeda S, Zuniga-Moya JC, Carlson B, Lopez B, Gajewski AM, Chowdhury M, Harris E, Balmaseda A, Gordon A. Clinical Spectrum of Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Protection From Symptomatic Reinfection. Clin Infect Dis 2022; 75:e257-e266. [PMID: 34411230 PMCID: PMC8499752 DOI: 10.1093/cid/ciab717] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND There are few data on the full spectrum of disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection across the lifespan from community-based or nonclinical settings. METHODS We followed 2338 people in Managua, Nicaragua, aged <94 years from March 2020 through March 2021. SARS-CoV-2 infection was identified through real-time reverse transcription polymerase chain reaction (RT-PCR) or through enzyme-linked immunosorbent assay. Disease presentation was assessed at the time of infection or retrospectively by survey at the time of blood collection. RESULTS There was a large epidemic that peaked between March and August 2020. In total, 129 RT-PCR-positive infections were detected, for an overall incidence rate of 5.3 infections per 100 person-years (95% confidence interval [CI], 4.4-6.3). Seroprevalence was 56.7% (95% CI, 53.5%-60.1%) and was consistent from age 11 through adulthood but was lower in children aged ≤10 years. Overall, 31.0% of the infections were symptomatic, with 54.7% mild, 41.6% moderate, and 3.7% severe. There were 2 deaths that were likely due to SARS-CoV-2 infection, yielding an infection fatality rate of 0.2%. Antibody titers exhibited a J-shaped curve with respect to age, with the lowest titers observed among older children and young adults and the highest among older adults. When compared to SARS-CoV-2-seronegative individuals, SARS-CoV-2 seropositivity at the midyear sample was associated with 93.6% protection from symptomatic reinfection (95% CI, 51.1%-99.2%). CONCLUSIONS This population exhibited a very high SARS-CoV-2 seropositivity with lower-than-expected severity, and immunity from natural infection was protective against symptomatic reinfection.
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Affiliation(s)
- Hannah E Maier
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Guillermina Kuan
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua
| | - Saira Saborio
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Fausto Andres Bustos Carrillo
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, California, USA
| | | | | | - Nery Sanchez
- Sustainable Sciences Institute, Managua, Nicaragua
| | - Roger Lopez
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Matt Smith
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - John Kubale
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Sergio Ojeda
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro de Salud Sócrates Flores Vivas, Ministry of Health, Managua, Nicaragua
| | - Julio C Zuniga-Moya
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Bradley Carlson
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Brenda Lopez
- Sustainable Sciences Institute, Managua, Nicaragua
| | | | - Mahboob Chowdhury
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Eva Harris
- Division of Infectious Diseases and Vaccinology, School of Public Health, University of California, Berkeley, California, USA
| | - Angel Balmaseda
- Sustainable Sciences Institute, Managua, Nicaragua
- Centro Nacional de Diagnóstico y Referencia, Ministry of Health, Managua, Nicaragua
| | - Aubree Gordon
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
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22
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Madureira R, Ferreira SA, Marion MAL, Bettoni F, Ganem F, Camargo AA, Morinaga CV. Seroprevalence of SARS-CoV-2 in Emergency Department Healthcare Workers at Sírio-Libanês Hospital, Brazil. Health Secur 2022; 20:359-367. [PMID: 35960271 DOI: 10.1089/hs.2022.0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
COVID-19 has spread rapidly worldwide. Information on its prevalence and factors associated with infection are important for protecting both professionals and patients in healthcare centers. This study evaluated the seroprevalence of antibodies against SARS-CoV-2 and its association with the degree of exposure and use of personal protective equipment by healthcare professionals dedicated to the treatment of patients with flu-like illnesses in the emergency room. The research team included an analysis of healthcare professionals who underwent enzyme-linked immunosorbent assay serological testing for SARS-CoV-2 between May 28 and June 26, 2020, in the emergency room of Sírio-Libanês Hospital in São Paulo, Brazil. Participants answered individual questionnaires on occupational information, medical health history, and factors associated with exposure to the novel coronavirus. The questionnaire variables were compared based on the serological results. Of the 164 study participants, 96 (58.54%) reported at least 1 flu-like symptom and 42 (25.61%) presented serology results that were compatible with SARS-CoV-2 infection. The asymptomatic declared group accounted for 62 participants; of these, 8 (12.90%) had positive serology results (neutralizing antibody and IgG) for SARS-CoV-2. Data analysis showed a positive correlation with duration of work, safety in wearing and reusing personal protective equipment, and presence of anosmia, and showed a negative relationship with duration of mask use. Our findings suggest that the perception of symptoms by healthcare professionals is not a good screening parameter for the diagnosis of an infectious disease with respiratory symptoms, such as COVID-19. The main influencing factor for the control of infection is the elaboration of workflows and safety protocols based on simple and clear rules as well as investments in team training.
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Affiliation(s)
- Ricardo Madureira
- Ricardo Madureira, MD, is a Physician, Emergency Department, Hospital Sírio-Libanês, São Paulo, Brazil
| | - Silvia Aparecida Ferreira
- Silvia Aparecida Ferreira, BSN, is a Nurse Care Coordinator, Emergency Department, Hospital Sírio-Libanês, São Paulo, Brazil
| | - Magali Aldrin Lopes Marion
- Magali Aldrin Lopes Marion, BSN, is Nurse Manager, Emergency Department, Hospital Sírio-Libanês, São Paulo, Brazil
| | - Fabiana Bettoni
- Fabiana Bettoni, PhD, is a Researcher, Molecular Oncology Center, Hospital Sírio-Libanês, São Paulo, Brazil
| | - Fernando Ganem
- Fernando Ganem, MD, PhD, is Hospital Director, Hospital Sírio-Libanês, São Paulo, Brazil
| | - Anamaria Aranha Camargo
- Anamaria Aranha Camargo, PhD, is Research Manager, Molecular Oncology Center, Hospital Sírio-Libanês, São Paulo, Brazil
| | - Christian Valle Morinaga
- Christian Valle Morinaga, MD, PhD, is Physician Practice Manager, Emergency Department, Hospital Sírio-Libanês, São Paulo, Brazil
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Free RJ, Annambhotla P, La Hoz RM, Danziger-Isakov L, Jones JM, Wang L, Sankthivel S, Levi ME, Michaels MG, Kuhnert W, Klassen D, Basavaraju SV, Kracalik IT. Risk of Severe Acute Respiratory Syndrome Coronavirus 2 Transmission Through Solid Organ Transplantation and Outcomes of Coronavirus Disease 2019 Among Recent Transplant Recipients. Open Forum Infect Dis 2022; 9:ofac221. [PMID: 35873294 PMCID: PMC9297154 DOI: 10.1093/ofid/ofac221] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 04/29/2022] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is transmissible through lung transplantation, and outcomes among infected organ recipients may be severe. Transmission risk to extrapulmonary organ recipients and recent (within 30 days of transplantation) SARS-CoV-2-infected recipient outcomes are unclear. METHODS During March 2020-March 2021, potential SARS-CoV-2 transmissions through solid organ transplantation were investigated. Assessments included SARS-CoV-2 testing, medical record review, determination of likely transmission route, and recent recipient outcomes. RESULTS During March 2020-March 2021, approximately 42 740 organs were transplanted in the United States. Forty donors, who donated 140 organs to 125 recipients, were investigated. Nine (23%) donors and 25 (20%) recipients were SARS-CoV-2 positive by nucleic acid amplification test (NAAT). Most (22/25 [88%]) SARS-CoV-2-infected recipients had healthcare or community exposures. Nine SARS-CoV-2-infected donors donated 21 organs to 19 recipients. Of these, 3 lung recipients acquired SARS-CoV-2 infections from donors with negative SARS-CoV-2 testing of pretransplant upper respiratory tract specimens but from whom posttransplant lower respiratory tract (LRT) specimens were SARS-CoV-2 positive. Sixteen recipients of extrapulmonary organs from SARS-CoV-2-infected donors had no evidence of posttransplant COVID-19. All-cause mortality within 45 days after transplantation was 6-fold higher among SARS-CoV-2-infected recipients (9/25 [36%]) than those without (6/100 [6%]). CONCLUSIONS Transplant-transmission of SARS-CoV-2 is uncommon. Pretransplant NAAT of lung donor LRT specimens may prevent transmission of SARS-CoV-2 through transplantation. Extrapulmonary organs from SARS-CoV-2-infected donors may be safely usable, although further study is needed. Reducing recent recipient exposures to SARS-CoV-2 should remain a focus of prevention.
