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Kroneman M, Williams GA, Winkelmann J, Spreeuwenberg P, Davidovics K, Groenewegen PP. Personal protective equipment for healthcare workers during COVID-19: Developing and applying a questionnaire and assessing associations between infection rates and shortages across 19 countries. Health Policy 2024; 146:105097. [PMID: 38870609 PMCID: PMC11292171 DOI: 10.1016/j.healthpol.2024.105097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 04/30/2024] [Accepted: 05/24/2024] [Indexed: 06/15/2024]
Abstract
This study aimed to assess the preparedness of European countries regarding personal protective equipment (PPE) for health and care workers (HCWs), the COVID-19 infection rates of HCWs compared to the general working age population, and the association between these. We developed a PPE-preparedness scale based on responses to a questionnaire from experts in the Health Systems and Policy Monitor network, with a response rate of 19 out of 31 countries. COVID-19 infection data were retrieved form the European center for Disease Prevention and Control. Shortages of PPE were found in most countries, in particular in home care and long-term care. HCW infection rates, compared to the general population, varied strongly between countries, influenced by different testing regimes. We found no relationships between HCW infection rates, PPE preparedness and shortages of PPE. Improved surveillance in the population as well as for HCWS are needed to be able to better assess these relationships.
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Affiliation(s)
- Madelon Kroneman
- Nivel - Netherlands Institute for Health Services Research, PO Box 1568 3500, BN, Utrecht, the Netherlands
| | - Gemma A Williams
- London School of Economics and Political Science, Houghton Street, London WC2A 2AE, UK; European Observatory on Health Systems and Policies, Place Victor Horta/Victor Hortaplein, 40 bte 30 1060, Brussels, Belgium
| | - Juliane Winkelmann
- European Observatory on Health Systems and Policies, Place Victor Horta/Victor Hortaplein, 40 bte 30 1060, Brussels, Belgium
| | - Peter Spreeuwenberg
- Nivel - Netherlands Institute for Health Services Research, PO Box 1568 3500, BN, Utrecht, the Netherlands
| | - Krisztina Davidovics
- Semmelweis University, Health Services Management Training Centre, Data-Driven Health Division of National Laboratory for Health Security, Kútvölgyi út 2 1125, Budapest, Hungary
| | - Peter P Groenewegen
- Nivel - Netherlands Institute for Health Services Research, PO Box 1568 3500, BN, Utrecht, the Netherlands.
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Landsmann L, Borodova A, Rocha C, Diallo AA, Diallo KM, Borchert M, Arvand M, Diallo M, Wood RR, Müller SA. Healthcare workers' knowledge, attitude and practices on infection prevention and control in the context of the COVID-19 pandemic at the Faranah regional hospital and associated healthcare centers, Guinea. Antimicrob Resist Infect Control 2024; 13:79. [PMID: 39020447 PMCID: PMC11256390 DOI: 10.1186/s13756-024-01435-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 07/07/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND In response to the COVID-19 pandemic, WHO launched a strategic preparedness and response plan, outlining public health measures to support countries worldwide. Healthcare workers have an increased risk of becoming infected and their behaviour regarding infection prevention and control (IPC) influences infection dynamics. IPC strategies are important across the globe, but even more in low-resource settings where capacities for testing and treatment are limited. Our study aimed to assess and implement COVID-19 pandemic preparedness and response measures in Faranah, Guinea, primarily focusing on healthcare workers' IPC knowledge, attitude and practice (KAP). METHODS The study was conducted between April 2020 and April 2021 assessing IPC pandemic preparedness and response measures such as healthcare workers' KAP, alcohol-based handrub (ABHR) consumption and COVID-19 triaging in the Faranah Regional Hospital and two associated healthcare centres. The assessment was accompanied by IPC training and visual workplace reminders and done in pre- and post- phases to evaluate possible impact of these IPC activities. RESULTS The overall knowledge score in the Faranah Regional Hospital was 32.0 out of 44 at baseline, and did not change in the first, but increased significantly by 3.0 points in the second follow-up. The healthcare workers felt closer proximity to SARS-CoV-2 overtime in addition to higher stress levels in all study sites. There was significant improvement across the observed triaging practices. Hand hygiene compliance showed a significant increase across study sites leading to 80% in Faranah Regional Hospital and 63% in healthcare centers. The average consumption of ABHR per consultation was 3.29 mL with a peak in February 2020 of 23 mL. CONCLUSION Despite increased stress levels among HCWs, the ongoing IPC partnership well prepared the FRH in terms of triaging processes with a stronger impact on IPC practice than on theoretical knowledge. Throughout the pandemic, global shortages and surges in consumption did not affect the continuous ABHR provision of the FRH. This highlights local ABHR production as a key pandemic preparedness strategy.
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Affiliation(s)
- Lena Landsmann
- Unit for Hospital Hygiene, Infection Prevention and Control, Robert Koch Institute, Berlin, Germany.
| | - Anna Borodova
- Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Carlos Rocha
- Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | | | | | - Matthias Borchert
- Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Mardjan Arvand
- Unit for Hospital Hygiene, Infection Prevention and Control, Robert Koch Institute, Berlin, Germany
| | | | - Rebekah R Wood
- Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Sophie A Müller
- Centre for International Health Protection, Robert Koch Institute, Berlin, Germany
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Bellemare F, Laguë I, Arenzon V, Khaldoun L, Geoffrion S. Exploring the needs of healthcare workers receiving psychological first aid during the COVID19 pandemic. Work 2024:WOR230116. [PMID: 38943416 DOI: 10.3233/wor-230116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2024] Open
Abstract
BACKGROUND Healthcare workers (HCW; e.g., nurses, social workers) work in stressful conditions, a situation that has been further exacerbated by the COVID-19 pandemic. A review of the supportive role of Psychological first aid (PFA) suggested that it can protect HCW from psychological distress. Despite the growing interest of PFA among public health organizations, there is a dearth of literature on its potential impact for the psychological well-being of HCW and its implementation within organizations. OBJECTIVE This study aimed to evaluate whether PFA met the psychological needs of HCW in Montreal, Quebec. METHODS A sample of 15 HCW who received PFA by a peer within their organization were recruited to participate in semi-structured interviews. Qualitative research using thematic analysis was conducted. RESULTS Five themes were identified: 1) PFA satisfied participants' psychosocial needs; 2) PFA provided by peers allowed participants to feel understood and supported; 3) High availability and multiple modalities facilitated PFA access; 4) Occupational and organizational cultures hindered PFA access; and 5) Recommendations to promote the use of the PFA service. CONCLUSION Results describe four psychosocial needs met by the PFA intervention: to have resources/strategies, to be validated, to obtain a better understanding of the psychological reactions they were experiencing, and to be guided and supported in their difficulties at work. Overall, these findings illustrate how PFA goes beyond the reduction of distress symptoms in the aftermath of a potentially traumatic event. The relevance to further the assessment of PFA's positive effects on psychological adaptation and/or recovery is also highlighted.
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Affiliation(s)
- François Bellemare
- Department of Psychology, Université de Montréal, Canada
- Trauma Studies Center, Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Canada
| | - Isabelle Laguë
- School of Psychoeducation, Université de Montréal, Canada
- Trauma Studies Center, Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Canada
| | - Valerie Arenzon
- Department of Psychology, Université de Montréal, Canada
- Trauma Studies Center, Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Canada
| | - Lydia Khaldoun
- School of Psychoeducation, Université de Montréal, Canada
- Trauma Studies Center, Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Canada
| | - Steve Geoffrion
- School of Psychoeducation, Université de Montréal, Canada
- Trauma Studies Center, Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Canada
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Jason K, Wilson M, Catoe J, Brown C, Gonzalez M. The Impact of the COVID-19 Pandemic on Black and Hispanic Americans' Work Outcomes: a Scoping Review. J Racial Ethn Health Disparities 2024; 11:1157-1172. [PMID: 37117935 PMCID: PMC10147367 DOI: 10.1007/s40615-023-01594-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/25/2023] [Accepted: 03/31/2023] [Indexed: 04/30/2023]
Abstract
In early 2020, it was hypothesized that COVID-19 would lead to disproportionately negative health and work outcomes for Black and Hispanic adults, but sufficient data had yet been collected to fully support this claim. Now, we have empirical evidence, but little has been done to aggregate this information to fully understand its impact on these communities. Utilizing 44 articles from a scoping review of three databases (PubMed, Web of Science, and Business Source Complete), this study seeks to identify the primary work-related risks that help explain Black and Hispanic adults' disparate COVID-19-related work outcomes (e.g., loss of hours, job disruption, stress). Findings illuminate four primary risks faced by Black and Hispanic workers: (1) being an essential worker, (2) type of work performed, (3) workplace factors; and (4) community and geographic factors. We conclude with policy recommendations that will help inform policy and practice for economic recovery from the pandemic for other marginalized populations.
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Affiliation(s)
- Kendra Jason
- University of North Carolina at Charlotte, Charlotte, North Carolina, USA.
| | - Miguel Wilson
- University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Jamel Catoe
- University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Courtney Brown
- University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Mayleen Gonzalez
- University of North Carolina at Charlotte, Charlotte, North Carolina, USA
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Ngomtcho SCH, Akenji BM, Tchio-Nighie KH, Fokam J, Guenou E, Nsa’Amang Eyebe C, Nzegni Kamkoum YJ, Ntale Tchoffo VD, Buh Nkum C, Tchoudjin Paho HC, Ebogo YMS, Nanfak A, Maidadi-Foudi M, Fouda C, Andigema AS, Nsah Bongdze-em L, Nfor BN, Torimiro J, Zoung-Kanyi Bissek AC, Noubom M, Assoumou Okomo MC, Ateudjieu J. SARS-CoV-2 active infection and antibodies amongst health personnel during the outbreak in Cameroon: Strengthening the health system for response to future public health emergencies. PLoS One 2024; 19:e0304477. [PMID: 38820301 PMCID: PMC11142533 DOI: 10.1371/journal.pone.0304477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/13/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Health personnel (HP) are on the frontlines during response to public health emergencies like COVID-19. This risk of exposure suggests the need for safety in responding to any pandemic. Therefore, to ascertain the rate of SARS-CoV-2 infection and immunity, and their determinants amongst HP become relevant. METHODS A cross sectional health facility-based study was carried-out amongst HP in the Centre Region of Cameroon from 1st February to 30th June 2021. Characteristics and access to preventive tools were collected using face-to-face administered questionnaire. Nasopharyngeal swabs and whole blood were collected for PCR, IgG and IgM testing respectively. STATA version 17 software was used for data analysis. Determinants of COVID-19 infection were explored by estimating crude and adjusted Odd Ratio. RESULTS Out of 510 HP reached, 458 were enrolled with mean age of 35 (±10) years. Thirty-four (7.4%) were PCR-positive to SARS-CoV-2 with 73.5% being clinicians versus 9 (26.4%) non-clinicians (p = 0.05). Sero-positivity to SARS-CoV-2 IgG/IgM was 40.2% (184/458), with 84.2% being clinicians versus 29 (15.8%) non-clinicians (p = 0.733). Amongst the 34 HP with PCR-positivity, 16 (47%) had no antibodies, while, 15 (44%) were IgG only. An estimate of HP (43.7%) had at least an evidence of PCR, IgG or IgM contact to COVID-19. Determinants of PCR-positivity was being clinical staff (AOR = 0.29, P = 0.039); and that of IgG/IgM were being non clinical staff (AOR = 0.41, p = 0.018) and regular use of face masks (AOR = 0.44, p = 0.001). HP trained on IPC (24%) were mainly from peripheral level (74.7%, p = 0.002). CONCLUSION Active infections were within the range of pandemic control (<10%). However, around two-fifths of participants have had contact with the virus, indicating that HP remains a population at risk of COVID-19 and other similarly-transmitted epidemic prone diseases, and also an important source of transmission. There is need of vaccine to achieve protectiveness, and optimal response also requires capacity building to improve the health system when challenged by a future pandemic.