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Affiliation(s)
- Rebecca J Free
- Correspondence: Rebecca Free, MD, MPH, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, MS V18-4, Atlanta, GA 30329-4027, USA ()
| | - Pallavi Annambhotla
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ricardo M La Hoz
- Division of Infectious Diseases and Geographic Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Lara Danziger-Isakov
- Department of Pediatrics, Division of Infectious Diseases, Cincinnati Children’s Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio, USA
| | - Jefferson M Jones
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lijuan Wang
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Senthil Sankthivel
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Marilyn E Levi
- Division of Transplantation, Health Systems Bureau, Health Resources and Services Administration, Rockville, Maryland, USA
| | - Marian G Michaels
- Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Pittsburgh School of Medicine and UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Wendi Kuhnert
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - David Klassen
- United Network for Organ Sharing, Richmond, Virginia, USA
| | - Sridhar V Basavaraju
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ian T Kracalik
- COVID-19 Response, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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24
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Gir E, Teles SA, Menegueti MG, Reis RK, de Carvalho MJ, Botelho EP, Milanês Sousa LR, Campos Coelho HF, Ávila FMP, Gimeniz Galvão MT, Nogueira WP, de Oliveira e Silva AC. Factors associated with the diagnosis of COVID-19 among Brazilian health professionals COVID-19 and health professionals. PLoS One 2022; 17:e0267121. [PMID: 35749441 PMCID: PMC9231739 DOI: 10.1371/journal.pone.0267121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 04/03/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction Health professionals are on the front lines against the Coronavirus 2019 (COVID-19) pandemic and are at high risk for acquiring the infection. Failures in precautionary measures, inadequacy/scarcity of Personal Protective Equipment (PPE), and lack of social and family distancing may be associated with increased exposure and contamination by the new coronavirus. This study investigated the prevalence of COVID-19 among Brazilian health professionals and associated factors according to demographic and occupational characteristics. Methods A cross-sectional, analytical study was conducted using an online survey with 12,086 health professionals from all regions of Brazil. Data were collected using an adaptation of the respondent-driven sampling method for the virtual environment. The outcome variable was the diagnosis of COVID-19. Bivariate and multiple logistic regression analyzes were used to identify an association between the diagnosis of COVID-19 and demographic and occupational variables. Variables were considered statistically significant based on p<0.05. Results Most participants were female, from the northeast region, and nursing professionals. A prevalence of 31.95% (95%CI: 31.0%, 32.9%) of COVID-19 was estimated. Following multiple regression analysis, the variables associated with the diagnosis of COVID-19 among health professionals were: male gender, married individuals, professionals who provide care to patients with COVID-19, who work in a field hospital, and those who work in institutions that did not offer enough quality PPE. Conclusions The study found a high prevalence of COVID-19 infection, with male professionals being those with greater chances. Inadequate supply or poor quality of PPE offered by health institutions compromises the health of professionals with an increase in positive diagnosis for COVID-19.
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25
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Free H, Luckhaupt SE, Billock RM, Groenewold MR, Burrer S, Sweeney MH, Wong J, Gibb K, Rodriguez A, Vergara X, Cummings K, Lavender A, Argueta G, Crawford HL, Erukunuapor K, Karlsson ND, Armenti K, Thomas H, Gaetz K, Dang G, Harduar-Morano L, Modji K. Reported Exposures Among In-Person Workers With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in 6 States, September 2020-June 2021. Clin Infect Dis 2022; 75:S216-S224. [PMID: 35717638 PMCID: PMC9214180 DOI: 10.1093/cid/ciac486] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Surveillance systems lack detailed occupational exposure information from workers with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The National Institute for Occupational Safety and Health partnered with 6 states to collect information from adults diagnosed with SARS-CoV-2 infection who worked in person (outside the home) in non-healthcare settings during the 2 weeks prior to illness onset. METHODS The survey captured demographic, medical, and occupational characteristics and work- and non-work-related risk factors for SARS-CoV-2 infection. Reported close contact with a person known or suspected to have SARS-CoV-2 infection was categorized by setting as exposure at work, exposure outside of work only, or no known exposure/did not know. Frequencies and percentages of exposure types are compared by respondent characteristics and risk factors. RESULTS Of 1111 respondents, 19.4% reported exposure at work, 23.4% reported exposure outside of work only, and 57.2% reported no known exposure/did not know. Workers in protective service occupations (48.8%) and public administration industries (35.6%) reported exposure at work most often. More than one third (33.7%) of respondents who experienced close contact with ≥10 coworkers per day and 28.8% of respondents who experienced close contact with ≥10 customers/clients per day reported exposures at work. CONCLUSIONS Exposure to occupational SARS-CoV-2 was common among respondents. Examining differences in exposures among different worker groups can help identify populations with the greatest need for prevention interventions. The benefits of recording employment characteristics as standard demographic information will remain relevant as new and reemerging public health issues occur.
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Affiliation(s)
| | - Sara E Luckhaupt
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention
| | - Rachael M Billock
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention
| | - Matthew R Groenewold
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention
| | - Sherry Burrer
- Emergency Preparedness and Response Office, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention
| | - Marie Haring Sweeney
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention
| | | | | | | | | | | | | | | | | | | | | | | | - Hannah Thomas
- New Hampshire Department of Health and Human Services
| | - Kim Gaetz
- North Carolina Department of Health and Human Services
| | - Gialana Dang
- North Carolina Department of Health and Human Services,Western States Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention
| | - Laurel Harduar-Morano
- Pennsylvania Department of Health,Division of State and Local Readiness, Center for Preparedness and Response, Centers for Disease Control and Prevention
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26
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Friedman SM, Davidow AL, Gurumurthy M, Peymani R, Webb J, Desai K, Siderits R, Nepomich A, Lifshitz E, Thomas PA. Antibody Seroprevalence, Infection and Surveillance for SARS-CoV-2 in Residents and Staff of New Jersey Long-Term Care Facilities. J Community Health 2022; 47:774-782. [PMID: 35704225 PMCID: PMC9199456 DOI: 10.1007/s10900-022-01104-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2022] [Indexed: 11/26/2022]
Abstract
Early in the pandemic, New Jersey (NJ) long-term care facilities (LTCFs) witnessed severe COVID-19 illness. With limited surveillance to characterize the scope of infection, we estimated the prevalence of antibody to the SARS-CoV-2 nucleocapsid protein among residents and staff, to describe the epidemiology, and to measure antibody distribution by prior PCR/antigen status and symptomatology. 10 NJ LTCFs of 20 solicited with diverse geography and bed-capacities were visited between October 2020 and March 2021. A single serum was tested for total N-antibody (ELISA) by the state laboratory. Residents' demographics and clinical history were transcribed from the patient record. For staff, this information was solicited directly from employees, supplemented by prior PCR/antigen results from facilities. 62% of 332 residents and 46% of 661 staff tested N-antibody positive. In a multivariable logistic regression in residents, odds ratios for older age and admission prior before March 1, 2020 were significant. Among the staff, odds ratios for older age, ethnic-racial group, nursing-related job, and COVID-19 symptoms were significantly associated with N-antibody positivity. In a sub-analysis in five better record-keeping LTCFs, 90% of residents and 85% of staff with positive PCR/antigen results were seropositive for N-antibody, yet 25% of residents and 22% of staff were N-antibody positive but PCR/antigen and symptoms negative. The high rate of clinically unsuspected infections likely contributed to the spread. These findings argue for robust surveillance, regular screening of asymptomatic individuals, and vaccinating both residents and staff to abate the pandemic. The data also provide guidance to prevent future outbreaks.
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Affiliation(s)
- Stephen M Friedman
- Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA.
- , Livingston, USA.
| | - Amy L Davidow
- Department of Biostatistics, New York University School of Global Public Health, New York, NY, USA
| | - Manisha Gurumurthy
- Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Reza Peymani
- Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - John Webb
- Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Keya Desai
- Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Richard Siderits
- New Jersey Department of Health, Public Health and Environmental Laboratory, Trenton, USA
| | - Anna Nepomich
- New Jersey Department of Health, Public Health and Environmental Laboratory, Trenton, USA
| | - Edward Lifshitz
- New Jersey Department of Health, Public Health and Environmental Laboratory, Trenton, USA
| | - Pauline A Thomas
- Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA
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27
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Jang HR, Kim JS. Emergency nurses' attitudes, perceptions about personal protective equipment and willingness to care for COVID-19 patients: A descriptive, cross-sectional study. J Nurs Manag 2022; 30:2514-2522. [PMID: 35700177 PMCID: PMC9353337 DOI: 10.1111/jonm.13720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 06/13/2022] [Indexed: 12/04/2022]
Abstract
Aims This study investigated emergency nurses' attitudes and perceptions about personal protective equipment and their association with the willingness to care for COVID‐19 patients. Background Emergency nurses are at increased risk for COVID‐19 infection as frontline workers and must wear personal protective equipment while attending suspected and confirmed COVID‐19 patients. Methods In September 2021, 188 nurses in four emergency departments completed online questionnaires. Results Multivariable logistic regression demonstrated that as perceptions of COVID‐19 infection risk increased by 1 point, 26% of nurses were willing to care of COVID‐19 patients. The willingness to care for COVID‐19 patients increased in their attitudes by 1.16 point and perceptions by 1.08 points about PPE. Conclusions Perceptions of the risk of infection exposure and confidence in safety of personal protective equipment are associated with nurses' willingness to care for COVID‐19 patients. Implications for Nursing Management Nurse managers need to assess nurses' needs for safety and provide a supportive climate to mitigate their concerns regarding infection risk and encourage nurses' willingness to care for patients. Nurse managers should provide precise guidelines on correct personal protective equipment use. Repetitive training on personal protective equipment should be provided to encourage nurses' adaptation to its use.
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Affiliation(s)
- Ha-Ra Jang
- Emergency Department, Gachon University Gil Medical Center, Incheon, South Korea
| | - Ji-Soo Kim
- College of Nursing, Gachon University, Incheon, South Korea
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28
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Hausfater P, Boutolleau D, Lacombe K, Beurton A, Dumont M, Constantin JM, Ghosn J, Combes A, Cury N, Guedj R, Djibré M, Bompard R, Mazerand S, Pourcher V, Gimeno L, Marois C, Teyssou E, Marcelin AG, Hajage D, Tubach F. Cumulative incidence of SARS-CoV-2 infection and associated risk factors among frontline health care workers in Paris: the SEROCOV cohort study. Sci Rep 2022; 12:7211. [PMID: 35508515 PMCID: PMC9068621 DOI: 10.1038/s41598-022-10945-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 03/30/2022] [Indexed: 12/30/2022] Open
Abstract
With the COVID-19 pandemic, documenting whether health care workers (HCWs) are at increased risk of SARS-CoV-2 contamination and identifying risk factors is of major concern. In this multicenter prospective cohort study, HCWs from frontline departments were included in March and April 2020 and followed for 3 months. SARS-CoV-2 serology was performed at month 0 (M0), M1, and M3 and RT-PCR in case of symptoms. The primary outcome was laboratory-confirmed SARS-CoV-2 infection at M3. Risk factors of laboratory-confirmed SARS-CoV-2 infection at M3 were identified by multivariate logistic regression. Among 1062 HCWs (median [interquartile range] age, 33 [28–42] years; 758 [71.4%] women; 321 [30.2%] physicians), the cumulative incidence of SARS-CoV-2 infection at M3 was 14.6% (95% confidence interval [CI] [12.5; 16.9]). Risk factors were the working department specialty, with increased risk for intensive care units (odds ratio 1.80, 95% CI [0.38; 8.58]), emergency departments (3.91 [0.83; 18.43]) and infectious diseases departments (4.22 [0.92; 18.28]); current smoking was associated with reduced risk (0.36 [0.21; 0.63]). Age, sex, professional category, number of years of experience in the job or department, and public transportation use were not significantly associated with laboratory-confirmed SARS-CoV-2 infection at M3. The rate of SARS-CoV-2 infection in frontline HCWs was 14.6% at the end of the first COVID-19 wave in Paris and occurred mainly early. The study argues for an origin of professional in addition to private life contamination and therefore including HCWs in the first-line vaccination target population. It also highlights that smokers were at lower risk. Trial registration The study has been registered on ClinicalTrials.gov: NCT04304690 first registered on 11/03/2020.
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Affiliation(s)
- Pierre Hausfater
- Emergency Department, Hôpital Pitié-Salpêtrière, APHP, Sorbonne Université, 83 Boulevard de l'Hôpital, 75651, Paris Cedex 13, France. .,GRC-14 BIOSFAST, UMR INSERM 1166, IHU ICAN, Sorbonne Université, Paris, France.
| | - David Boutolleau
- INSERM, Institut Pierre Louis d'Epidémiologie Et de Santé Publique (iPLESP), GH AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Sorbonne Université, Paris, France
| | - Karine Lacombe
- Infectious Disease Department, Sorbonne Université Hôpital Saint-Antoine, Paris, France
| | - Alexandra Beurton
- Service de Pneumologie-Médecine Intensive Réanimation, Hôpital Pitié-Salpêtrière, APHP, Sorbonne Université Inserm UMRS Neurophysiologie Respiratoire Expérimentale et Clinique, Sorbonne Université, Paris, France
| | - Margaux Dumont
- Emergency Department, Hôpital Pitié-Salpêtrière, APHP, Sorbonne Université, 83 Boulevard de l'Hôpital, 75651, Paris Cedex 13, France
| | - Jean-Michel Constantin
- Department of Anaesthesiology and Critical Care, GRC 29, AP-HP, DMU DREAM, Hôpital Pitié-Salpêtrière, GH APHP, Sorbonne Université, Paris, France
| | - Jade Ghosn
- AP-HP, Nord, Service des Maladies Infectieuses et Tropicales, Hôpital Bichat-Claude Bernard, and Université de Paris, INSERM, UMR 1137 IAME, Paris, France
| | - Alain Combes
- INSERM, UMRS_1166-ICAN, Institute of Cardiometabolism and Nutrition, and Service de Médecine Intensive-Réanimation, Institut de Cardiologie, GH APHP Sorbonne Université Hôpital Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | - Nicolas Cury
- Emergency Department, APHP, Sorbonne Université Hôpital Saint-Antoine, Paris, France
| | - Romain Guedj
- Pediatric Emergency Deparment, APHP Hôpital Armand Trousseau-Sorbonne Université, Faculté de Médecine, Paris, France.,Centre of Research in Epidemiology and Statistics-CRESS, INSERM, Université de Paris, 75004, Paris, France
| | - Michel Djibré
- Service de Médecine Intensive Réanimation, APHP, Sorbonne Université Hôpital Tenon, Paris, France
| | - Rudy Bompard
- Emergency Department, Hôpital Tenon, APHP, Sorbonne Université, Paris, France
| | - Sandie Mazerand
- Service de Médecine Intensive-Réanimation, APHP, Sorbonne Université Hôpital Saint-Antoine, Paris, France
| | - Valérie Pourcher
- AP-HP, Hôpitaux Universitaires Pitié-Salpêtrière Charles Foix, Service de Maladies Infectieuses et Tropicales, INSERM 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Sorbonne Université, 75013, Paris, France
| | - Linda Gimeno
- APHP, Unité de Recherche Clinique Pitié Salpêtrière Charles Foix, Sorbonne Université, 75013, Paris, France
| | - Clémence Marois
- Unité de Médecine Intensive Réanimation Neurologique, Département de Neurologie, DMU Neurosciences, APHP, Sorbonne Université Hôpital Pitié-Salpêtrière, Paris, France
| | - Elisa Teyssou
- INSERM, Institut Pierre Louis d'Epidémiologie Et de Santé Publique (iPLESP), GH AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Sorbonne Université, Paris, France
| | - Anne-Geneviève Marcelin
- INSERM, Institut Pierre Louis d'Epidémiologie Et de Santé Publique (iPLESP), GH AP-HP, Hôpital Pitié-Salpêtrière, Service de Virologie, Sorbonne Université, Paris, France
| | - David Hajage
- APHP, Unité de Recherche Clinique Pitié Salpêtrière Charles Foix, Sorbonne Université, 75013, Paris, France.,Département de Santé Publique, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié Salpêtrière, Sorbonne Université, CIC-1422, 75013, Paris, France
| | - Florence Tubach
- APHP, Unité de Recherche Clinique Pitié Salpêtrière Charles Foix, Sorbonne Université, 75013, Paris, France.,Département de Santé Publique, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Pitié Salpêtrière, Sorbonne Université, CIC-1422, 75013, Paris, France
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Billock RM, Groenewold MR, Sweeney MH, de Perio MA, Gaughan DM, Luckhaupt SE. Reported exposure trends among healthcare personnel COVID-19 cases, USA, March 2020-March 2021. Am J Infect Control 2022; 50:548-554. [PMID: 35431105 PMCID: PMC9007729 DOI: 10.1016/j.ajic.2022.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 11/26/2022]
Abstract
Background Health care personnel (HCP) have experienced significant SARS-CoV-2 risk, but exposure settings among HCP COVID-19 cases are poorly characterized. Methods We assessed exposure settings among HCP COVID-19 cases in the United States from March 2020 to March 2021 with reported exposures (n = 83,775) using national COVID-19 surveillance data. Exposure setting and reported community incidence temporal trends were described using breakpoint estimation. Among cases identified before initiation of COVID-19 vaccination programs (n = 65,650), we used separate multivariable regression models to estimate adjusted prevalence ratios (aPR) for associations of community incidence with health care and household and/or community exposures. Results Health care exposures were the most reported (52.0%), followed by household (30.8%) and community exposures (25.6%). Health care exposures and community COVID-19 incidence showed similar temporal trends. In adjusted analyses, HCP cases were more likely to report health care exposures (aPR = 1.31; 95% CI:1.26-1.36) and less likely to report household and/or community exposures (aPR = 0.73; 95% CI:0.70-0.76) under the highest vs lowest community incidence levels. Discussion These findings highlight HCP exposure setting temporal trends and workplace exposure hazards under high community incidence. Findings also underscore the need for robust collection of work-related data in infectious disease surveillance. Conclusions Many reported HCP cases experienced occupational COVID-19 exposures, particularly during periods of higher community COVID-19 incidence.