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Affiliation(s)
- Sen Claudine Henriette Ngomtcho
- National Public Health Laboratory, Ministry of Public Health, Yaoundé, Cameroon
- Department of Microbiology, Hematology and Immunology, Faculty of Medicine and Pharmaceutical Sciences (FMPS), University of Dschang, Dschang, Cameroon
- Genomic Surveillance Study Group, Ministry of Public Health, Yaoundé, Cameroon
| | | | | | - Joseph Fokam
- Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon
| | - Etienne Guenou
- National Public Health Laboratory, Ministry of Public Health, Yaoundé, Cameroon
| | - Carolle Nsa’Amang Eyebe
- Department of Biological Sciences, Faculty of Medicine and Pharmaceutical Sciences (FMPS), University of Douala, Douala, Cameroon
| | - Yvan Junior Nzegni Kamkoum
- Department of Microbiology, Hematology and Immunology, Faculty of Medicine and Pharmaceutical Sciences (FMPS), University of Dschang, Dschang, Cameroon
| | - Valdex Derick Ntale Tchoffo
- Department of Microbiology, Hematology and Immunology, Faculty of Medicine and Pharmaceutical Sciences (FMPS), University of Dschang, Dschang, Cameroon
| | - Collins Buh Nkum
- M.A. SANTE (Meilleur Accès aux Soins de Santé), Yaoundé, Cameroon
| | | | | | - Aude Nanfak
- M.A. SANTE (Meilleur Accès aux Soins de Santé), Yaoundé, Cameroon
| | - Martin Maidadi-Foudi
- Centre de Recherche en Maladies Emergentes et Re-emergentes (CREMER), Yaoundé, Cameroun
| | - Crescence Fouda
- National Public Health Laboratory, Ministry of Public Health, Yaoundé, Cameroon
| | - Angyiba Serge Andigema
- Department of Microbiology, Hematology and Immunology, Faculty of Medicine and Pharmaceutical Sciences (FMPS), University of Dschang, Dschang, Cameroon
| | - Lilian Nsah Bongdze-em
- Department of Microbiology, Hematology and Immunology, Faculty of Medicine and Pharmaceutical Sciences (FMPS), University of Dschang, Dschang, Cameroon
| | - Beri Nadin Nfor
- Department of Microbiology, Hematology and Immunology, Faculty of Medicine and Pharmaceutical Sciences (FMPS), University of Dschang, Dschang, Cameroon
| | - Judith Torimiro
- Chantal Biya International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon
| | - Anne Cécile Zoung-Kanyi Bissek
- Division for Operational Health Research (DROS), Ministry of Public Health, Yaoundé, Cameroon
- Department of internal Medicine, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Michel Noubom
- Department of Microbiology, Hematology and Immunology, Faculty of Medicine and Pharmaceutical Sciences (FMPS), University of Dschang, Dschang, Cameroon
| | | | - Jérôme Ateudjieu
- M.A. SANTE (Meilleur Accès aux Soins de Santé), Yaoundé, Cameroon
- Department of Public Health, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
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Kasztelewicz B, Skrok K, Burzyńska J, Migdał M, Dzierżanowska-Fangrat K. Incidence of SARS-CoV-2 infection among healthcare workers before and after COVID-19 vaccination in a tertiary paediatric hospital in Warsaw: A retrospective cohort study. PLoS One 2024; 19:e0301612. [PMID: 38781220 PMCID: PMC11115228 DOI: 10.1371/journal.pone.0301612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 03/19/2024] [Indexed: 05/25/2024] Open
Abstract
A retrospective observational study was conducted among healthcare workers (HCWs) in a tertiary paediatric hospital. The study covered the period before and after implementation of the vaccination programme and evaluated the incidence of new SARS-CoV-2 infections in both periods. Risk factors of the new SARS-CoV-2 infection and COVID-19 vaccine effectiveness was also assessed in a real-world setting. The overall incidence of SARS-CoV-2 infections among HCWs in the study period was 19.4% with a high proportion of asymptomatic individuals (45.1%). The incidence before vaccination was 16.6% and nurses had a higher risk of infection, while physicians had a reduced risk (OR 1.80, 95% CI 1.29-2.52; and OR 0.45, 95% CI 0.30-0.68). Within two months of implementation, the programme achieved a high (88.9%) vaccination coverage in our cohort, although some disparities in vaccination rates were observed. In particular, older individuals, physicians, those working in clinical settings, and those previously uninfected were more likely to be vaccinated. The overall incidence of SARS-CoV-2 infection after vaccination deployment was 6.4% (40.0% in unvaccinated individuals and 3.2% in individuals vaccinated with at least one dose). The estimated vaccine efficacy was high (95.0%) in fully vaccinated HCWs and similar to those observed previously in clinical trials and real-world settings.
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Affiliation(s)
- Beata Kasztelewicz
- Department of Clinical Microbiology and Immunology, The Children’s Memorial Health Institute, Warsaw, Poland
| | - Katarzyna Skrok
- Department of Clinical Microbiology and Immunology, The Children’s Memorial Health Institute, Warsaw, Poland
| | - Julia Burzyńska
- Department of Clinical Microbiology and Immunology, The Children’s Memorial Health Institute, Warsaw, Poland
| | - Marek Migdał
- CEO of the Children’s Memorial Health Institute, Warsaw, Poland
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Millar MM, Mayer J, Crook J, Stratford KM, Huber T, Samore MH. Factors associated with testing positive for SARS-CoV-2 and evaluation of a recruitment protocol among healthcare personnel in a COVID-19 vaccine effectiveness study. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2024; 4:e47. [PMID: 38628372 PMCID: PMC11019576 DOI: 10.1017/ash.2024.44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 02/25/2024] [Accepted: 03/01/2024] [Indexed: 04/19/2024]
Abstract
Objective The objective of this study was to determine factors associated with testing positive for SARS-CoV-2 among healthcare personnel. Secondary objectives were to assess representativeness of recruited participants and the effectiveness of a multiple-contact protocol for recruiting healthcare personnel in this COVID-19 study. Design Survey study, conducted as part of an observational test-negative study of COVID-19 vaccine effectiveness. Setting University of Utah Health system, including both inpatient and outpatient facilities. Participants Clinical and non-clinical healthcare personnel at University of Utah Health. 1456 were contacted and 503 (34.5%) completed the survey. Cases were all eligible employees testing positive for COVID-19, with 3:1 randomly selected, matched controls (test negative) selected weekly. Methods Online survey. Results Significant differences in the demographics of participants and the source population were observed; e.g., nursing staff comprised 31.6% of participants but only 23.3% of the source population. The multiple-contact recruitment protocol increased participation by ten percentage points and ensured equal representation of controls. Potential exposure to illness outside of work was strongly predictive of testing positive for SARS-CoV-2 (OR = 3.74; 95% CI: 2.29, 6.11) whereas potential exposure at work was protective against testing positive (OR: 0.51, 95% CI: 0.29, 0.88). Conclusions Carefully designed recruitment protocols increase participation and representation of controls, but bias in participant demographics still exists. The negative association between potential workplace exposure and positive test suggests testing bias in the test-negative design. Healthcare personnel's potential exposures to COVID-19 outside of the workplace are important predictors of SARS-CoV-2 seropositivity.
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Affiliation(s)
- Morgan M. Millar
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Jeanmarie Mayer
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Jacob Crook
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
- Department of Veterans Affairs, Salt Lake City Healthcare System, Salt Lake City, UT, USA
| | - Kristina M. Stratford
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
- Department of Veterans Affairs, Salt Lake City Healthcare System, Salt Lake City, UT, USA
| | - Tavis Huber
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
- Department of Veterans Affairs, Salt Lake City Healthcare System, Salt Lake City, UT, USA
| | - Matthew H. Samore
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
- Department of Veterans Affairs, Salt Lake City Healthcare System, Salt Lake City, UT, USA
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Shahriarirad S, Asmarian N, Shahriarirad R, Moghadami M, Askarian M, Hashemizadeh Fard Haghighi L, Javadi P, Sabetian G. High Post-Infection Protection after COVID-19 among Healthcare Workers: A Population-Level Observational Study. IRANIAN JOURNAL OF MEDICAL SCIENCES 2024; 49:247-258. [PMID: 38680224 PMCID: PMC11053253 DOI: 10.30476/ijms.2023.97708.2951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 04/04/2023] [Accepted: 05/04/2023] [Indexed: 05/01/2024]
Abstract
Background Even though a few years have passed since the coronavirus disease 2019 (COVID-19) outbreak, information regarding certain aspects of the disease, such as post-infection immunity, is still quite limited. This study aimed to evaluate post-infection protection and COVID-19 features among healthcare workers (HCWs), during three successive surges, as well as the rate of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection, reactivation, re-positivity, and severity. Methods This cross-sectional population-level observational study was conducted from 20 April 2020 to 18 February 2021. The study population included all HCWs in public or private hospitals in Fars Province, Southern Iran. The infection rate was computed as the number of individuals with positive polymerase chain reaction (PCR) tests divided by the total number of person-days at risk. The re-infection was evaluated after 90 days. Results A total of 30,546 PCR tests were performed among HCWs, of which 13,749 (61.94% of total HCWs) were positive. Considering the applied 90-day threshold, there were 44 (31.2%) cases of reactivation and relapse, and 97 (68.8% of infected and 1.81% of total HCWs) cases of reinfection among 141 (2.64%) diagnosed cases who experienced a second episode of COVID-19. There was no significant difference in symptoms (P=0.65) or the necessity for ICU admission (P=0.25). The estimated protection against repeated infection after a previous SARS-CoV-2 infection was 94.8% (95% CI=93.6-95.7). Conclusion SARS-CoV-2 re-positivity, relapse, and reinfection were rare in the HCW population. After the first episode of infection, an estimated 94.8% protection against recurring infections was achieved. A preprint version of this manuscript is available at DOI:10.21203/rs.3.rs-772662/v1 (https://www.researchsquare.com/article/rs-772662/v1).
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Affiliation(s)
- Sepehr Shahriarirad
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Naeimehossadat Asmarian
- Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Reza Shahriarirad
- Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Moghadami
- Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehrdad Askarian
- Department of Community Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Parisa Javadi
- Department of Anesthesiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Golnar Sabetian
- Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Landmesser P, Weissbrich B, Peter-Kern M, Krone M, Liese JG, Streng A. [SARS-CoV-2 Exposure and Seroprevalence of SARS-CoV-2 Antibodies among Medical Students in the First Phase of the Pandemic 2020-2021]. DAS GESUNDHEITSWESEN 2024; 86:311-314. [PMID: 38181814 PMCID: PMC11003243 DOI: 10.1055/a-2183-7279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2024]
Abstract
BACKGROUND Due to their clinical training and secondary activities in the hospital, medical students are exposed to contact with SARS-CoV-2 infected people more often than the general population. We determined the seroprevalence of SARS-CoV-2 antibodies in medical students in clinical training at different times during the pandemic and asked participants about possible SARS-CoV-2 exposures in both medical and private settings. METHODS From May 2020 to June 2021, medical students each in their 3rd year of training at the University Hospital Würzburg participated in the cross-sectional survey. All SARS-CoV-2 unvaccinated students were offered a determination of their SARS-CoV-2 serostatus. The blood samples were tested by an immunoassay (Elecsys, Roche) for IgG/IgM/IgA antibodies against the SARS-CoV-2 N antigen. Demographic data, SARS-CoV-2 disease and vaccination status, as well as possible SARS-CoV-2 exposures were collected using a questionnaire. RESULTS Overall, 383 (86.1%) of 445 students took part in the cross-sectional survey (65% female; median age 22 years; IQR 21-24). Serostatus was determined in 223 (58.2% of 383) SARS-CoV-2 unvaccinated participants. In the period between the beginning of the pandemic in Germany (February 2020) and the time of the survey, 332 (86.7% of 383) students stated that they worked in the medical field, mainly in the context of clinical traineeships (76.8%) or secondary activities with patient contact (48.8%); 129 (33.7%) reported previous contact with a COVID-19 patient, of which 78.3% of contacts took place at a medical facility. Antibodies against SARS-CoV-2 were detected in 8 (3.6%) of the 223 unvaccinated participants tested, and in 3 infected persons an association between infection and contact in the course of medical activity seemed likely. CONCLUSION Despite frequent patient contact and the associated increased risk of infection, medical students in their 3rd year of training did not show an increased seroprevalence compared to the general population and showed a lower or similar seroprevalence rate than medical students in other European countries in the first 18 months of the pandemic. This indicates sufficient protection of medical students at the beginning of clinical training through the hygiene and infection protection measures implemented at that time during medical activities.
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Affiliation(s)
- Patricia Landmesser
- Kinderklinik und Poliklinik, Universitätsklinikum
Würzburg, Würzburg, Germany
| | - Benedikt Weissbrich
- Institut für Virologie und Immunbiologie, Universität
Würzburg, Würzburg, Germany
| | - Martina Peter-Kern
- Kinderklinik und Poliklinik, Universitätsklinikum
Würzburg, Würzburg, Germany
| | - Manuel Krone
- Zentrale Einrichtung Krankenhaushygiene und Antimicrobial Stewardship,
Universitätsklinikum Würzburg, Würzburg,
Germany
| | - Johannes G. Liese
- Kinderklinik und Poliklinik, Universitätsklinikum
Würzburg, Würzburg, Germany
| | - Andrea Streng
- Kinderklinik und Poliklinik, Universitätsklinikum
Würzburg, Würzburg, Germany
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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] [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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11
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Pouquet M, Decarreaux D, Di Domenico L, Sabbatini CE, Prévot-Monsacre P, Fourié T, Villarroel PMS, Priet S, Blanché H, Sebaoun JM, Deleuze JF, Turbelin C, Rossignol L, Werner A, Kochert F, Grosgogeat B, Rabiega P, Laupie J, Abraham N, Noël H, van der Werf S, Colizza V, Carrat F, Charrel R, de Lamballerie X, Blanchon T, Falchi A. SARS-CoV-2 infection prevalence and associated factors among primary healthcare workers in France after the third COVID-19 wave. Sci Rep 2024; 14:5418. [PMID: 38443618 PMCID: PMC10914718 DOI: 10.1038/s41598-024-55477-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/23/2024] [Indexed: 03/07/2024] Open
Abstract
Data on the SARS-CoV-2 infection among primary health care workers (PHCWs) are scarce but essential to reflect on policy regarding prevention and control measures. We assessed the prevalence of PHCWs who have been infected by SARS-CoV-2 in comparison with modeling from the general population in metropolitan France, and associated factors. A cross-sectional study was conducted among general practitioners (GPs), pediatricians, dental and pharmacy workers in primary care between May and August 2021. Participants volunteered to provide a dried-blood spot for SARS-CoV-2 antibody assessment and completed a questionnaire. The primary outcome was defined as the detection of infection-induced antibodies (anti-nucleocapsid IgG, and for non-vaccinees: anti-Spike IgG and neutralizing antibodies) or previous self-reported infection (positive RT-qPCR or antigenic test, or positive ELISA test before vaccination). Estimates were adjusted using weights for representativeness and compared with prediction from the general population. Poisson regressions were used to quantify associated factors. The analysis included 1612 PHCWs. Weighted prevalences were: 31.7% (95% CI 27.5-36.0) for GPs, 28.7% (95% CI 24.4-33.0) for pediatricians, 25.2% (95% CI 20.6-31.0) for dentists, and 25.5% (95% CI 18.2-34.0) for pharmacists. Estimates were compatible with model predictions for the general population. PHCWs more likely to be infected were: GPs compared to pharmacist assistants (adjusted prevalence ratio [aPR] = 2.26; CI 95% 1.01-5.07), those living in Île-de-France (aPR = 1.53; CI 95% 1.14-2.05), South-East (aPR = 1.57; CI 95% 1.19-2.08), North-East (aPR = 1.81; CI 95% 1.38-2.37), and those having an unprotected contact with a COVID-19 case within the household (aPR = 1.48; CI 95% 1.22-1.80). Occupational factors were not associated with infection. In conclusion, the risk of SARS-CoV-2 exposure for PHCWs was more likely to have occurred in the community rather than at their workplace.
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Affiliation(s)
- Marie Pouquet
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France.
| | - Dorine Decarreaux
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
- Laboratoire de Virologie, Université de Corse Pascal Paoli, UR7310 Bioscope, 20250, Corte, France
- Unité Des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005, Marseille, France
| | - Laura Di Domenico
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
| | - Chiara E Sabbatini
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
| | - Pol Prévot-Monsacre
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
| | - Toscane Fourié
- Unité Des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005, Marseille, France
| | | | - Stephane Priet
- Unité Des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005, Marseille, France
| | | | | | | | - Clément Turbelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
| | - Louise Rossignol
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
| | - Andréas Werner
- Association Française de Pédiatrie Ambulatoire (AFPA), Zone de la Fouquetière, 155 Rue Edouard Branly, 44150, Ancenis-Saint-Géréon, France
| | - Fabienne Kochert
- Association Française de Pédiatrie Ambulatoire (AFPA), Zone de la Fouquetière, 155 Rue Edouard Branly, 44150, Ancenis-Saint-Géréon, France
| | - Brigitte Grosgogeat
- Faculté d'Odontologie, Université Claude Bernard Lyon 1, Université de Lyon, 69000, Lyon, France
- Laboratoire des Multimatériaux et Interfaces, UMR CNRS 5615, Université Claude Bernard Lyon 1, Université de Lyon, 69000, Lyon, France
- Réseau ReCOL, Association Dentaire Française, 75000, Paris, France
- Service d'Odontologie, Hospices Civils de Lyon, 69007, Lyon, France
| | | | - Julien Laupie
- Réseau ReCOL, Association Dentaire Française, 75000, Paris, France
| | | | - Harold Noël
- Infectious Diseases Division, Santé Publique France, 94410, Saint Maurice, France
| | - Sylvie van der Werf
- Institut Pasteur, Université Paris Cité, CNRS UMR3569, Molecular Genetics of RNA Viruses Unit, 75015, Paris, France
- Institut Pasteur, Université Paris Cité, National Reference Center for Respiratory Viruses, 75015, Paris, France
| | - Vittoria Colizza
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
| | - Fabrice Carrat
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
- Département de Santé Publique, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Sorbonne Université, 75012, Paris, France
| | - Remi Charrel
- Unité Des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005, Marseille, France
- LE Service de Prévention du Risque Infectieux (LESPRI), CLIN AP-HM Hôpitaux Universitaires de Marseille, 13005, Marseille, France
| | - Xavier de Lamballerie
- Unité Des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005, Marseille, France
| | - Thierry Blanchon
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), 75012, Paris, France
| | - Alessandra Falchi
- Laboratoire de Virologie, Université de Corse Pascal Paoli, UR7310 Bioscope, 20250, Corte, France
- Unité Des Virus Emergents, Aix Marseille University, IRD 190, INSERM U1207, 13005, Marseille, France
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12
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Sakr CJ, Abou Hassan FF, Fakih L, Bou Hamdan M, Assaf S, Rahme D, Melhem NM. Risk Factors for SARS-CoV-2 Among a Cohort of Healthcare Workers in Lebanon. Workplace Health Saf 2024; 72:48-59. [PMID: 38158826 DOI: 10.1177/21650799231214234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
BACKGROUND Healthcare workers (HCWs) faced substantial risk of infection during the COVID-19 outbreak. This study aims to determine the prevalence of anti-SARS-CoV-2 antibodies in a cross-sectional sample of HCWs as well as risk factors associated with exposure to SARS-CoV-2. METHODS The study was conducted between March and May 2021 at the American University of Beirut Medical Center (AUBMC), a tertiary hospital located in Lebanon. Socio-demographic and clinical data, as well as data on exposure, PCR results, PPE adherence, and vaccination status, were collected using an online questionnaire. Sera were also collected to determine seropositivity using commercially available enzyme-linked immunoassay (ELISA) targeting the spike (S) and the nucleocapsid proteins (NCP) of SARS-CoV-2. FINDINGS Among 92 recruited HCWs, 72.3% received PPE training, more than 70% were adherent to using appropriate PPEs, and around 80% were vaccinated. Nurses in this study population were at higher risk of exposure compared to medical doctors, technicians, and other HCWs. Among the HCWs who performed a PCR test, 28.6% were infected with SARs-CoV-2 with workplace exposure not associated with COVID-19 infection. All vaccinated HCWs were seropositive for anti-S IgG with high titer (≥384 BAU/mL), with a significantly higher median anti-S IgG titer compared to unvaccinated HCWs with previous infection (384 vs. 140.1 BAU/mL; p = .0043). CONCLUSIONS Our study highlights the importance of implementing strict infection control policies among HCWs and deploying an effective COVID-19 vaccination strategy. More studies are needed in Lebanon to assess risk factors of SARS-CoV-2 exposure in the workplace.
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Affiliation(s)
- Carine J Sakr
- Employee Health Unit, Department of Family Medicine, American University of Beirut Medical Center
| | - Farouk F Abou Hassan
- Medical Laboratory Sciences Program, Division of Health Professions, Faculty of Health Sciences, American University of Beirut
| | - Lina Fakih
- Employee Health Unit, Department of Family Medicine, American University of Beirut Medical Center
| | - Mirna Bou Hamdan
- Medical Laboratory Sciences Program, Division of Health Professions, Faculty of Health Sciences, American University of Beirut
| | - Sara Assaf
- Employee Health Unit, Department of Family Medicine, American University of Beirut Medical Center
| | - Diana Rahme
- Employee Health Unit, Department of Family Medicine, American University of Beirut Medical Center
| | - Nada M Melhem
- Medical Laboratory Sciences Program, Division of Health Professions, Faculty of Health Sciences, American University of Beirut
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13
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Gehring S, Kowalzik F, Okasha O, Engelmann T, Schreiner D, Jensen C, Mähringer-Kunz A, Hartig-Merkel W, Mai Phuong Tran T, Oostvogels C, Verstraeten T. A prospective cohort study of SARS-CoV-2 infection-induced seroconversion and disease incidence in German healthcare workers before and during the rollout of COVID-19 vaccines. PLoS One 2024; 19:e0294025. [PMID: 38289913 PMCID: PMC10826949 DOI: 10.1371/journal.pone.0294025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 07/22/2023] [Indexed: 02/01/2024] Open
Abstract
We assessed the seroepidemiology of SARS-CoV-2 infection and the incidence of coronavirus disease 2019 (COVID-19) before and during the rollout of COVID-19 vaccines, in a prospective observational cohort study on healthcare workers (HCWs) in a large tertiary hospital in Mainz, Germany. Antibody status was assessed during six visits between September 2020 and February 2022. Self-reported symptoms were collected using a smartphone application; symptomatic HCWs were tested using real-time polymerase chain reaction (RT-PCR) assays for SARS-CoV-2. Rates of virologically confirmed and severe COVID-19 were estimated using the U.S. Food and Drug Administration (FDA) and Coalition for Epidemic Preparedness Innovations (CEPI) case definitions, respectively, and were contrasted to background community transmission and circulating SARS-CoV-2 variants. A total of 3665 HCWs were enrolled (mean follow-up time: 18 months); 97 met the FDA definition of virologically confirmed COVID-19 (incidence rate (IR) 2.3/1000 person-months (PMs), one severe case). Most cases reported ≥2 symptoms, commonly, cough and anosmia or ageusia. Overall, 263 individuals seroconverted (IR 6.6/1000 PMs-2.9 times the estimated IR of COVID-19), indicating many cases were missed, either due to asymptomatic infections or to an atypical presentation of symptoms. A triphasic trend in anti-SARS-CoV-2 seroprevalence and seroconversion was observed, with an initial increase following the rollout of COVID-19 vaccines, a two-fold decline six months later, and finally a six-fold increase by the end of the study when Omicron was the dominant circulating variant. Despite the increase in infection rates at the end of the study due to the circulation of the Omicron variant, the infection and disease rates observed were lower than the published estimates in HCWs and rates in the general local population. Preferential vaccination of HCWs and the strict monitoring program for SARS-CoV-2 infection are the most likely reasons for the successful control of COVID-19 in this high-risk population.
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Affiliation(s)
- Stephan Gehring
- Zentrum für Kinder- und Jugendmedizin, Universitätsmedizin Mainz, Mainz, Germany
| | - Frank Kowalzik
- Zentrum für Kinder- und Jugendmedizin, Universitätsmedizin Mainz, Mainz, Germany
| | - Omar Okasha
- P95 Pharmacovigilance and Epidemiology, Leuven, Belgium
| | - Tobias Engelmann
- Zentrum für Kinder- und Jugendmedizin, Universitätsmedizin Mainz, Mainz, Germany
| | - Daniel Schreiner
- Zentrum für Kinder- und Jugendmedizin, Universitätsmedizin Mainz, Mainz, Germany
| | - Christian Jensen
- Zentrum für Kinder- und Jugendmedizin, Universitätsmedizin Mainz, Mainz, Germany
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14
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Chasinga TB, Cikwanine JPB, Kribi S, Yoyu JT, Hofmann N, Grossegesse M, Nitsche A, Tomczyk S, Vietor AC, Leendertz FH, Eckmanns T, Kusinza AB, Munguakonkwa E, Kalk A, Raha M, Kambale NS, Ayagirwe RB, Schubert G, Mukwege D. Seroprevalence of anti-SARS-CoV-2 antibodies and risk of viral exposure among healthcare workers in the South Kivu province, eastern Democratic Republic of the Congo: a cross-sectional study. BMJ Open 2024; 14:e072212. [PMID: 38176860 PMCID: PMC10773362 DOI: 10.1136/bmjopen-2023-072212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 11/20/2023] [Indexed: 01/06/2024] Open
Abstract
OBJECTIVES Healthcare workers (HCWs) are on the frontline of combating COVID-19, hence are at elevated risk of contracting an infection with SARS-CoV-2. The present study aims to measure the impact of SARS-CoV-2 on HCWs in central sub-Saharan Africa. SETTING A cross-sectional serological study was conducted at six urban and five rural hospitals during the first pandemic wave in the South Kivu province, Democratic Republic of the Congo (DRC). PARTICIPANTS Serum specimens from 1029 HCWs employed during the first pandemic wave were collected between August and October 2020, and data on demographics and work-related factors were recorded during structured interviews. PRIMARY AND SECONDARY OUTCOME MEASURES The presence of IgG antibodies against SARS-CoV-2 was examined by ELISA. Positive specimens were further tested using a micro-neutralisation assay. Factors driving SARS-CoV-2 seropositivity were assessed by multivariable analysis. RESULTS Overall SARS-CoV-2 seroprevalence was high among HCWs (33.1%), and significantly higher in urban (41.5%) compared with rural (19.8%) hospitals. Having had presented with COVID-19-like symptoms before was a strong predictor of seropositivity (31.5%). Personal protective equipment (PPE, 88.1% and 11.9%) and alcohol-based hand sanitizer (71.1% and 28.9%) were more often available, and hand hygiene was more often reported after patient contact (63.0% and 37.0%) in urban compared with rural hospitals, respectively. This may suggest that higher exposure during non-work times in high incidence urban areas counteracts higher work protection levels of HCWs. CONCLUSIONS High SARS-CoV-2 seropositivity indicates widespread transmission of the virus in this region of DRC. Given the absence of publicly reported cases during the same time period at the rural sites, serological studies are very relevant in revealing infection dynamics especially in regions with low diagnostic capacities. This, and discrepancies in the application of PPE between urban and rural sites, should be considered in future pandemic response programmes.