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30
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Hussein K, Shachor-Meyouhas Y, Dabaja-Younis H, Szwarcwort-Cohen M, Tarabeia J, Weissman A, Mekel M, Hyams G, Halberthal M. COVID-19: Healthcare Workers May Be at Greater Risk Outside Their Work Environment-A Retrospective Observational Study. Rambam Maimonides Med J 2022; 13:RMMJ.10469. [PMID: 35482461 PMCID: PMC9049148 DOI: 10.5041/rmmj.10469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND With the availability of coronavirus disease 2019 (COVID-19) vaccine, concerns have been raised regarding pre-vaccination seroprevalence in healthcare workers (HCW). This study examines the seroprevalence of HCW at an Israeli tertiary medical center before first BNT162b2 vaccination. METHODS This was a retrospective observational study. Before vaccination, HCW at our center were offered serological testing. Data on their epidemiological, workplace, and quarantine history were collected. The SARS-CoV-2 IgG assay was performed pre-vaccination. RESULTS A total of 4,519 (82.5%) of the HCW were tested. Of these, 210 were seropositive; 101 had no known history of COVID-19. Of the 101 asymptomatic HCW, only 3 (3%) had worked at COVID-19 departments, and 70 (69.3%) had not been previously quarantined. Positive serology was similarly distributed across age groups, and about 40% had no children. Nearly half of the HCW tested were administrative and service staff. Overall, seropositive tests were associated with having no children (OR 1.42, 95% CI 1.06-1.89; P=0.0218), history of having been quarantined without proof of disease (OR 6.04, 95% CI 4.55-8.01; P<0.001), and Arab ethnicity (OR 3.36, 95% CI 2.54-4.43; P<0.001). Seropositivity was also more prevalent in members of the administration compared to other sectors, medical and paramedical, who are exposed to patients in their daily work (OR 1.365, 95% CI 1.02-1.82; P=0.04). CONCLUSIONS The low percentage of asymptomatic COVID-19 among our HCW may reflect the high compliance to personal protective equipment use despite treating hundreds of COVID-19 patients. The relatively high number of childless seropositive HCW could reflect misconceptions regarding children as a main source of infection, leading to carelessness regarding the need for appropriate out-of-hospital protection.
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Affiliation(s)
- Khetam Hussein
- The Infection Control Unit, Rambam Health Care Campus, Haifa, Israel
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel
- To whom correspondence should be addressed. E-mail: or
| | - Yael Shachor-Meyouhas
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel
- Pediatric Infectious Diseases Unit, Ruth Rappaport Children’s Hospital, Rambam Health Care Campus, Haifa, Israel
- Management, Rambam Health Care Campus, Haifa, Israel
- To whom correspondence should be addressed. E-mail: or
| | - Halima Dabaja-Younis
- Pediatric Infectious Diseases Unit, Ruth Rappaport Children’s Hospital, Rambam Health Care Campus, Haifa, Israel
| | | | - Jalal Tarabeia
- The Infection Control Unit, Rambam Health Care Campus, Haifa, Israel
| | - Avi Weissman
- Management, Rambam Health Care Campus, Haifa, Israel
| | - Michal Mekel
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel
- Management, Rambam Health Care Campus, Haifa, Israel
| | - Gila Hyams
- Nursing Administration and Management, Rambam Health Care Campus, Haifa, Israel
| | - Michael Halberthal
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel
- Management, Rambam Health Care Campus, Haifa, Israel
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Ward MJ, Douin DJ, Gong W, Ginde AA, Hough CL, Exline MC, Tenforde MW, Stubblefield WB, Steingrub JS, Prekker ME, Khan A, Files DC, Gibbs KW, Rice TW, Casey JD, Henning DJ, Wilson JG, Brown SM, Patel MM, Self WH, Lindsell CJ; Influenza and Other Viruses in the Acutely Ill (IVY) Network. Modeling Clinical Trajectory Status of Critically Ill COVID-19 Patients Over Time: A Method for Analyzing Discrete Longitudinal and Ordinal Outcomes. J Clin Transl Sci. [PMID: 35720967 PMCID: PMC9161049 DOI: 10.1017/cts.2022.393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/14/2022] [Accepted: 04/18/2022] [Indexed: 12/15/2022] Open
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Graciaa DS, Kempker RR, Wang YF, Schurr H, Krishnan SD, Carroll K, Toomer L, Merritt S, King D, Hunter M, Rebolledo PA. SARS-CoV-2 seroprevalence among healthcare personnel at a large health system in Atlanta. Am J Med Sci 2022; 364:296-303. [PMID: 35430255 PMCID: PMC9008978 DOI: 10.1016/j.amjms.2022.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 12/06/2021] [Accepted: 04/08/2022] [Indexed: 11/18/2022]
Abstract
Background Estimates of the prevalence of SARS-CoV-2 antibodies and factors associated with infection among healthcare personnel (HCP) vary widely. We conducted a serosurvey of HCP at a large public healthcare system in the Atlanta area. Materials and methods All employees of Grady Health System were invited to participate in mid-2020; a volunteer sample of those completing testing was included. Asymptomatic HCP were offered testing for IgG antibody and for SARS-CoV-2 RNA using polymerase chain reaction (PCR). Symptomatic HCP were offered PCR testing. Antibody index values for IgG and cycle threshold values for PCR were evaluated for those with a positive result. An online survey was distributed at the time of testing. Results 624 of 1677 distributed surveys (37.2%) were completed by 608 unique HCP. The majority were female (76.4%) and provided clinical care (70.9%). The most common occupations were clinician (24.8%) and nurse (23.5%). 37 of 608 (6.1%) HCP had detectable IgG. Exposure to a confirmed case of COVID-19 outside of the hospital was associated with detectable IgG (12.8% vs 4.4%, p = 0.02), but exposure to a patient with COVID-19 was not. Conclusions Among HCP in a large healthcare system, 6.1% had detectable SARS-CoV-2 IgG. Seropositivity was associated with exposures outside of the healthcare setting.
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Affiliation(s)
- Daniel S Graciaa
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
| | - Russell R Kempker
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Yun F Wang
- Grady Health System, Atlanta, GA, USA; Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Hanna Schurr
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | | | | | | | | | - Mary Hunter
- Grady Health System, Atlanta, GA, USA; Division of General Medicine and Geriatrics, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Paulina A Rebolledo
- Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Yun BJ, Baugh JJ, Dutta S, Brown DF, Temin ES, Turbett SE, Shenoy ES, Biddinger PD, Dighe AS, Kays K, Parry BA, McKaig B, Beakes C, Margolin J, Russell N, Lodenstein C, McEvoy DS, Filbin MR. COVID-19 Seroprevalence in Emergency Department Healthcare Professionals Study (COV-ED): A Cross-sectional study. J Emerg Nurs 2022; 48:417-422. [PMID: 35697551 PMCID: PMC9023353 DOI: 10.1016/j.jen.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 04/05/2022] [Accepted: 04/13/2022] [Indexed: 11/25/2022]
Abstract
Introduction ED health care professionals are at the frontline of evaluation and management of patients with acute, and often undifferentiated, illness. During the initial phase of the SARS-CoV-2 outbreak, there were concerns that ED health care professionals may have been at increased risk of exposure to SARS-CoV-2 due to difficulty in early identification of patients. This study assessed the seroprevalence of SARS-CoV-2 antibodies among ED health care professionals without confirmed history of COVID-19 infection at a quaternary academic medical center. Methods This study used a cross-sectional design. An ED health care professional was deemed eligible if they had worked at least 4 shifts in the adult emergency department from April 1, 2020, through May 31, 2020, were asymptomatic on the day of blood draw, and were not known to have had prior documented COVID-19 infection. The study period was December 17, 2020, to January 27, 2021. Eligible participants completed a questionnaire and had a blood sample drawn. Samples were run on the Roche Cobas Elecsys Anti-SARS-CoV-2 antibody assay. Results Of 103 health care professionals (16 attending physicians, 4 emergency residents, 16 advanced practice professionals, and 67 full-time emergency nurses), only 3 (2.9%; exact 95% CI, 0.6%-8.3%) were seropositive for SARS-CoV-2 antibodies. Discussion At this quaternary academic medical center, among those who volunteered to take an antibody test, there was a low seroprevalence of SARS-CoV-2 antibodies among ED clinicians who were asymptomatic at the time of blood draw and not known to have had prior COVID-19 infection.
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Wang RC, Murphy CE, Kornblith AE, Hohenstein NA, Carter CM, Wong AHK, Kurtz T, Kohn MA. SARS COV-2 anti-nucleocapsid and anti-spike antibodies in an emergency department healthcare worker cohort: September 2020 – April 2021. Am J Emerg Med 2022; 54:81-86. [PMID: 35144108 PMCID: PMC8808429 DOI: 10.1016/j.ajem.2022.01.055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 01/06/2023] Open
Abstract
Background Emergency department (ED) workers have an increased seroprevalence of SARS-CoV-2 antibodies. However, breakthrough infections in ED workers have led to a reduced workforce within a strained healthcare system. By measuring levels of IgG antibodies to the SARS-CoV-2 nucleocapsid and spike antigens in ED workers, we determined the incidence of infection and described the course of antibody levels. We also measured the antibody response to vaccination and examined factors associated with immunogenicity. Methods We conducted a prospective cohort study of ED workers conducted at a single ED from September 2020–April 2021. IgG antibodies to the SARS-CoV-2 nucleocapsid antigen were measured at baseline, 3, and 6 months, and IgG antibodies to the SARS-CoV-2 spike antigen were measured at 6 months. Results At baseline, we found 5 out of 139 (3.6%) participants with prior infection. At 6 months, 4 of the 5 had antibody results below the test manufacturer's positivity threshold. We identified one incident case of SARS-COV-2 infection out of 130 seronegative participants (0.8%, 95% CI 0.02–4.2%). In 131 vaccinated participants (125 BNT162b2, 6 mRNA-1273), 131 tested positive for anti-spike antibodies. We identified predictors of anti-spike antibody levels: time since vaccination, prior COVID-19 infection, age, and vaccine type. Each additional week since vaccination was associated with an 11.1% decrease in anti-spike antibody levels. (95% CI 6.2–15.8%). Conclusion ED workers experienced a low incidence of SARS-CoV-2 infection and developed antibodies in response to vaccines and prior infection. Antibody levels decreased markedly with time since infection or vaccination.
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Affiliation(s)
- Ralph C Wang
- Department of Emergency Medicine, University of California, San Francisco, CA, United States of America.
| | - Charles E Murphy
- Department of Emergency Medicine, University of California, San Francisco, CA, United States of America.
| | - Aaron E Kornblith
- Department of Emergency Medicine and Department of Pediatrics, University of California, , San Francisco, CA, United States of America.
| | - Nicole A Hohenstein
- Department of Emergency Medicine, University of California, San Francisco, CA, United States of America.
| | - Cornelius M Carter
- Department of Emergency Medicine, University of California, San Francisco, CA, United States of America.
| | - Angela H K Wong
- Department of Emergency Medicine, University of California, San Francisco, CA, United States of America.
| | - Theodore Kurtz
- Department of Laboratory Medicine, University of California, , San Francisco, CA, United States of America.
| | - Michael A Kohn
- Department of Epidemiology and Biostatistics, University of California, , San Francisco, CA, United States of America.
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Pagheh AS, Asghari A, Abrari Romenjan K, Mousavi T, Abedi F, Ziaee A, Malakimoghadam H, Ziaee M. Seroprevalence of SARS-COV-2 antibodies among health-care workers exposed to COVID-19 patients in a large reference hospital, Iran. Iran J Microbiol 2022; 14:138-144. [PMID: 35765550 PMCID: PMC9168247 DOI: 10.18502/ijm.v14i2.9178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background and Objectives Health care workers (HCWs) are a high-risk group for acquiring and transmitting severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Aim of the study was the evaluation of seroprevalence of SARS-CoV-2 in a random sample of HCWs at a large acute care hospital in Iran. Materials and Methods We collected blood samples of 180 medical staffs from September 22, 2020 to January 26, 2021. The enzyme linked immunosorbent assays (ELISA) tests were used for evaluation of the presence of IgG antibodies. Participants completed a self-report questionnaire, comprising demographics, occupational, the work area, and personal protection data. Results Of the 180 HCWs who participated in this study, 44 (24.4%) were seropositive for anti-SARS-CoV-2 IgG. The percentage of IgG positivity was higher in males than females (P<0.05). Also, there was statistically significant difference between presence of the antibodies and the occupation, location, and infecting family members with Covid -1 (P<0.05). Other factors did not associate significantly to antibody presence against SARS-CoV-2 (P>0.05). Conclusion According to this point that the number of COVID-19 cases is still growing rapidly among HCWs. So, the epidemiological estimate of SARS-CoV-2 infection remains a major challenge that is needed to prevent the spread of infection in the hospitals.
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Affiliation(s)
- Abdol Sattar Pagheh
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Arghavan Asghari
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | | | - Tahoora Mousavi
- Molecular and Cell Biology Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Molecular and Cell Biology Research Center, Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Farshid Abedi
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Arash Ziaee
- Department of Neuroscience, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hakime Malakimoghadam
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Masood Ziaee
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Tuells J, Parra-grande M, Santos-calle FJ, Montagud AC, Egoavil CM, García-rivera C, Caballero P, Gabaldón-bravo EM, Rodríguez-diaz JC, Hurtado-sánchez JA. Detection of Neutralizing Antibodies against SARS-CoV-2 Post-Vaccination in Health Care Workers of a Large Tertiary Hospital in Spain by Using a Rapid Test LFIC and sVNT-ELISA. Vaccines (Basel) 2022; 10:510. [PMID: 35455259 PMCID: PMC9032347 DOI: 10.3390/vaccines10040510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 03/23/2022] [Accepted: 03/24/2022] [Indexed: 02/01/2023] Open
Abstract
The presence of neutralizing antibodies (NAbs) against SARS-CoV-2 represent a surrogate marker of immunologic protection in populations at high risk of infection such as healthcare workers caring for hospitalized patients with COVID-19. As recommended by CDC and the European CDC, the use of rapid diagnostic tests during population-based evaluations offers an opportunity to identify individuals with serologic evidence of natural infection or who have undergone vaccination. We carried out a cross-sectional study to assess the presence of neutralizing antibodies against SARS-CoV-2 among medical providers at an intensive care unit of a large referral hospital in Alicante, Spain. In addition, we tested for the presence of neutralizing antibodies compared to serum of uninfected individuals from a Biobank. We were also interested in evaluating the use of a rapid lateral flow immunochromatography (LFIC) test against a surrogate ELISA viral neutralization test (sVNT). This rapid test demonstrated a specificity of 1.000 95% CI (0.91–1.00) and the sensitivity of 0.987 95% CI (0.93–1.00). The negative predictive value was 95%. After six months, this rapid test demonstrated that those immunized with two doses of BioNTech/Pfizer vaccine, maintained optimal levels of neutralizing antibodies. We concluded that all Health Care Workers develop NAbs and the use of this rapid immunochromatographic test represents a potential tool to be used in population-based studies to detect serological antibody responses to vaccination. Vaccination policies could benefit from this tool to assess additional doses of vaccine or boosters among high-risk populations.