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Affiliation(s)
- Tshass B Chasinga
- Université Evangélique en Afrique, Bukavu, Congo (the Democratic Republic of the)
- Panzi General Referral Hospital, Bukavu, Congo (the Democratic Republic of the)
| | - Jean-Paul Buhendwa Cikwanine
- Université Evangélique en Afrique, Bukavu, Congo (the Democratic Republic of the)
- Panzi General Referral Hospital, Bukavu, Congo (the Democratic Republic of the)
| | | | - Jonathan Tunangoya Yoyu
- Université Evangélique en Afrique, Bukavu, Congo (the Democratic Republic of the)
- Département des Œuvres et Recherches Médicales, ECC-NK, Goma, Congo (the Democratic Republic of the)
| | | | | | | | | | | | - Fabian H Leendertz
- Robert Koch Institute, Berlin, Germany
- Helmholtz Institute for One Health, Greifswald, Germany
| | | | - Aline B Kusinza
- Université Evangélique en Afrique, Bukavu, Congo (the Democratic Republic of the)
- Panzi General Referral Hospital, Bukavu, Congo (the Democratic Republic of the)
| | - Eric Munguakonkwa
- Panzi General Referral Hospital, Bukavu, Congo (the Democratic Republic of the)
| | - Andreas Kalk
- Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ), Kinshasa, Congo (the Democratic Republic of the)
| | - Maroyi Raha
- Université Evangélique en Afrique, Bukavu, Congo (the Democratic Republic of the)
- Panzi General Referral Hospital, Bukavu, Congo (the Democratic Republic of the)
| | - Nelson S Kambale
- Université Evangélique en Afrique, Bukavu, Congo (the Democratic Republic of the)
- Département des Œuvres et Recherches Médicales, ECC-NK, Goma, Congo (the Democratic Republic of the)
| | - Rodrigue B Ayagirwe
- Université Evangélique en Afrique, Bukavu, Congo (the Democratic Republic of the)
| | | | - Denis Mukwege
- Université Evangélique en Afrique, Bukavu, Congo (the Democratic Republic of the)
- Panzi General Referral Hospital, Bukavu, Congo (the Democratic Republic of the)
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Wang RC, Degesys NF, Fahimi J, Jin C, Rosenthal E, Lazar AA, Yaffee AQ, Peterson S, Rothmann RE, Jones CMC, Tolia V, Shah MN, Raven MC. Incidence of Fit Test Failure During N95 Respirator Reuse and Extended Use. JAMA Netw Open 2024; 7:e2353631. [PMID: 38277142 DOI: 10.1001/jamanetworkopen.2023.53631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Abstract
Importance The COVID-19 pandemic resulted in a widespread acute shortage of N95 respirators, prompting the Centers for Disease Control and Prevention to develop guidelines for extended use and limited reuse of N95s for health care workers (HCWs). While HCWs followed these guidelines to conserve N95s, evidence from clinical settings regarding the safety of reuse and extended use is limited. Objective To measure the incidence of fit test failure during N95 reuse and compare the incidence between N95 types. Design, Setting, and Participants This prospective cohort study, conducted from April 2, 2021, to July 15, 2022, at 6 US emergency departments (EDs), included HCWs who practiced N95 reuse for more than half of their clinical shift. Those who were unwilling to wear an N95 for most of their shift, repeatedly failed baseline fit testing, were pregnant, or had facial hair or jewelry that interfered with the N95 face seal were excluded. Exposures Wearing the same N95 for more than half of each clinical shift and for up to 5 consecutive shifts. Participants chose an N95 model available at their institution; models were categorized into 3 types: dome (3M 1860R, 1860S, and 8210), trifold (3M 1870+ and 9205+), and duckbill (Halyard 46727, 46767, and 46827). Participants underwent 2 rounds of testing using a different mask of the same type for each round. Main Outcomes and Measures The primary outcome was Occupational Safety and Health Administration-approved qualitative fit test failure. Trained coordinators conducted fit tests after clinical shifts and recorded pass or fail based on participants tasting a bitter solution. Results A total of 412 HCWs and 824 N95s were fit tested at baseline; 21 N95s (2.5%) were withdrawn. Participants' median age was 34.5 years (IQR, 29.5-41.8 years); 252 (61.2%) were female, and 205 (49.8%) were physicians. The overall cumulative incidence of fit failure after 1 shift was 38.7% (95% CI, 35.4%-42.1%), which differed by N95 type: dome, 25.8% (95% CI, 21.2%-30.6%); duckbill, 28.3% (95% CI, 22.2%-34.7%); and trifold, 61.3% (95% CI, 55.3%-67.3%). The risk of fit failure was significantly higher for trifold than dome N95s (adjusted hazard ratio, 1.75; 95% CI, 1.46-2.10). Conclusions and Relevance In this cohort study of ED HCWs practicing N95 reuse, fit failure occurred in 38.7% of masks after 1 shift. Trifold N95s had higher incidence of fit failure compared with dome N95s. These results may inform pandemic preparedness, specifically policies related to N95 selection and reuse practices.
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Affiliation(s)
- Ralph C Wang
- Department of Emergency Medicine, University of California, San Francisco
| | - Nida F Degesys
- Department of Emergency Medicine, University of California, San Francisco
| | - Jahan Fahimi
- Department of Emergency Medicine, University of California, San Francisco
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco
| | - Chengshi Jin
- Department of Epidemiology & Biostatistics, University of California, San Francisco
| | - Efrat Rosenthal
- Department of Emergency Medicine, University of California, San Francisco
| | - Ann A Lazar
- Department of Epidemiology & Biostatistics, University of California, San Francisco
| | - Anna Q Yaffee
- Department of Emergency Medicine, Emory University, Atlanta, Georgia
| | - Susan Peterson
- Department of Emergency Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Richard E Rothmann
- Department of Emergency Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Courtney M C Jones
- Department of Emergency Medicine, University of Rochester Medical Center, Rochester, New York
| | - Vaishal Tolia
- Department of Emergency Medicine, University of California, San Diego
| | - Manish N Shah
- BerbeeWalsh Department of Emergency Medicine, University of Wisconsin, Madison
| | - Maria C Raven
- Department of Emergency Medicine, University of California, San Francisco
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco
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16
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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] [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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17
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Taher WT, Bawazir AA, Sallam TA, Alsurimi K. Seroprevalence and factors associated with SARS-CoV-2 infection among healthcare workers: cross-sectional study. BMC Infect Dis 2023; 23:761. [PMID: 37932664 PMCID: PMC10626741 DOI: 10.1186/s12879-023-08760-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 10/27/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Healthcare workers (HCWs) are at a higher risk of contracting COVID-19 due to their close contact with infected patients. However, the true burden of COVID-19 among HCWs in Yemen is unknown due to the inadequate availability of healthcare and the subclinical nature of the disease. This study aims to estimate the seroprevalence of SARS-CoV-2 infection among HCWs in two Yemeni governorates and identify associated factors using a cross-sectional design. METHOD A total of 404 HCWs were surveyed from June 2022 to September 2022 in Lahj and AL-Dhalea hospitals. A self-administered questionnaire collected demographic data, COVID-19 infection history, and vaccination status. A total of 404 human sera were tested using a specific electrochemiluminescence immunoassay assay. Association analysis was conducted to identify associations between antibody prevalence and demographic and vaccine-related variables. RESULT The median age of the HCWs was 31 (Range 20-64) years, with 65.0% being male and 35.0% female. Of all HCWs, 94% were SARS-CoV-2 seropositive and 77.0% had no confirmed test of COVID-19-related symptoms. There was no significant association between seropositivity and demographic factors such as age, gender, occupation, or COVID-19 vaccination (P > 0.05). CONCLUSION The seroprevalence of SARS-CoV-2 was high among HCWs in Yemen, primarily due to natural infection rather than vaccination. Compliance with infection prevention and control measures did not significantly affect seropositivity. This study highlights the need for improved healthcare systems and resources to reduce the burden of COVID-19 and promote infection prevention and control (IPC) measures among HCWs in Yemen.
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Affiliation(s)
- Watheq Thabet Taher
- Faculty of Medicine and Health Sciences, The University of Aden, Aden, Republic of Yemen
| | - Amen A Bawazir
- Faculty of Medicine and Health Sciences, The University of Aden, Aden, Republic of Yemen.
- College of Medicine, AlMaarefa University, Diriyah, Saudi Arabia.
| | - Talal A Sallam
- Faculty of Medicine, Al-Baha University, Al Bahah, Kingdom of Saudi Arabia
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18
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Ige FA, Ohihoin GA, Osuolale K, Dada A, Onyia N, Johnson A, Okwuraiwe AP, Odediran O, Liboro G, Aniedobe M, Mogaji S, Nwaiwu SO, Akande IR, Audu RA, Salako BL. Seroprevalence of SARS-CoV-2 IgG among healthcare workers in Lagos, Nigeria. PLoS One 2023; 18:e0292440. [PMID: 37796780 PMCID: PMC10553227 DOI: 10.1371/journal.pone.0292440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 09/20/2023] [Indexed: 10/07/2023] Open
Abstract
Healthcare workers (HCWs) are disproportionately infected with SARS-CoV-2 when compared to members of the general public; estimating the seroprevalence of SARS-CoV-2 antibody and SARS-CoV-2 infection rate among HCWs is therefore crucial. This study was carried out in four health facilities in Lagos Nigeria to determine the prevalence of IgG antibodies (seroprevalence) and SARS-CoV-2 active infection rate via a positive rtPCR result, the cross-sectional study was conducted between December 2020 and July 2021. Nasopharyngeal and blood samples were collected from HCWs and screened for SARS-CoV-2 infection using the rtPCR technique and antibody using the Abbott anti-SARS-CoV-2 IgG CMIA assay, respectively. Demographic and occupational exposures data were obtained and analysed using descriptive and inferential statistics, variables significant via inferential statistics were subjected to a multivariate analysis. A total of 413 participants were enrolled, with a mean age in years of 38.4±11.0. The seroprevalence was 30.9% (115/372) while 63/395 (15.9%) were actively infected with the virus. HCWs whose job role had direct contact with patients had a higher percentage of SARS-CoV-2 infection when compared with those not in direct contact, also being a health care worker was significantly associated with getting a positive COVID-19 PCR result. In conclusion the SARS-CoV-2 seroprevalence seen in this study was higher than national serosurvey estimates indicating HCWs are at higher risk of COVID-19 infection when compared to the general public. Vaccination and effective implementation of infection control measures are important to protect HCWs.
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Affiliation(s)
- Fehintola Anthonia Ige
- Center for Human Virology and Genomics, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Gregory Aigbe Ohihoin
- Clinical Science Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Kazeem Osuolale
- Monitoring and Evaluation Unit, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | | | - Ngozi Onyia
- Paelon Memorial Medical Center, Victoria Island, Lagos, Nigeria
| | | | - Azuka Patrick Okwuraiwe
- Center for Human Virology and Genomics, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Omoladun Odediran
- Body Soul and Spirit Project, Department of Community Health and Primary Care College of Medicine, University of Lagos, Lagos, Nigeria
| | - Gideon Liboro
- Center for Human Virology and Genomics, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Maureen Aniedobe
- Clinical Diagnostic Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | | | - Stephanie Ogechi Nwaiwu
- Center for Human Virology and Genomics, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Ibukun Ruth Akande
- Center for Human Virology and Genomics, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Rosemary Ajuma Audu
- Center for Human Virology and Genomics, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Babatunde Lawal Salako
- Clinical Science Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
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19
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Tancredi S, Chiolero A, Wagner C, Haller ML, Chocano-Bedoya P, Ortega N, Rodondi N, Kaufmann L, Lorthe E, Baysson H, Stringhini S, Michel G, Lüdi C, Harju E, Frank I, Imboden M, Witzig M, Keidel D, Probst-Hensch N, Amati R, Albanese E, Corna L, Crivelli L, Vincentini J, Gonseth Nusslé S, Bochud M, D'Acremont V, Kohler P, Kahlert CR, Cusini A, Frei A, Puhan MA, Geigges M, Kaufmann M, Fehr J, Cullati S. Seroprevalence trends of anti-SARS-CoV-2 antibodies and associated risk factors: a population-based study. Infection 2023; 51:1453-1465. [PMID: 36870034 PMCID: PMC9985433 DOI: 10.1007/s15010-023-02011-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 02/22/2023] [Indexed: 03/05/2023]
Abstract
PURPOSE We aimed to assess the seroprevalence trends of SARS-CoV-2 antibodies in several Swiss cantons between May 2020 and September 2021 and investigate risk factors for seropositivity and their changes over time. METHODS We conducted repeated population-based serological studies in different Swiss regions using a common methodology. We defined three study periods: May-October 2020 (period 1, prior to vaccination), November 2020-mid-May 2021 (period 2, first months of the vaccination campaign), and mid-May-September 2021 (period 3, a large share of the population vaccinated). We measured anti-spike IgG. Participants provided information on sociodemographic and socioeconomic characteristics, health status, and adherence to preventive measures. We estimated seroprevalence with a Bayesian logistic regression model and the association between risk factors and seropositivity with Poisson models. RESULTS We included 13,291 participants aged 20 and older from 11 Swiss cantons. Seroprevalence was 3.7% (95% CI 2.1-4.9) in period 1, 16.2% (95% CI 14.4-17.5) in period 2, and 72.0% (95% CI 70.3-73.8) in period 3, with regional variations. In period 1, younger age (20-64) was the only factor associated with higher seropositivity. In period 3, being aged ≥ 65 years, with a high income, retired, overweight or obese or with other comorbidities, was associated with higher seropositivity. These associations disappeared after adjusting for vaccination status. Seropositivity was lower in participants with lower adherence to preventive measures, due to a lower vaccination uptake. CONCLUSIONS Seroprevalence sharply increased over time, also thanks to vaccination, with some regional variations. After the vaccination campaign, no differences between subgroups were observed.
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Affiliation(s)
- Stefano Tancredi
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Route Des Arsenaux 41, 1700, Fribourg, Switzerland.
| | - Arnaud Chiolero
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Route Des Arsenaux 41, 1700, Fribourg, Switzerland
- School of Population and Global Health, McGill University, Montreal, Canada
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Cornelia Wagner
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Route Des Arsenaux 41, 1700, Fribourg, Switzerland
| | - Moa Lina Haller
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Patricia Chocano-Bedoya
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Route Des Arsenaux 41, 1700, Fribourg, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Natalia Ortega
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Route Des Arsenaux 41, 1700, Fribourg, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Nicolas Rodondi
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Laurent Kaufmann
- Cantonal Public Health Service of the Canton of Neuchâtel, Neuchâtel, Switzerland
| | - Elsa Lorthe
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Hélène Baysson
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Silvia Stringhini
- Unit of Population Epidemiology, Division of Primary Care Medicine, Geneva University Hospitals, Geneva, Switzerland
- Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- University Center for General Medicine and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Gisela Michel
- Department Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Chantal Lüdi
- Department Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Erika Harju
- Department Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Clinical Trial Unit, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Irene Frank
- Clinical Trial Unit, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Medea Imboden
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Melissa Witzig
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Dirk Keidel
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Rebecca Amati
- Institute of Public Health, Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland
| | - Emiliano Albanese
- Institute of Public Health, Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland
| | - Laurie Corna
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Luca Crivelli
- Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Julia Vincentini
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Semira Gonseth Nusslé
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Murielle Bochud
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Valérie D'Acremont
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Philipp Kohler
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St Gallen, St Gallen, Switzerland
| | - Christian R Kahlert
- Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St Gallen, St Gallen, Switzerland
- Department of Infectious Diseases and Hospital Epidemiology, Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland
| | - Alexia Cusini
- Division of Infectious Diseases, Cantonal Hospital of Grisons, Chur, Switzerland
| | - Anja Frei
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Milo A Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Marco Geigges
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Marco Kaufmann
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Jan Fehr
- Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland
| | - Stéphane Cullati
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Route Des Arsenaux 41, 1700, Fribourg, Switzerland
- Department of Readaptation and Geriatrics, University of Geneva, Geneva, Switzerland
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Zhu F, Su H, Kong Y, Xu B, Lv Q, Lin J, Yi L, Xie J. Evaluation of dressings preventing facial medical device-related pressure injury in medical staff during the COVID-19 pandemic: A systematic review and network meta-analysis. J Clin Nurs 2023; 32:5988-5999. [PMID: 37082837 DOI: 10.1111/jocn.16721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/06/2023] [Accepted: 04/05/2023] [Indexed: 04/22/2023]
Abstract
AIM This study systematically compared the efficacy of various dressings that may prevent facial medical device-related pressure injury (MRDPI) in medical staff during the COVID-19 pandemic. BACKGROUND During the COVID-19 pandemic, medical staff who are required to wear masks, goggles and other personal protective equipment (PPE) are susceptible to facial MRDPI, which exacerbates working conditions. Dressings can effectively prevent or alleviate MRDPI, but it is unclear which dressings are most effective. DESIGN A systematic review and network meta-analysis, in accordance with PRISMA. METHODS A comprehensive literature search was conducted in four English and four Chinese databases to identify relevant studies published up to 8 September 2022. The selected studies were randomised controlled trials, with populations comprising medical staff who wore PPE during the COVID-19 pandemic and included an observation and control group. RESULTS The network meta-analysis of the 12 selected articles showed that foam dressing, hydrocolloid dressing and petrolatum gauze were better than conventional protection for preventing MRDPI. The surface under the cumulative ranking curve indicated that foam dressing was the best preventative. CONCLUSION Foam dressing is more effective than other dressings in preventing facial MRDPI in medical staff. When PPE must be worn for many hours, such as during the COVID-19 pandemic, medical staff can use foam dressings to prevent MRDPI. RELEVANCE TO CLINICAL PRACTICE The results support the use of dressings, especially foam dressings, to prevent MRDPI in healthcare workers. The appropriate dressings are recommended to prevent MRDPI associated with wearing PPE.