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Shorunke FO, Okolocha EC, Kia GS, Usman A, Akano O, Awosanya EJ. Prevalence and risk factors associated with SARS-CoV-2 infections among veterinary practitioners and dogs patients, June-August 2020, Lagos, Nigeria. One Health Outlook 2022; 4:4. [PMID: 35321753 PMCID: PMC8942610 DOI: 10.1186/s42522-022-00062-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 01/19/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Lagos State is the epicenter of COVID-19 in Nigeria, having the highest number of cases and death. Veterinary practitioners play an important role in public health and risk exposure to SARS-CoV-2, the virus that causes COVID-19 while attending to animal patients and owners. We determined the prevalence of covid-19 among veterinary practitioners and their dog patients in Lagos, and the associated risk factors during the lockdown. METHODS We administered questionnaires, reviewed clinical records and conducted serological test to determine the COVID-19 status of 112 veterinary practitioners and 154 dog patients and to assess the associated factors in nine veterinary clinics or hospitals between June to August 2020. Data were analyzed using descriptive statistics, bivariate and multivariate analyses at 5% significant level. RESULT The mean age of participants was 37.5±10.5 and 66 (58.9%) were male. COVID-19 cases among the veterinary practitioners and dogs were 29 (25.9%) and 3 (2%), respectively. Predictors of COVID-19 cases among veterinary practitioners were contact with a SARS-CoV-2 infected dog (AOR: 25.42; CI 4.73-136.66); being a veterinary doctor working during the lockdown (AOR: 6.11; CI 1.56-24.00) and not disinfecting examination table after attending to dogs (AOR: 12.43; CI 1.39-110.99). CONCLUSION Veterinary practitioners and dogs in Lagos were exposed to SARS-COV-2 virus during the COVID-19 lockdown. Contact with SARS-CoV-2 infected dogs, being a veterinary doctor working during the lockdown and not disinfecting examination tables after clinical examination were predictors of COVID-19 cases among veterinary practitioners in Lagos State. Strict Infection, Prevention and Control measures are recommended in veterinary practice.
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Affiliation(s)
| | - Emmanuel C. Okolocha
- Department of Veterinary Public Health, Faculty of Veterinary Medicine, Ahmadu Bello University, Zaria, Nigeria
| | - Grace S. Kia
- Department of Veterinary Public Health, Faculty of Veterinary Medicine, Ahmadu Bello University, Zaria, Nigeria
| | - Aishat Usman
- African Field Epidemiology Network, Abuja, Nigeria
| | - Oluseyi Akano
- Nigerian Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
| | - Emmanuel J. Awosanya
- Department of Veterinary Public Health and Preventive Medicine, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Nigeria
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Darvishian M, Sharafkhah M, Mohammadi Z, Sadeghniiat-haghighi K, Abdollahi A, Jafary M, Talaschian M, Tabarsi P, Baghai P, Mardani M, Shayanrad A, Shafighian F, Markarian M, Roozafzai F, Zamani M, Alvand S, Hariri S, Sadeghi A, Poustchi H, Malekzadeh R. SARS-CoV-2 Seroprevalence Among Health Care Workers in Major Private and Public Hospitals With COVID-19 Patient's Referral in Tehran, Iran. Front Public Health 2022; 10:832003. [PMID: 35400056 PMCID: PMC8987007 DOI: 10.3389/fpubh.2022.832003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 02/22/2022] [Indexed: 12/24/2022] Open
Abstract
Estimating the prevalence of SARS-CoV-2 antibody seropositivity among health care workers (HCWs) is crucial. In this study, the seroprevalence of anti-SARS-CoV-2 antibodies among HCWs of five hospitals of Tehran, Iran with high COVID-19 patient's referrals from April to June, 2020, was assessed. In this cross-sectional study, HCWs from three public and two private hospitals, selected randomly as a pilot, were included. Participants were asked questions on their demographic characteristics, medical history, hospital role, and usage of personal protective equipment (PPE). Iran FDA-approved SARS-CoV-2 ELISA kits were used to detect IgG and IgM antibodies in blood samples. The seroprevalence was estimated on the basis of ELISA test results and adjusted for test performance. Among the 2,065 participants, 1,825 (88.4%) and 240 (11.6%) HCWs were recruited from public and private hospitals, respectively. A total of 340 HCWs were tested positive for SARS-CoV-2-specific IgG or IgM antibodies, and 17.9% of seropositive individuals were asymptomatic. The overall test performance-adjusted seroprevalence estimate among HCWs was 22.6 (95% CI: 20.2–25.1), and PPE usage was significantly higher among HCWs of public vs. private hospitals (66.5 vs. 20.0%). This study found that seroprevalence of SARS-CoV-2 among HCWs was higher in private hospitals (37.0%; 95% CI: 28.6–46.2) than public hospitals (20.7%; 95% CI: 18.2–23.3), and also highest among assistant nurses and nurses, and lowest among janitor or superintendent categories. The PPE usage was especially suboptimal among HCWs in private hospitals. Continued effort in access to adequate PPE and regular screening of hospital staff for detecting asymptomatic personnel, especially during the upcoming wave of infection, are warranted.
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Affiliation(s)
- Maryam Darvishian
- Cancer Control Research, BC Cancer Research Centre, Vancouver, BC, Canada
| | - Maryam Sharafkhah
- Liver and Pancreatobiliary Diseases Research Center, Shariati Hospital, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Mohammadi
- Liver and Pancreatobiliary Diseases Research Center, Shariati Hospital, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Alireza Abdollahi
- Department of Pathology, School of Medicine, Imam Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mona Talaschian
- Department of Internal Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Payam Tabarsi
- Clinical Tb and Epidemiology Research Center, NRITLD, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvaneh Baghai
- Clinical Tb and Epidemiology Research Center, NRITLD, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoud Mardani
- Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amaneh Shayanrad
- Liver and Pancreatobiliary Diseases Research Center, Shariati Hospital, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Shafighian
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Melineh Markarian
- Digestive Disease Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzin Roozafzai
- Liver and Pancreatobiliary Diseases Research Center, Shariati Hospital, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Zamani
- Digestive Disease Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Saba Alvand
- Liver and Pancreatobiliary Diseases Research Center, Shariati Hospital, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sanam Hariri
- Liver and Pancreatobiliary Diseases Research Center, Shariati Hospital, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Sadeghi
- Digestive Disease Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Poustchi
- Liver and Pancreatobiliary Diseases Research Center, Shariati Hospital, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- *Correspondence: Hossein Poustchi
| | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Digestive Disease Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Reza Malekzadeh
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Maza MDC, Úbeda M, Delgado P, Horndler L, Llamas MA, van Santen HM, Alarcón B, Abia D, García-Bermejo L, Serrano-Villar S, Bastolla U, Fresno M. ACE2 Serum Levels as Predictor of Infectability and Outcome in COVID-19. Front Immunol 2022; 13:836516. [PMID: 35401548 PMCID: PMC8986157 DOI: 10.3389/fimmu.2022.836516] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 02/22/2022] [Indexed: 12/26/2022] Open
Abstract
Background COVID‐19 can generate a broad spectrum of severity and symptoms. Many studies analysed the determinants of severity but not among some types of symptoms. More importantly, very few studies analysed patients highly exposed to the virus that nonetheless remain uninfected. Methods We analysed serum levels of ACE2, Angiotensin II and anti-Spike antibodies in 2 different cohorts at high risk of viral exposure, highly exposed but uninfected subjects, either high risk health care workers or persons cohabiting with infected close relatives and seropositive patients with symptoms. We tested the ability of the sera of these subjects to neutralize lentivirus pseudotyped with the Spike-protein. Results We found that the serum levels of ACE2 are significantly higher in highly exposed but uninfected subjects. Moreover, sera from this seronegative persons can neutralize SARS-CoV-2 infection in cellular assays more strongly that sera from non-exposed negative controls eventhough they do not have anti-CoV-2 IgG antibodies suggesting that high levels of ACE2 in serum may somewhat protect against an active infection without generating a conventional antibody response. Finally, we show that among patients with symptoms, ACE2 levels were significantly higher in infected patients who developed cutaneous as compared with respiratory symptoms and ACE2 was also higher in those with milder symptoms. Conclusions These findings suggest that soluble ACE2 could be used as a potential biomarker to predict SARS-CoV-2 infection risk and to discriminate COVID-19 disease subtypes.