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Affiliation(s)
- Fangfang Zhu
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Honghong Su
- Nursing College, Fuzhou Institute of Technology, Fuzhou, China
| | - Yue Kong
- Teaching and Research Department, Fuzong Clinical Medical College of Fujian Medical University (The 900th Hospital of Joint Logistic Support Force, PLA), Fuzhou, China
| | - Baoling Xu
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Qian Lv
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jiamin Lin
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Luanxing Yi
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jieling Xie
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
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21
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Kääriäinen S, Harjunmaa U, Hannila-Handelberg T, Ollgren J, Lyytikäinen O. Risk of COVID-19 in different groups of healthcare professionals between February 2020 and June 2021 in Finland: a register-based cohort study. Infect Prev Pract 2023; 5:100297. [PMID: 37560347 PMCID: PMC10406617 DOI: 10.1016/j.infpip.2023.100297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 07/03/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND During the Coronavirus Disease 2019 (COVID-19) pandemic, healthcare workers (HCWs) have been a risk group for COVID-19. AIM To assess the cumulative incidence in different groups of HCWs and the risk factors and outcomes of COVID-19 in HCWs between February 2020 and June 2021 in Finland. METHODS We linked two national registers, National Infectious Diseases Register (NIDR) and Register of Social Welfare and Healthcare Professionals (Terhikki), using national identity codes. COVID-19 cases were identified from NIDR notifications made by laboratories and physicians, and their healthcare professions from Terhikki. We categorized healthcare professions into seven groups and calculated cumulative incidences using Kaplan-Meier estimate during three periods (1/2/2020-30/6/2020, 1/7/2020-31/12/2020, 1/1/2021-30/6/2021). We identified risk factors in a multivariable model using Cox's regression. FINDINGS We identified 8,009 COVID-19-cases among HCWs, with cumulative incidence of 1.79%; 83% were female, median age was 40.9 years (interquartile range, 31.2-51.6). Most COVID-19-cases occurred in nursing assistants (53%) and nurses (17%), with the highest cumulative incidences 2.07% (95%CI, 2.01-2.13%) and 1.82% (95%CI, 1.73-1.91%), respectively. Risk factors were male sex (hazard ratio (HR) 1.2; 95%CI, 1.1-1.3), foreign native language (HR 2.5; 95%CI, 2.2-2.9) and foreign country of birth (HR 1.2; 95%CI, 1.1-1.4). Physician notification data was available for 6,113/8,009 cases (76.3%); 244/6,113 (4.0%) were hospitalized and 37/6,113 (0.6%) in intensive care. CONCLUSION Nurses and nursing assistant, especially men and professionals with foreign background, were at higher risk of COVID-19. This should be specifically addressed during training and implementing infection control measures to protect themselves and patients.
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Affiliation(s)
- Sohvi Kääriäinen
- Finnish Institute for Health and Welfare, Helsinki, Finland
- ECDC Fellowship Programme, Field Epidemiology Path (EPIET), European Centre for Disease Prevention and Control (ECDC), Solna, Sweden
| | - Ulla Harjunmaa
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Jukka Ollgren
- Finnish Institute for Health and Welfare, Helsinki, Finland
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Milambo JPM, Ndirangu J, Mangala S, Simba H, Kabego L. Incidence of Coronavirus Disease 2019 (COVID-19) among healthcare workers during the first and second wave in the Democratic Republic of the Congo: a descriptive study. BMC Infect Dis 2023; 23:519. [PMID: 37553564 PMCID: PMC10408040 DOI: 10.1186/s12879-023-08494-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 07/29/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Healthcare workers (HCWs) are at the frontline of response to the COVID-19 pandemic. Protecting HCWs is of paramount importance to the World Health Organization (WHO). Outbreak investigation which is based on a critical assessment of core components of infection prevention and control (IPC) programs allows for the identification of different sources of exposure to the COVID-19 virus and for informing additional IPC recommendations. To date, the Democratic Republic of the Congo (DRC) is categorized as a high-risk country due to weaknesses in the health system, low capacity for diagnosis, socioeconomic characteristics of the population, and insufficient vaccination coverage. AIM To investigate the burden of COVID-19 among HCWs and identification of IPC gaps to reduce HCWs-associated infection at different levels (facilities, communities, and points of entry) following the WHO strategy for IPC program implementation during the first to the third wave of the pandemic. METHODS A retrospective cohort study was conducted using the DRC National Department of Health (NDOH) database and WHO questionnaire suspected and confirmed COVID-19 cases among HCWs from 10/03/2020 to 22/06/2021. The investigation was conducted by a trained IPC response team to identify the sources of the exposures. The questionnaire included demographics, profession, types of interaction between HCWs and patients, and community-based questions regarding family members and other behaviors. These variables were assessed using a multimodal strategy framework. Knowledge and adherence to IPC gaps using WHO guidelines were performed for each COVID-19-positive or suspected HCW. WHO rapid Scorecard dashboard was conducted for evaluating healthcare facilities (HCFs) performance during the COVID-19 pandemic. RESULTS Cumulative incidence of positive HCWs was 809 /35,898(2.2%) from the first to the third wave of COVID-19 among 6 provinces of DRC. The distribution of the HCWs infected by COVID-19 was predominated by nurses (42%), doctors (27%), biologists (8%), environmental health practitioners (5%), interns (3%), and other categories (15%). Other categories included nutritionists, physiotherapists, midwives, pharmacists, and paramedics. The investigation revealed that about 32% of HCWs were infected from household contacts, 11% were infected by HCFs, 35% were infected in the community and 22% were infected from unknown exposures. The mean score of IPC performance for all evaluated HCFs was 27/42(64%). This shows that IPC performance was moderate. Lower or minimal performance was noted in the implementation of the IPC program at the national and facility level, triage and screening, isolation handwashing and multimodal strategies of hand hygiene, PPE availability, and rationale, waste segregation, waste disposal, sterilization, and training of HCWs. CONCLUSION This study revealed that the prevalence of HCWs who tested positive for the COVID-19 virus was high among frontline healthcare workers from 6 provinces of DRC. A high prevalence of nosocomial infection was correlated with insufficient IPC adherence in the context of COVID-19. Strategies to strengthen IPC capacity building and provide HCWs with sufficient PPE stocks and budgets may improve IPC performance in the Democratic Republic of the Congo. This will further allow for adherence to WHO recommendations for successful program implementation to minimize COVID-19 transmission in HCFs, communities, and public gatherings. And this may be transferable to other infectious diseases.
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Affiliation(s)
- Jean Paul Muambangu Milambo
- Division of Public Health, University of Free State, Bloenfontein, South Africa.
- Department of Health and Prevention, Kinshasa, Democratic Republic of the Congo.
- Faculty of Medicine and Health Sciences, Department of Global Health, Stellenbosch University, Cape Town, South Africa.
- Health Emergencies Programme, WHO, African Region, Democratic Republic of the Congo.
| | - James Ndirangu
- Division of Public Health, University of Free State, Bloenfontein, South Africa
| | - Samuel Mangala
- Department of Health and Prevention, Kinshasa, Democratic Republic of the Congo
| | - Hannah Simba
- Faculty of Medicine and Health Sciences, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Landry Kabego
- Faculty of Medicine and Health Sciences, Department of Global Health, Stellenbosch University, Cape Town, South Africa
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Wahrendorf M, Schaps V, Reuter M, Hoebel J, Wachtler B, Jacob J, Alibone M, Dragano N. [Occupational differences of COVID-19 morbidity and mortality in Germany. An analysis of health insurance data from 3.17 million insured persons]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023; 66:857-868. [PMID: 37466654 PMCID: PMC10371894 DOI: 10.1007/s00103-023-03738-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 06/14/2023] [Indexed: 07/20/2023]
Abstract
INTRODUCTION During the COVID-19 pandemic, occupation was assumed to play a central role in the occurrence of infection and disease. For Germany, however, there are only a few studies that analyse occupational differences in risk of COVID-19, COVID-19-associated hospitalisation, and mortality. METHODS The study uses longitudinal health insurance data from the research database of the Institute for Applied Health Research (InGef) with information on 3.17 million insured persons aged 18-67 years (1,488,452 women; 1,684,705 men). Outcomes (morbidity, hospitalisation, and mortality) were determined on the basis of submitted COVID-19 diagnoses between 1 January 2020 and 31 December 2021. Occupations were classified according to four groupings of the official German classification of occupations. In addition to cumulative incidences, relative risks (RR) were calculated - separately for men and women. RESULTS There is an increased risk of disease in personal service occupations, especially in health care, compared to other occupations (RR for women 1.46; for men 1.30). The same applies to social and cultural service occupations (but only for women) and for manufacturing occupations (only for men). In addition, the risks for hospitalisation and mortality are increased for cleaning occupations and transport and logistics occupations (especially for men). For all three outcomes, the risks are higher in non-managerial occupations and differ by skill level (highest for unskilled jobs and lowest for expert positions). CONCLUSION The study provides important findings on work- and gender-related differences in COVID-19 morbidity and mortality in Germany, which indicate starting points for structural infection protection measures.
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Affiliation(s)
- Morten Wahrendorf
- Institut für Medizinische Soziologie, Centre for Health and Society, Medizinische Fakultät und Universitätsklinikum, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland.
| | - Valerie Schaps
- Institut für Medizinische Soziologie, Centre for Health and Society, Medizinische Fakultät und Universitätsklinikum, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - Marvin Reuter
- Juniorprofessur für Soziologie, insb. Arbeit und Gesundheit, Fakultät für Wirtschafts- und Sozialwissenschaften, Otto-Friedrich-Universität Bamberg, Bamberg, Deutschland
| | - Jens Hoebel
- Fachgebiet Soziale Determinanten der Gesundheit, Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin, Deutschland
| | - Benjamin Wachtler
- Fachgebiet Soziale Determinanten der Gesundheit, Abteilung für Epidemiologie und Gesundheitsmonitoring, Robert Koch-Institut, Berlin, Deutschland
| | - Josephine Jacob
- InGef - Institut für angewandte Gesundheitsforschung, Berlin GmbH, Berlin, Deutschland
| | - Marco Alibone
- InGef - Institut für angewandte Gesundheitsforschung, Berlin GmbH, Berlin, Deutschland
| | - Nico Dragano
- Institut für Medizinische Soziologie, Centre for Health and Society, Medizinische Fakultät und Universitätsklinikum, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
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Doctor JN, Berg AH, Knight TK, Kadono M, Stewart E, Sonik R, Hochman M, Sood N. Cross-sectional study examining household factors associated with SARS-CoV-2 seropositivity in low-income children in Los Angeles. BMJ Open 2023; 13:e070291. [PMID: 37258079 PMCID: PMC10254815 DOI: 10.1136/bmjopen-2022-070291] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 05/12/2023] [Indexed: 06/02/2023] Open
Abstract
OBJECTIVES This study aims to quantify the degree to which an underserved, Hispanic population in Los Angeles is impacted by SARS-CoV-2, and determine factors associated with paediatric seropositivity. DESIGN Cross-sectional. SETTING AltaMed, a Federally Qualified Health Center in Los Angeles. PARTICIPANTS A random sample of households who had received healthcare at AltaMed Medical Group was invited to participate. Households with at least one adult and one paediatric participant between 5 and 17 years of age were eligible to participate. Consented participants completed a survey on social determinants of health and were tested for antibodies using Abbott Architect SARS-CoV-2-IgG and SARS-CoV-2-IgM tests. PRIMARY OUTCOME MEASURE Seropositive status. RESULTS We analysed 390 adults (mean age in years, 38.98 (SD 12.11)) and 332 paediatric participants (11.26 (SD 3.51)) from 196 households. Estimated seropositivity was 52.11% (95% CI 49.61% to 55.19%) in paediatric participants and 63.58% (95% CI 60.39% to 65.24%) in adults. Seropositivity was 11.47% (95% CI 6.82% to 14.09%) lower in paediatric participants, but high relative to other populations. A household member with type 2 diabetes (OR 2.94 (95% CI 1.68 to 5.14)), receipt of food stamps (OR 1.66 (95% CI 1.08 to 2.56)) and lower head-of-household education (OR 1.73 (95% CI 1.06 to 2.84)) were associated with paediatric seropositivity. CONCLUSIONS SARS-CoV-2 seropositivity is high in Hispanic children and adolescents in Los Angeles. Food insecure households with low head-of-household education, and at least one household member with type 2 diabetes, had the highest risk. These factors may inform paediatrician COVID-19 mitigation recommendations. TRIAL REGISTRATION NUMBER NCT04901624.