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Affiliation(s)
- María del Carmen Maza
- Centro de Biología Molecular Severo Ochoa, Consejo Superior de Investigaciones Científicas (CSIC), Universidad Autónoma de Madrid, Madrid, Spain
| | - María Úbeda
- Centro de Biología Molecular Severo Ochoa, Consejo Superior de Investigaciones Científicas (CSIC), Universidad Autónoma de Madrid, Madrid, Spain
- Instituto Sanitario Princesa, Madrid, Spain
- *Correspondence: Manuel Fresno, ; María Úbeda,
| | - Pilar Delgado
- Centro de Biología Molecular Severo Ochoa, Consejo Superior de Investigaciones Científicas (CSIC), Universidad Autónoma de Madrid, Madrid, Spain
| | - Lydia Horndler
- Centro de Biología Molecular Severo Ochoa, Consejo Superior de Investigaciones Científicas (CSIC), Universidad Autónoma de Madrid, Madrid, Spain
| | - Miguel A. Llamas
- EMPIREO Diagnóstico Molecular Sociedad Limitada (SL), Madrid, Spain
| | - Hisse M. van Santen
- Centro de Biología Molecular Severo Ochoa, Consejo Superior de Investigaciones Científicas (CSIC), Universidad Autónoma de Madrid, Madrid, Spain
| | - Balbino Alarcón
- Centro de Biología Molecular Severo Ochoa, Consejo Superior de Investigaciones Científicas (CSIC), Universidad Autónoma de Madrid, Madrid, Spain
| | - David Abia
- Centro de Biología Molecular Severo Ochoa, Consejo Superior de Investigaciones Científicas (CSIC), Universidad Autónoma de Madrid, Madrid, Spain
| | - Laura García-Bermejo
- Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Universidad de Alcalá, Madrid, Spain
| | - Sergio Serrano-Villar
- Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Universidad de Alcalá, Madrid, Spain
| | - Ugo Bastolla
- Centro de Biología Molecular Severo Ochoa, Consejo Superior de Investigaciones Científicas (CSIC), Universidad Autónoma de Madrid, Madrid, Spain
| | - Manuel Fresno
- Centro de Biología Molecular Severo Ochoa, Consejo Superior de Investigaciones Científicas (CSIC), Universidad Autónoma de Madrid, Madrid, Spain
- Instituto Sanitario Princesa, Madrid, Spain
- *Correspondence: Manuel Fresno, ; María Úbeda,
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Card L, Litwin CM, Curry S, Mack EH, Nietert PJ, Meissner EG. Self-Administered, Remote Assessment of SARS-CoV-2 Seroprevalence in Health Care Workers. Am J Med Sci 2022; 364:281-288. [PMID: 35278364 PMCID: PMC8906004 DOI: 10.1016/j.amjms.2022.01.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/19/2021] [Accepted: 01/31/2022] [Indexed: 11/16/2022]
Abstract
Background Our objective was to safely and remotely assess longitudinal SARS-CoV-2 seroprevalence in at-risk health care workers at the onset of the epidemic. Methods Self-administered serologic testing was performed every 30 days up to 5 times using a point-of-care, lateral flow SARS-CoV-2 nucleocapsid IgG immunoassay in a cohort of at-risk health care workers (n = 339) and lower-risk controls (n = 100). Results Subjects were enrolled between 4/14/20–5/6/20 and most were clinicians (41%) or nurses (27%). Of 20 subjects who reported confirmed SARS-CoV-2 infection prior to (n = 5, 1%) or during the study (n = 15, 3%), half (10/20) were seropositive. Five additional subjects were seropositive and did not report documented infection. Estimated infection rates in health care workers did not differ from concurrent community rates. Conclusions This remotely conducted, contact-free study did not identify serologic evidence of widespread occupational SARS-CoV-2 infection in health care workers.
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Affiliation(s)
- Lauren Card
- South Carolina Clinical & Translational Research Institute, Medical University of South Carolina, Charleston, SC, USA
| | - Christine M Litwin
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Scott Curry
- Department of Medicine, Division of Infectious Diseases, Medical University of South Carolina, Charleston, SC, USA
| | - Elizabeth H Mack
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, USA
| | - Paul J Nietert
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Eric G Meissner
- Department of Medicine, Division of Infectious Diseases, Medical University of South Carolina, Charleston, SC, USA; Department of Microbiology and Immunology, Medical University of South Carolina, Charleston, SC, USA.
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Correia RF, da Costa ACC, Moore DCBC, Gomes Junior SC, de Oliveira MPC, Zuma MCC, Galvani RG, Savino W, Bonomo AC, Vasconcelos ZFM, Artmann E. SARS-CoV-2 seroprevalence and social inequalities in different subgroups of healthcare workers in Rio de Janeiro, Brazil. Lancet Reg Health Am 2022; 7:100170. [PMID: 35005692 PMCID: PMC8718903 DOI: 10.1016/j.lana.2021.100170] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background COVID-19 has exacerbated health inequalities worldwide. Yet, such a perspective has not been investigated in specific healthcare workers and their resulting inclusion as a priority group for vaccination have been an important focus of political and social discussion. This study aimed at investigating whether SARS-CoV-2-seropositivity in healthcare workers in a public hospital in Rio de Janeiro, Brazil, was influenced by social determinants of health and the social vulnerability in subgroups of workers. Methods A serological survey was conducted in 1,154 healthcare workers in June and July 2020. The association between the serological test results for detection of IgG antibodies to SARS-CoV-2 and socioeconomic, occupational characteristics and transportation used by the workers to commute was assessed using the Pearson´s chi-square test and Cramer's V. Findings Overall, the serum prevalence for the virus in the healthcare workers was 30% (342/1141). Non-white workers (208/561) with lower income (169/396) and schooling (150/353), as well as users of the mass transportation system (157/246) showed the highest infection rates. Importantly they mostly corresponded to hospital support workers (131/324), in particular the cleaning personnel (42/70). Accordingly, income, schooling and work modality appeared as negative predictors, as ascertained by forest plot analysis. Interpretations The data clearly illustrate the inequality in SARS-CoV-2 infection in the Brazilian population, comprising even healthcare workers of the Brazilian unified health system. Fundings This study was financed by Fiocruz, CNPq, Faperj, Capes, FOCEM/Mercosur and the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) – Finance Code 001.