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Affiliation(s)
- Jason N Doctor
- University of Southern California Sol Price School of Public Policy, Los Angeles, California, USA
| | - Anders H Berg
- Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Tara K Knight
- University of Southern California Sol Price School of Public Policy, Los Angeles, California, USA
| | - Mika Kadono
- Institute of Health Equity, AltaMed Health Services Corporation, Los Angeles, California, USA
| | - Emily Stewart
- University of Southern California Sol Price School of Public Policy, Los Angeles, California, USA
| | - Rajan Sonik
- Institute of Health Equity, AltaMed Health Services Corporation, Los Angeles, California, USA
| | - Michael Hochman
- Institute of Health Equity, USC Keck School of Medicine, Los Angeles, California, USA
| | - Neeraj Sood
- University of Southern California Sol Price School of Public Policy, Los Angeles, California, USA
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Wojczyk M, Niewiadomska E, Kowalska M. The Incidence Proportion of SARS-CoV-2 Infections and the Percentage of Deaths among Infected Healthcare Workers in Poland. J Clin Med 2023; 12:jcm12113714. [PMID: 37297910 DOI: 10.3390/jcm12113714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023] Open
Abstract
(1) Background: The incidence proportion of SARS-CoV-2 infection among healthcare workers (HCWs) in Poland is not exactly known. This study aims to present secondary epidemiological data identifying the scale of the spread of novel coronavirus infection and the estimation of vaccination coverage in selected professional groups of HCWs in Poland. (2) Methods: The secondary epidemiological data included both the number of infections and infection fatality rate (IFR) in individual occupational groups, which occurred throughout the observation period (January 2021-July 2022), both in the country and in individual voivodeship (administrative area). (3) Results: The incidence proportion of SARS-CoV-2 infections among HCWs was 16.48%. The highest percentage of infected workers concerned laboratory scientists (21.62%) and paramedics (18%). The highest frequency of infections among HCWs occurred in the province of Zachodnio-Pomorskie (18.9%). Due to COVID-19, 558 healthcare workers died during the analysed period, mostly nurses (n = 236) and doctors (n = 200). The results regarding the vaccination coverage of HCWs against COVID-19 indicate the highest percentage of vaccinated were among doctors (83.63%) and the lowest among physiotherapists (38.2%). (4) Conclusions: In general, the percentage of infections was high in Poland during the pandemic (16.48%). Significant territorial differences were observed in the frequency of infections, deaths, and percentage of vaccinated workers in individual voivodeships.
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Affiliation(s)
- Marek Wojczyk
- Doctoral School, Medical University of Silesia, 40-055 Katowice, Poland
| | - Ewa Niewiadomska
- Department of Epidemiology and Biostatistics, Faculty of Health Science, Medical University of Silesia, 41-902 Bytom, Poland
| | - Małgorzata Kowalska
- Department of Epidemiology, Faculty of Medical Science, Medical University of Silesia, 40-055 Katowice, Poland
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Tavakoli A, Lotfi F, Lotfi M, Bayati M, Seif M, Salesi M, Emadi M, Keshavarz K, Delavari S. COVID-19 Reinfection Rate and Related Risk Factors in Fars Province, Iran: A Retrospective Cohort Study. IRANIAN JOURNAL OF MEDICAL SCIENCES 2023; 48:302-312. [PMID: 37791328 PMCID: PMC10542930 DOI: 10.30476/ijms.2022.94615.2598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 05/02/2022] [Accepted: 05/18/2022] [Indexed: 10/05/2023]
Abstract
Background Reinfection with Coronavirus Diseases 2019 (COVID-19) has raised remarkable public health concerns globally. Therefore, the present retrospective cohort study intended to investigate COVID-19 reinfection in registered patients of Fars province in Iran from February 2020 to April 2021. Methods The patients' data, including the COVID-19 infection, symptoms, comorbidities, and demographics, were collected using the Health Information Systems (HISs). The patients were divided into three groups in terms of the duration between the initial infection and reinfection, including 28-44, 45-89, and more than 90 days. Following the univariate analysis, logistic regression was used to investigate the factors effective on COVID-19 reinfection. Results A total of 213768 patients had a positive Polymerase Chain Reaction (PCR) test. The reinfection rate was 0.97% (2079 patients). Of these re-infected individuals, 14.9%, 18.5%, and 66.6% had their second positive test 28-45, 45-89, and ≥90 days later, respectively. The mean duration between the initial infection and reinfection was 130.56 days (29-370 days). The chance of reinfection was significantly higher in the youths (Odds Ratio (OR)=2.055; P<0.001), men (OR=1.283; P<0.001), urban population (OR=1.313; P<0.001), and healthcare providers (OR=4.453; P<0.001). The patients with chronic pulmonary diseases, chronic kidney diseases, and malignancy were 1.421 (P=0.036), 2.239 (P<0.001), and 3.437 (P<0.001) times, respectively, more likely prone to reinfection. Conclusion The results of this study showed that there is a higher risk of reinfection in several vulnerable groups including healthcare providers, young individuals, residents of urban areas, men, and individuals with underlying diseases.
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Affiliation(s)
- Ali Tavakoli
- Research Center for Traditional Medicine and History of Medicine, Department of Persian Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farhad Lotfi
- Health Human Resources Research Center, Department of Health Economics, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Emergency Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehrzad Lotfi
- Medical Imaging Research Center, Department of Radiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohsen Bayati
- Health Human Resources Research Center, Department of Health Economics, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mozhgan Seif
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahmood Salesi
- Chemical Injuries Research Ccenter, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mehrnoosh Emadi
- Student Research Committee, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Khosro Keshavarz
- Health Human Resources Research Center, Department of Health Economics, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
- Emergency Medicine Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sajad Delavari
- Health Human Resources Research Center, Department of Health Economics, School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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Moreno-Medina K, Sáenz Pérez LD, Villar JC, Váquiro Herrera E, Pérez Franco JE, Varón-Vega FA, Guanes Cortés R, Steevens Gualdrón A, Sarmiento Becerra MS. SARS-CoV-2 seroprevalence in workers from a Colombian University Hospital. Occup Med (Lond) 2023; 73:128-132. [PMID: 36719103 PMCID: PMC10132206 DOI: 10.1093/occmed/kqad003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Antibody (Ab) tests for SARS-CoV-2 virus allows for the estimation of incidence, level of exposure and duration of immunity acquired by a previous infection. In health workers, the hospital setting might convey a greater risk of infection. AIMS To describe the frequency of immunoglobulin G (IgG) Abs (IgG-Abs) to the SARS-CoV-2 virus among workers at a third-level university hospital in Colombia. METHODS In this cross-sectional study, we included medical and non-medical personnel with at least one real-time polymerase chain reaction (RT-PCR)/antigen test between March 2020 and March 2021. In April 2021, an IgG-Ab test against SARS-CoV-2 was conducted for all participants and replicated 2 weeks later in a random sample (10%). The frequency of IgG-Abs is presented based on status (positive/negative) and time elapsed since RT-PCR/antigen test (<3 months, 3-6 months, >6 months). RESULTS We included 1021 workers (80% women, median age 34 years (interquartile range 28-42), 73% medical personnel, 23% with previous positive RT-PCR/antigen). The overall seroprevalence was 35% (95% CI 31.6-37.4, 35% in medical and 33% in non-medical personnel). For those with a previous positive RT-PCR/antigen test, the seroprevalence was 90% (<3 months), 82% (3-6 months) and 48% (>6 months). In participants with a previous negative RT-PCR/antigen test, the seroprevalence was 17% (<3 months), 21% (3-6 months) and 29% (>6 months). CONCLUSIONS High IgG-Ab positivity was found in hospital personnel, regardless of work activities. The prevalence of detectable Abs differed by previous RT-PCR/antigen status and time elapsed since the diagnostic test.
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Affiliation(s)
- K Moreno-Medina
- Research Centre, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá 110131, Colombia
| | - L D Sáenz Pérez
- Research Centre, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá 110131, Colombia
| | - J C Villar
- Research Centre, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá 110131, Colombia
| | - E Váquiro Herrera
- Research Centre, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá 110131, Colombia
| | - J E Pérez Franco
- Infectology, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá 110131, Colombia
| | - F A Varón-Vega
- Intensive Care Unit, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá 110131, Colombia
| | - R Guanes Cortés
- Clinical Laboratory, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá 110131, Colombia
| | - A Steevens Gualdrón
- Clinical Laboratory, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá 110131, Colombia
| | - M S Sarmiento Becerra
- Occupational Health and Safety, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá 110131, Colombia
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Helou M, Zoghbi S, El Osta N, Mina J, Mokhbat J, Husni R. COVID-19 infection and seroconversion rates in healthcare workers in Lebanon: An observational study. Medicine (Baltimore) 2023; 102:e32992. [PMID: 37115042 PMCID: PMC10143398 DOI: 10.1097/md.0000000000032992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 04/29/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) infection is a recent pandemic. Healthcare workers (HCW) are at high risk of acquiring the infection and transmitting it to others. Seroprevalence for COVID-19 among HCW varies between countries, hospitals in the same country and even among different departments in the same hospital. In this study, we aim to determine the prevalence of severe acute respiratory syndrome coronavirus 2 antibodies and the seroconversion among the HCW in our hospital. A total of 203 HCW were included. The rate of conversion to seropositive was 19.7% in total, with a rate of 13.4% in female versus 25% in male. The seropositivity in the House keeping group was 83%, followed by 45% in the COVID Floor while the seropositivity in the Anesthesia was 4% and the Infection Control 0%. The highest seropositivity rate in the COVID floor, and in the intensive care unit was explained by the long time spent with the patients. While in the inhalation team and the anesthesia, the lower rates of seropositivity was due to the N95 mask wearing the whole time. Seropositivity for COVID-19 in HCW is a major public health concern. Policies should be implemented to better protect HCWs.
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Affiliation(s)
- Mariana Helou
- Division of Emergency, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Sanaa Zoghbi
- Division of Infection Control, Lebanese American University Medical Center, Beirut, Lebanon
| | - Nour El Osta
- Division of Emergency, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Jonathan Mina
- Division of Infectious Diseases, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Jacques Mokhbat
- Division of Infectious Diseases, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Rola Husni
- Division of Infectious Diseases, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
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Schablon A, Harth V, Terschüren C, Kleinmüller O, Wohlert C, Schnabel C, Brehm TT, Schulze zur Wiesch J, Kersten JF, Nienhaus A. Longitudinal SARS-CoV-2 Seroprevalence among Employees in Outpatient Care Services in Hamburg. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085599. [PMID: 37107881 PMCID: PMC10138530 DOI: 10.3390/ijerph20085599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 05/10/2023]
Abstract
The risk of SARS-CoV-2 infection is particularly high for healthcare workers during the pandemic. Home care workers visit many different households per shift. Encounters with mostly elderly patients and their relatives increase the potential for the undetected spread of SARS-CoV-2. In order to gain insight into the seroprevalence of SARS-CoV-2 antibodies and possible transmission risks in outpatient care, this follow-up study was conducted with nursing services in Hamburg. The aim was to estimate the dynamics of seroprevalence in this occupational group over a 12-month period, to identify occupation-specific risk factors, and to collect information on the vaccination status of the surveyed nursing staff. Antibody testing for SARS-CoV-2 IgG against the S1 domain (EUROIMUN Analyser I® Lübeck, Germany) was performed on participating healthcare workers with patient contact at a total of four time points within one year from July 2020 to October 2021 (baseline, follow-up after three, six and twelve months). The data were mostly analysed descriptively. Differences in IgG titres were analysed using variance analysis methods, particularly Tukey's range test. The seroprevalence was 1.2% (8/678) at baseline and 1.5% (9/581) at the three-month follow-up (T1). At the second follow-up (T2) after six months, vaccination against SARS-CoV-2 was available from January 2021 onwards. The prevalence rate of positive IgG antibodies relative to the S1 domain of the spike protein test among unvaccinated individuals was 6.5%. At (T3) after twelve months (July to October 2021), 482 participants were enrolled, and 85.7% of the workers were considered fully vaccinated at this time point, while 51 individuals were unvaccinated. The prevalence was 13.7% (7/51). In our study, a low seroprevalence was found among home care workers, which was lower than in our studies conducted in the clinical setting. Therefore, it can be assumed that the occupational risk of infection is rather low for both the nursing staff and the patients/clients cared for in the outpatient setting. The good provision of protective equipment and the high vaccination rate of the staff probably had a positive influence.
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Affiliation(s)
- Anja Schablon
- Competence Centre for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany
- Correspondence:
| | - Volker Harth
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Centre Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany
| | - Claudia Terschüren
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Centre Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany
| | - Olaf Kleinmüller
- Competence Centre for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany
| | - Claudia Wohlert
- Competence Centre for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany
| | - Claudia Schnabel
- Laboratory of Fenner and Colleagues, Bergstrasse 14, 20095 Hamburg, Germany
- Asklepios Campus Hamburg, Semmelweis University, Lohmühlenstrasse 5, 20099 Hamburg, Germany
| | - Thomas Theo Brehm
- Division of Infectious Diseases, Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
- German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, 20246 Hamburg, Germany
| | - Julian Schulze zur Wiesch
- Division of Infectious Diseases, Department of Internal Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
- German Center for Infection Research (DZIF), Partner Site Hamburg-Lübeck-Borstel-Riems, 20246 Hamburg, Germany
| | - Jan Felix Kersten
- Competence Centre for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany
| | - Albert Nienhaus
- Competence Centre for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany
- Department of Occupational Medicine, Hazardous Substances and Public Health (AGG), Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), 22089 Hamburg, Germany
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Jorgensen P, Schmid A, Sulo J, Preza I, Hasibra I, Kissling E, Fico A, Sridhar S, Rubin-Smith JE, Kota M, Vasili A, Daja R, Nika M, Pebody R, Lafond KE, Katz MA, Bino S. Factors associated with receipt of COVID-19 vaccination and SARS-CoV-2 seropositivity among healthcare workers in Albania (February 2021-June 2022): secondary analysis of a prospective cohort study. THE LANCET REGIONAL HEALTH. EUROPE 2023; 27:100584. [PMID: 37013112 PMCID: PMC9969343 DOI: 10.1016/j.lanepe.2023.100584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 12/23/2022] [Accepted: 01/03/2023] [Indexed: 03/02/2023]
Abstract
Background Healthcare workers (HCWs) have been disproportionally affected by COVID-19. We investigated factors associated with two- and three-dose COVID-19 vaccine uptake and SARS-CoV-2 seropositivity among 1504 HCWs enrolled (19 February-7 May 2021) in a prospective COVID-19 vaccine effectiveness cohort in Albania through a secondary analysis. Methods We collected sociodemographic, occupational, health, prior SARS-CoV-2 infection, and COVID-19 vaccination data from all HCWs at enrollment. Vaccination status was assessed weekly through June 2022. A serum sample was collected from all participants at enrollment and tested for anti-spike SARS-CoV-2 antibodies. We analyzed HCWs characteristics and outcomes using multivariable logistic regression. Findings By 11 June 2022, 1337 (88.9%) HCWs had received two COVID-19 vaccine doses, of whom 255 (19.1%) received a booster. Factors significantly associated with receiving three doses (adjusted odds ratio (aOR), 95% CIs) were being ≥35 years (35-44 years: 1.76 (1.05-2.97); 45-54 years: 3.11 (1.92-5.05); ≥55 years: 3.38 (2.04-5.59)) and vaccinated against influenza (1.78; 1.20-2.64). Booster dose receipt was lower among females (0.58; 0.41-0.81), previously infected (0.67; 0.48-0.93), nurses and midwives (0.31; 0.22-0.45), and support staff (0.19; 0.11-0.32). Overall 1076 (72%) were SARS-CoV-2 seropositive at enrollment. Nurses and midwifes (1.45; 1.05-2.02), support staff (1.57; 1.03-2.41), and HCWs performing aerosol-generating procedures (AGPs) (1.40; 1.01-1.94) had higher odds of being seropositive, while smokers had reduced odds (0.55; 0.40-0.75). Interpretation In a large cohort of Albanian HCWs, COVID-19 vaccine booster dose uptake was very low, particularly among younger, female, and non-physician HCWs, despite evidence demonstrating the added benefit of boosters in preventing infection and severe disease. Reasons behind these disparities should be explored to develop targeted strategies in order to promote uptake in this critical population. SARS-CoV-2 seroprevalence was higher among non-physicians and HCWs performing APGs. A better understanding of the factors contributing to these differences is needed to inform interventions that could reduce infections in the future. Funding This study was funded by the Task Force for Global Health (US Centers for Disease Control (CDC) cooperative agreement # NU51IP000873) and the World Health Organization, Regional Office for Europe.
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Affiliation(s)
- Pernille Jorgensen
- World Health Organization, Regional Office for Europe, Marmorvej 51, 2100, Copenhagen, Denmark
| | - Alexis Schmid
- Boston Children's Hospital Global Health Program, Boston, MA, USA
| | - Jonilda Sulo
- Southeast European Center for Surveillance and Control of Infectious Diseases, Alexander Moisiut Street N.80, 1001, Tirana, Albania
| | - Iria Preza
- Institute of Public Health, Alexander Moisiut Street N.80, 1001, Tirana, Albania
| | - Iris Hasibra
- Institute of Public Health, Alexander Moisiut Street N.80, 1001, Tirana, Albania
| | | | - Albana Fico
- Institute of Public Health, Alexander Moisiut Street N.80, 1001, Tirana, Albania
| | - Shela Sridhar
- Boston Children's Hospital Global Health Program, Boston, MA, USA
- Brigham and Women's Hospital, Department of Global Health Equity, 651 Huntington Avenue FXB, Building, 7th Floor, Boston, MA, USA
| | | | - Majlinda Kota
- Institute of Public Health, Alexander Moisiut Street N.80, 1001, Tirana, Albania
| | - Adela Vasili
- Institute of Public Health, Alexander Moisiut Street N.80, 1001, Tirana, Albania
| | - Rovena Daja
- Institute of Public Health, Alexander Moisiut Street N.80, 1001, Tirana, Albania
| | - Miljana Nika
- Tirana University Hospital “Mother Theresa”, Dibra Street N.372, 1001, Tirana, Albania
| | - Richard Pebody
- World Health Organization, Regional Office for Europe, Marmorvej 51, 2100, Copenhagen, Denmark
| | - Kathryn E. Lafond
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Mark A. Katz
- World Health Organization, Regional Office for Europe, Marmorvej 51, 2100, Copenhagen, Denmark
| | - Silvia Bino
- Institute of Public Health, Alexander Moisiut Street N.80, 1001, Tirana, Albania
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Yap JF, Ng RJ, Chin SM, Mohammed Abu Bakar R, Nik Jaafar NZ, Mohamad Razali SZ, Ahmad SN, Ng CW, Ahmad Zaki R, Syed Omar SF, Kamarulzaman A, Hasnan N, Ponnampalavanar SSLS, Cheng Lim Y, Hoe VCW. Factors Associated With Nosocomial COVID-19 Infection Among Health Care Workers in an Urban-Setting Malaysia Hospital. Asia Pac J Public Health 2023; 35:162-167. [PMID: 36872616 PMCID: PMC9988598 DOI: 10.1177/10105395231159262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
This single-center study aimed to explore the factors associated with coronavirus disease (COVID-19) transmission in a hospital. All laboratory-confirmed COVID-19 cases among health care workers (HCWs) in a tertiary hospital in Malaysia were analyzed cross-sectionally from January 25, 2020, to September 10, 2021. A total of 897 HCWs in the hospital had laboratory-confirmed COVID-19 infection during the study period. Around 37.4% of HCWs were suspected to acquire COVID-19 infection from the hospital workplace. Factors associated with lower odds of workplace COVID-19 transmission were being females, ≥30 years old, fully vaccinated, and working as clinical support staff. Involvement in COVID-19 patient care was significantly associated with higher odds (adjusted odds ratio = 3.53, 95% confidence interval: [2.42, 5.12]) of workplace COVID-19 transmission as compared with non-workplace transmission. Most HCWs in the tertiary hospital acquired COVID-19 infection from non-workplace settings. During a pandemic, it is important to communicate with HCWs about the risk of both workplace and non-workplace COVID-19 transmission and to implement measures to reduce both workplace and non-workplace COVID-19 transmission.
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Affiliation(s)
- Jun Fai Yap
- Department of Public Health, University Malaya Medical Centre, Kuala Lumpur, Malaysia.,Department of Social and Preventive Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Rui Jie Ng
- Department of Public Health, University Malaya Medical Centre, Kuala Lumpur, Malaysia.,Department of Social and Preventive Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Si Ming Chin
- Department of Public Health, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | | | | | | | - Siti Nadhila Ahmad
- Department of Public Health, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Chiu Wan Ng
- Department of Public Health, University Malaya Medical Centre, Kuala Lumpur, Malaysia.,Department of Social and Preventive Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Rafdzah Ahmad Zaki
- Department of Public Health, University Malaya Medical Centre, Kuala Lumpur, Malaysia.,Department of Social and Preventive Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Sharifah Faridah Syed Omar
- Department of Infection Control, University Malaya Medical Centre, Kuala Lumpur, Malaysia.,Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Adeeba Kamarulzaman
- Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Nazirah Hasnan
- Department of Rehabilitation Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Sasheela Sri La Sri Ponnampalavanar
- Department of Infection Control, University Malaya Medical Centre, Kuala Lumpur, Malaysia.,Department of Medicine, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Yin Cheng Lim
- Department of Public Health, University Malaya Medical Centre, Kuala Lumpur, Malaysia.,Department of Social and Preventive Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Victor Chee Wai Hoe
- Department of Public Health, University Malaya Medical Centre, Kuala Lumpur, Malaysia.,Department of Social and Preventive Medicine, University Malaya, Kuala Lumpur, Malaysia
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Li Y, Yamamoto S, Oshiro Y, Inamura N, Nemoto T, Horii K, Takeuchi JS, Mizoue T, Konishi M, Ozeki M, Sugiyama H, Sugiura W, Ohmagari N. Comparison of risk factors for SARS-CoV-2 infection among healthcare workers during Omicron and Delta dominance periods in Japan. J Hosp Infect 2023; 134:97-107. [PMID: 36805085 PMCID: PMC9933573 DOI: 10.1016/j.jhin.2023.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/18/2023] [Accepted: 01/23/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND The risk factors for coronavirus disease (COVID-19) among healthcare workers (HCWs) might have changed since the emergence of the highly immune evasive Omicron variant. AIM To compare the risk factors for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among HCWs during the Delta- and Omicron-predominant periods. METHODS Using data from repeated serosurveys among the staff of a medical research centre in Tokyo, two cohorts were established: Delta period cohort (N = 858) and Omicron period cohort (N = 652). The potential risk factors were assessed using a questionnaire. Acute/current or past SARS-CoV-2 infection was identified by polymerase chain reaction or anti-nucleocapsid antibody tests, respectively. Poisson regression was used to calculate the risk ratio (RR) of infection risk. FINDINGS The risk of SARS-CoV-2 infection during the early Omicron-predominant period was 3.4-fold higher than during the Delta-predominant period. Neither working in a COVID-19-related department nor having a higher degree of occupational exposure to SARS-CoV-2 was associated with an increased infection risk during both periods. During the Omicron-predominant period, infection risk was higher among those who spent ≥30 min in closed spaces, crowded spaces, and close-contact settings without wearing mask (≥3 times versus never: RR: 6.62; 95% confidence interval: 3.01-14.58), whereas no such association was found during the Delta period. CONCLUSION Occupational exposure to COVID-19-related work was not associated with the risk of SARS-CoV-2 infection in the Delta or Omicron period, whereas high-risk behaviours were associated with an increased infection risk during the Omicron period.
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Affiliation(s)
- Y Li
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - S Yamamoto
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Y Oshiro
- Department of Laboratory Testing, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - N Inamura
- Department of Laboratory Testing, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - T Nemoto
- Department of Laboratory Testing, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - K Horii
- Infection Control Office, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - J S Takeuchi
- Department Academic-Industrial Partnerships Promotion, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - T Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
| | - M Konishi
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - M Ozeki
- Department of Laboratory Testing, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - H Sugiyama
- Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - W Sugiura
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - N Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
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Non-patient-related SARS-CoV-2 exposure from colleagues and household members poses the highest infection risk for hospital employees in a German university hospital: follow-up of the prospective Co-HCW seroprevalence study. Infection 2023:10.1007/s15010-023-01995-z. [PMID: 36788173 PMCID: PMC9928590 DOI: 10.1007/s15010-023-01995-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 01/30/2023] [Indexed: 02/16/2023]
Abstract
PURPOSE The Co-HCW study is a prospective, longitudinal, single-center observational study that aims to assess the SARS-CoV-2 seroprevalence and infection status in staff members of Jena University Hospital (JUH) in Jena, Germany. METHODS This follow-up study covers the observation period from 19th May 2020 to 22nd June 2021. At each of the three voluntary study visits, participants filled out a questionnaire regarding their SARS-CoV-2 exposure and provided serum samples to detect specific SARS-CoV-2 antibodies. Participants who were tested positive for antibodies against nucleocapsid and/or spike protein without previous vaccination and/or reported a positive SARS-CoV-2 PCR test were regarded to have been infected with SARS-CoV-2. Multivariable logistic regression modeling was applied to identify potential risk factors for infected compared to non-infected participants. RESULTS Out of 660 participants that were included during the first study visit, 406 participants (61.5%) were eligible for the final analysis as their COVID-19 risk area (high-risk n = 76; intermediate-risk n = 198; low-risk n = 132) did not change during the study. Forty-four participants [10.8%, 95% confidence interval (95%CI) 8.0-14.3%] had evidence of a current or past SARS-CoV-2 infection detected by serology (n = 40) and/or PCR (n = 28). No association between SARS-CoV-2 infection and the COVID-19 risk group according to working place was detected. However, exposure to a SARS-CoV-2 positive household member [adjusted OR (AOR) 4.46, 95% CI 2.06-9.65] or colleague (AOR 2.30, 95%CI 1.10-4.79) was found to significantly increase the risk of a SARS-CoV-2 infection. CONCLUSION Our results demonstrate that non-patient-related SARS-CoV-2 exposure posed the highest infection risk for hospital staff members of JUH.
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Bastuji-Garin S, Brouard L, Bourgeon-Ghittori I, Zebachi S, Boutin E, Hemery F, Fourreau F, Oubaya N, De Roux Q, Mongardon N, Fourati S, Decousser JW. The Relative Contributions of Occupational and Community Risk Factors for COVID-19 among Hospital Workers: The HOP-COVID Cohort Study. J Clin Med 2023; 12:jcm12031208. [PMID: 36769854 PMCID: PMC9917902 DOI: 10.3390/jcm12031208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/27/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
The relative contributions of occupational and community sources of COVID-19 among health-care workers (HCWs) are still subject to debate. In a cohort study at a 2814-bed tertiary medical center (five hospitals) in the Paris area of France, we assessed the proportion of hospital-acquired cases among staff and identified risk factors. Between May 2020 and June 2021, HCWs were invited to complete a questionnaire on their COVID-19 risk factors. RT-PCR and serology test results were retrieved from the virology department. Mixed-effects logistic regression was used to account for clustering by hospital. The prevalence of COVID-19 was 15.6% (n = 213/1369 respondents) overall, 29.7% in the geriatric hospitals, and 56.8% of the infections were hospital-acquired. On multivariable analyses adjusted for COVID-19 incidence and contact in the community, a significantly higher risk was identified for staff providing patient care (especially nursing assistants), staff from radiology/functional assessment units and stretcher services, and staff working on wards with COVID-19 clusters among patients or HCWs. The likelihood of infection was greater in geriatric wards than in intensive care units. The presence of significant occupational risk factors after adjustment for community exposure is suggestive of a high in-hospital risk and emphasizes the need for stronger preventive measures-especially in geriatric settings. Clinicaltrials.gov NCT04386759.