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Affiliation(s)
- Roberta Fernandes Correia
- National Institute of Health for Women, Children and Adolescents Fernandes Figueira/Oswaldo Cruz Foundation, Rio de Janeiro 22250-020, Brazil
| | - Ana Carolina Carioca da Costa
- National Institute of Health for Women, Children and Adolescents Fernandes Figueira/Oswaldo Cruz Foundation, Rio de Janeiro 22250-020, Brazil
| | - Daniella Campelo Batalha Cox Moore
- National Institute of Health for Women, Children and Adolescents Fernandes Figueira/Oswaldo Cruz Foundation, Rio de Janeiro 22250-020, Brazil
| | - Saint Clair Gomes Junior
- National Institute of Health for Women, Children and Adolescents Fernandes Figueira/Oswaldo Cruz Foundation, Rio de Janeiro 22250-020, Brazil
| | - Maria Paula Carneiro de Oliveira
- National Institute of Health for Women, Children and Adolescents Fernandes Figueira/Oswaldo Cruz Foundation, Rio de Janeiro 22250-020, Brazil
| | - Maria Célia Chaves Zuma
- National Institute of Health for Women, Children and Adolescents Fernandes Figueira/Oswaldo Cruz Foundation, Rio de Janeiro 22250-020, Brazil
| | - Rômulo Gonçalves Galvani
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21045-900, Brazil.,Laboratory of Biomedicine, Veiga de Almeida University, Rio de Janeiro 20271-091, Brazil
| | - Wilson Savino
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21045-900, Brazil.,National Institute of Science and Technology on Neuroimmunomodulation, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21045-900, Brazil.,Rio de Janeiro Research Network on Neuroinflammation, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21045-900, Brazil
| | - Adriana Cesar Bonomo
- Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21045-900, Brazil.,National Institute of Science and Technology on Neuroimmunomodulation, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21045-900, Brazil.,Rio de Janeiro Research Network on Neuroinflammation, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21045-900, Brazil
| | - Zilton Farias Meira Vasconcelos
- National Institute of Health for Women, Children and Adolescents Fernandes Figueira/Oswaldo Cruz Foundation, Rio de Janeiro 22250-020, Brazil
| | - Elizabeth Artmann
- National School of Public Health/Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil
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Abstract
COVID-19 is a nonspecific viral illness caused by a novel coronavirus, SARS-CoV-2, and led to an ongoing global pandemic. Transmission is primarily human-to-human via contact with respiratory particles containing infectious virus. The risk of transmission to health care personnel is low with proper use of personal protective equipment, including gowns, gloves, N95 or surgical mask, and eye protection. Additional measures affecting the risk of transmission include physical distancing, hand hygiene, routine cleaning and disinfection, appropriate air handling and ventilation, and public health interventions such as universal masking and stay-at-home orders.
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Affiliation(s)
- Patrick Reich
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8116, St Louis, MO 63110-1093, USA.
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Sonmezer MC, Erul E, Sahin TK, Rudvan Al I, Cosgun Y, Korukluoglu G, Zengin H, Telli Dizman G, Inkaya AC, Unal S. Seroprevalence of SARS-CoV-2 Antibodies and Associated Factors in Healthcare Workers before the Era of Vaccination at a Tertiary Care Hospital in Turkey. Vaccines (Basel) 2022; 10:258. [PMID: 35214715 PMCID: PMC8875971 DOI: 10.3390/vaccines10020258] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/01/2022] [Accepted: 02/04/2022] [Indexed: 12/22/2022] Open
Abstract
Healthcare workers (HCWs), as frontliners, are assumed to be among the highest risk groups for COVID-19 infection, especially HCWs directly involved in patient care. However, the data on the COVID-19 infection and seroprevalence rates are limited in HCWs. Therefore, we aimed to evaluate the seroprevalence rates in HCWs according to risk groups for COVID-19 contraction in a large cross-sectional study from a tertiary care hospital in Turkey. We enrolled 1974 HCWs before the vaccination programs. In two separate semi-quantitative ELISAs, either IgA or IgG antibodies against SARS-CoV-2 spike protein subunit 1 (S1) were measured. The proportion of positive test results for IgG, IgA, or both against SARS-CoV-2 of study subjects was 19% (375/1974). Frontline HCWs who had contact with patients (21.7%, RR 2.1 [1.51–2.92]) and HCWs in working in the COVID-19 units, intensive care units, or emergency department (19.7%, RR 1.61 [1.12–2.32]) had a notably higher Anti-SARS-CoV-2 IgG compared to the rest of HCWs who has no daily patient contacts ([11.1%]; p < 0.0001). HCWs who care for regular patients in the medium-risk group have also experienced a sustained higher risk of exposure to SARS-CoV-2. We should enhance the precaution against COVID-19 to protect HCW’s safety through challenging times.
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Hong BE, Myo Bui CC, Huang YM, Grogan T, Duval VF, Cannesson M. Implementing COVID-19 Simulation Training for Anesthesiology Residents. MedEdPORTAL 2022; 18:11215. [PMID: 35178468 PMCID: PMC8801548 DOI: 10.15766/mep_2374-8265.11215] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 10/27/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION During the COVID-19 pandemic, anesthesiology residents faced increased risk of exposure to SARS-CoV-2 while performing aerosolizing procedures. We developed an airway simulation on the out-of-operating-room management of COVID-19 patients. METHODS A 90-minute simulation focused on caring for a 45-year-old COVID-19 patient provided training in donning and doffing personal protective equipment, intubation, management of postinduction hypotension, management of ICU ventilators, treatment strategies for acute respiratory distress syndrome (ARDS), interpersonal communication, and resource management. Presimulation, postsimulation, and 3-months postsimulation questionnaires measured changes in confidence, knowledge, and clinical practice. Statistical analysis was completed using related-samples Wilcoxon signed rank tests. RESULTS Twenty-four residents participated in the simulation. Questionnaire response rates were 100% presimulation and postsimulation and 88% 3-months postsimulation. Confidence scores (1 = not at all, 5 = extremely) improved with donning and doffing personal protective equipment (from 3.0 to 4.1, p < .001), ARDS management (from 3.1 to 4.0, p < .001), and COVID-19 airway management (from 2.8 to 4.0, p < .001). Correct answers on 10 knowledge questions increased significantly between presimulation and postsimulation (from 5.1 to 9.0, p < .001) but not between presimulation and 3-months postsimulation (from 5.1 to 5.8, p = .27). All participants who cared for COVID-19 patients at 3 months agreed or strongly agreed that their current management of COVID-19 patients was directly influenced by the simulation session (M = 4.4). DISCUSSION This simulation is a safe, effective method of providing the experiential training necessary to care for actual COVID-19 patients during an active pandemic.
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Affiliation(s)
- Bryant E. Hong
- Resident, Department of Anesthesiology and Perioperative Medicine, University of California, Los Angeles, David Geffen School of Medicine
| | - Christine C. Myo Bui
- Associate Clinical Professor and Associate Residency Program Director, Department of Anesthesiology and Perioperative Medicine, University of California, Los Angeles, David Geffen School of Medicine
| | - Yue Ming Huang
- Interim Executive Director, UCLA Simulation Center; Associate Adjunct Professor, Department of Anesthesiology and Perioperative Medicine, University of California, Los Angeles, David Geffen School of Medicine
| | - Tristan Grogan
- Principal Statistician, Department of Medicine Statistics Core, University of California, Los Angeles, David Geffen School of Medicine
| | - Victor F. Duval
- Anesthesiology Liaison and Lead Instructor, UCLA Simulation Center; Associate Clinical Professor, Department of Anesthesiology and Perioperative Medicine, University of California, Los Angeles, David Geffen School of Medicine
| | - Maxime Cannesson
- Professor and Chair, Department of Anesthesiology and Perioperative Medicine, University of California, Los Angeles, David Geffen School of Medicine
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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] [What about the content of this article? (0)] [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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Hoover SE, Reed V. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody prevalence in a healthcare worker population exceeded self-reported infection rates, 2020. ASHE 2022; 2:e21. [PMID: 36310797 PMCID: PMC9614817 DOI: 10.1017/ash.2022.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/27/2021] [Accepted: 12/28/2021] [Indexed: 11/29/2022]
Abstract
A study of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) seroprevalence at a healthcare institution prior to the availability of vaccine showed that seroprevalence in the cohort increased over 6 months from 25% to 55%. The number of employees with antibodies was higher than the number who reported an exposure or diagnosis at each time point.
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Cunha GHD, Siqueira LR, Fontenele MSM, Moreira LA, Ramalho AKL, Fechine FV. Prevalence of testing and coronavirus-19 among nurses in the pandemic. Rev Bras Enferm 2022; 75Suppl 1:e20210365. [DOI: 10.1590/0034-7167-2021-0365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 12/07/2021] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Objective: To determine the prevalence of testing and COVID-19 among nurses during the pandemic in the State of Ceará. Method: A cross-sectional study with 379 nurses, through a network sampling technique, using a sociodemographic, labor, and clinical questionnaire. The study performed a descriptive statistics, univariate and multivariate logistic regression analysis. Results: The prevalence of testing and COVID-19 were, respectively, 63.3% and 25.0%. The most common symptoms were anosmia, ageusia, and myalgia. There was inadequate use of personal protective equipment due to material shortage. The odds ratio for COVID-19 was higher in those with children, people with diabetes, from the capital, with more than two jobs, in hospital and emergency room, and from the frontline. In the multivariate logistic regression, nurses with children (p=0.011), diabetics (p=0.018) and frontline (p<0.001) had more chances for COVID-19. Conclusion: Expanded testing, ongoing in-service education, and adequate personal protective equipment are needed to improve nurses’ work.
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