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Affiliation(s)
- Sylvie Bastuji-Garin
- IMRB, INSERM, University Paris Est Creteil, 94010 Créteil, France
- Department of Public Health, Hôpitaux Universitaires Henri-Mondor AP-HP, 94010 Créteil, France
- Correspondence: (S.B.-G.); (J.-W.D.)
| | - Ludivine Brouard
- Clinical Research Unit (URC Mondor), Hôpitaux Universitaires Henri-Mondor AP-HP, 94010 Créteil, France
| | - Irma Bourgeon-Ghittori
- IMRB, INSERM, University Paris Est Creteil, 94010 Créteil, France
- CARMAS, University Paris Est Creteil, 94010 Créteil, France
- DMU SAPHIRE, Hôpitaux Universitaires Henri-Mondor AP-HP, 94010 Créteil, France
| | - Sonia Zebachi
- Clinical Research Unit (URC Mondor), Hôpitaux Universitaires Henri-Mondor AP-HP, 94010 Créteil, France
| | - Emmanuelle Boutin
- IMRB, INSERM, University Paris Est Creteil, 94010 Créteil, France
- Clinical Research Unit (URC Mondor), Hôpitaux Universitaires Henri-Mondor AP-HP, 94010 Créteil, France
| | - Francois Hemery
- Département d’Information Médicale, Hôpitaux Universitaires Henri-Mondor AP-HP, 94010 Créteil, France
| | - Frédéric Fourreau
- Equipe Opérationnelle d’Hygiène, Département Prévention, Diagnostic, Traitement des Infections, Hôpitaux Universitaires Henri-Mondor AP-HP, 94010 Créteil, France
| | - Nadia Oubaya
- IMRB, INSERM, University Paris Est Creteil, 94010 Créteil, France
- Department of Public Health, Hôpitaux Universitaires Henri-Mondor AP-HP, 94010 Créteil, France
| | - Quentin De Roux
- Service D’Anesthésie-Réanimation Chirurgicale, DMU CARE, Hôpitaux Universitaires Henri-Mondor AP-HP, 94010 Créteil, France
| | - Nicolas Mongardon
- IMRB, INSERM, University Paris Est Creteil, 94010 Créteil, France
- Service D’Anesthésie-Réanimation Chirurgicale, DMU CARE, Hôpitaux Universitaires Henri-Mondor AP-HP, 94010 Créteil, France
- IMRB, EnvA, 94700 Maisons-Alfort, France
| | - Slim Fourati
- Département de Virologie, Bactériologie, Parasitologie-Mycologie, Hôpitaux Universitaires Henri-Mondor AP-HP, 94010 Créteil, France
| | - Jean-Winoc Decousser
- Equipe Opérationnelle d’Hygiène, Département Prévention, Diagnostic, Traitement des Infections, Hôpitaux Universitaires Henri-Mondor AP-HP, 94010 Créteil, France
- DYNAMYC, University Paris Est Creteil, 94010 Créteil, France
- DYNAMYC, EnvA, 94700 Maisons-Alfort, France
- Correspondence: (S.B.-G.); (J.-W.D.)
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Kameyama K, Mizutani K, Miyake Y, Iwase T, Mizutani Y, Yamada M, Ito Y, Ishihara S, Deguchi T. Evaluation of physical and psychological status of health care workers infected with COVID-19 during a hospital outbreak in Japan. J Infect Chemother 2023; 29:126-130. [PMID: 36241127 PMCID: PMC9553961 DOI: 10.1016/j.jiac.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/27/2022] [Accepted: 10/02/2022] [Indexed: 01/25/2023]
Abstract
PURPOSE COVID-19 causes physical and psychological impacts on health care workers (HCWs), especially when it occurs during an outbreak. As there are few reports on outcomes of HCWs infected with COVID-19 during a hospital outbreak, we investigated the physical and psychological impacts on HCWs infected with COVID-19 during an outbreak in our hospital. METHODS During the outbreak in our hospital, 231 people were infected with COVID-19 including patients, HCWs and their families. Among them, 83 HCWs were enrolled in this study. Current quality of life (QOL) was assessed with the EuroQol-visual analogue scales (EQ-VAS), and motivation to keep on working was evaluated by a 10-point analogue scale. Physiological recovery rates including return to work (RTW) period were also analyzed. RESULTS One nurse quit work due to anxiety regarding re-infection with COVID-19. The median period to RTW from the diagnosis was 14.0 (12.0-17.0) days. Motivation to keep on working was slightly reduced, and the EQ-VAS was 75.0 (65.0-83.6). There were no significant differences in QOL and motivation between male and female HCWs, nurses and other HCWs, treatment and non-treatment group, and supplemental and non-supplemental oxygen group. The most frequent persistent symptoms at 1,3 and 6 months after infection were anosmia followed by fatigue. CONCLUSION Although QOL and motivation to keep on working were slightly reduced, only one HCW quit work. No severe persistent symptoms were observed, and the RTW period was relatively short.
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Affiliation(s)
- Koji Kameyama
- Department of Urology, Central Japan International Medical Center, 1-1 Kenkonomati, Minokamo, Gifu, 505-8510, Japan,Corresponding author. 1-1 Kenkonomati, Minokamo, Gifu, 505-8510, Japan
| | - Kosuke Mizutani
- Department of Urology, Central Japan International Medical Center, 1-1 Kenkonomati, Minokamo, Gifu, 505-8510, Japan
| | - Yukiko Miyake
- Department of Nursing, Central Japan International Medical Center, 1-1 Kenkonomati, Minokamo, Gifu, 505-8510, Japan
| | - Toma Iwase
- Department of Emergency Medicine, Central Japan International Medical Center, 1-1 Kenkonomati, Minokamo, Gifu, 505-8510, Japan
| | - Yoshio Mizutani
- Department of Emergency Medicine, Central Japan International Medical Center, 1-1 Kenkonomati, Minokamo, Gifu, 505-8510, Japan
| | - Mikito Yamada
- Department of Emergency Medicine, Central Japan International Medical Center, 1-1 Kenkonomati, Minokamo, Gifu, 505-8510, Japan
| | - Yoshiki Ito
- Department of Orthopedic Surgery, Central Japan International Medical Center, 1-1 Kenkonomati, Minokamo, Gifu, 505-8510, Japan
| | - Satoshi Ishihara
- Department of Urology, Central Japan International Medical Center, 1-1 Kenkonomati, Minokamo, Gifu, 505-8510, Japan
| | - Takashi Deguchi
- Department of Urology, Central Japan International Medical Center, 1-1 Kenkonomati, Minokamo, Gifu, 505-8510, Japan
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McGrath J, Kenny C, Nielsen CS, Domegan L, Walsh C, Rooney P, Walsh S, Conlon N, Brady G, Ibrahim A, Dunne J, McCormack W, Corcoran N, Allen N, Fleming C, Bergin C. SARS-CoV-2 epidemiology, antibody dynamics, and neutralisation capacity in Irish healthcare workers in the era of booster COVID-19 vaccinations. Front Med (Lausanne) 2023; 10:1078022. [PMID: 36778745 PMCID: PMC9909389 DOI: 10.3389/fmed.2023.1078022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 01/09/2023] [Indexed: 01/27/2023] Open
Abstract
Background The PRECISE Study, a multi-phase cross-sectional seroprevalence study of anti-SARS-CoV-2 antibodies in Irish healthcare workers (HCW) investigated: (1) risk factors for SARS-CoV-2 seropositivity, (2) the durability of antibody responses in a highly vaccinated HCW cohort, and (3) the neutralisation capacity of detected antibodies, prior to booster COVID-19 vaccination. Materials and methods Serology samples were collected across two hospital sites in November 2021 and analysed using the Roche Elecsys Anti-SARS-CoV-2/Elecsys-S Anti-SARS-CoV-2 assays to detect anti-nucleocapsid (N) and anti-spike (S) antibodies respectively. Paired serology results from prior study phases were used to analyse changes in individual HCW serostatus over time. Risk-factors for SARS-CoV-2 infection were assessed for demographic and work-related factors. Antibody neutralisation capacity was assessed in a subset of samples via an in vitro ACE2 binding enzyme-linked immunosorbent assay. Results 2,344 HCW samples were analysed. Median age was 43 years (IQR 33-50) with 80.5% (n = 1,886) female participants. Irish (78.9%, n = 1,850) and Asian (12.3%, n = 288) were the most commonly reported ethnicities. Nursing/midwifery (39.3%, n = 922) was the most common job role. 97.7% of participants were fully vaccinated, with Pfizer (81.1%, n = 1,902) and AstraZeneca (16.1%, n = 377) the most common vaccines received. Seroprevalence for anti-SARS-CoV-2 antibodies indicating prior infection was 23.4%, of these 33.6% represented previously undiagnosed infections. All vaccinated participants demonstrated positive anti-S antibodies and in those with paired serology, no individual demonstrated loss of previously positive anti-S status below assay threshold for positivity. Interval loss of anti-N antibody positivity was demonstrated in 8.8% of previously positive participants with paired results. Risk factors for SARS-CoV-2 seropositivity suggestive of previous infection included age 18-29 years (aRR 1.50, 95% CI 1.19-1.90, p < 0.001), India as country of birth (aRR 1.35, 95% CI 1.01-1.73, p = 0.036), lower education level (aRR 1.35, 95% CI 1.11-1.66, p = 0.004) and HCA job role (aRR 2.12, 95% CI 1.51-2.95, p < 0.001). Antibody neutralisation varied significantly by anti-SARS-CoV-2 antibody status, with highest levels noted in those anti-N positive, in particular those with vaccination plus previous SARS-CoV-2 infection. Conclusion All vaccinated HCWs maintained anti-S positivity prior to COVID-19 booster vaccination, however anti-N positivity was more dynamic over time. Antibody neutralisation capacity was highest in participants with COVID-19 vaccination plus prior SARS-CoV-2 infection.
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Affiliation(s)
- Jonathan McGrath
- Department of Genitourinary Medicine and Infectious Diseases (GUIDe), St. James’s Hospital, Dublin, Ireland,*Correspondence: Jonathan McGrath,
| | - Claire Kenny
- Department of Infectious Diseases, University Hospital Galway, Galway, Ireland
| | - Charlotte Salgaard Nielsen
- European Centre for Disease Prevention and Control (ECDC) Fellowship Programme, Field Epidemiology Path (EPIET), Solna, Sweden,Health Protection Surveillance Centre (HPSC), Dublin, Ireland
| | - Lisa Domegan
- Health Protection Surveillance Centre (HPSC), Dublin, Ireland
| | - Cathal Walsh
- Health Protection Surveillance Centre (HPSC), Dublin, Ireland
| | - Peadar Rooney
- Department of Infectious Diseases, University Hospital Galway, Galway, Ireland
| | - Shane Walsh
- Department of Genitourinary Medicine and Infectious Diseases (GUIDe), St. James’s Hospital, Dublin, Ireland
| | - Niall Conlon
- Department of Immunology, St. James’s Hospital, Dublin, Ireland,Department of Clinical Medicine, Trinity College, Dublin, Ireland
| | - Gareth Brady
- Trinity College, Trinity Health Kidney Centre, Trinity Translational Medicine Institute, St. James’s Hospital, Dublin, Ireland
| | - Aya Ibrahim
- Department of Immunology, St. James’s Hospital, Dublin, Ireland,Department of Clinical Medicine, Trinity Translational Medicine Institute, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Jean Dunne
- Department of Immunology, St. James’s Hospital, Dublin, Ireland
| | - William McCormack
- Department of Clinical Medicine, Trinity Translational Medicine Institute, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Niamh Corcoran
- Department of Infectious Diseases, University Hospital Galway, Galway, Ireland
| | - Niamh Allen
- Department of Genitourinary Medicine and Infectious Diseases (GUIDe), St. James’s Hospital, Dublin, Ireland
| | - Catherine Fleming
- Department of Infectious Diseases, University Hospital Galway, Galway, Ireland
| | - Colm Bergin
- Department of Genitourinary Medicine and Infectious Diseases (GUIDe), St. James’s Hospital, Dublin, Ireland,Department of Clinical Medicine, Trinity College, Dublin, Ireland
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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] [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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Luo Y, Feng X, Wang D, Qiao X, Xiao X, Jia S, Zheng M, Reinhardt JD. Experience of clinical nurses engaged in caring for patients with COVID-19: A qualitative systematic review and meta-synthesis. J Clin Nurs 2023. [PMID: 36639947 DOI: 10.1111/jocn.16613] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 11/03/2022] [Accepted: 12/14/2022] [Indexed: 01/15/2023]
Abstract
AIMS AND OBJECTIVE This qualitative review summarises and synthesises the available evidence on subjective experiences of clinical nurses who cared for patients with COVID-19. BACKGROUND Nurses are first responders and play a vital role in emerging infectious disease epidemics such as the COVID-19 pandemic. In this context, they also face many difficulties and challenges related, for example to the imbalance between extensive demands and low control over work tasks. DESIGN AND METHOD A systematic review of qualitative studies and meta-synthesis focused on the experiences of clinical nurses caring for patients with COVID-19 during the pandemic was carried out. RESULTS A total of 279 findings were extracted, aggregated into 21 categories and combined into seven synthesised findings, namely (1) professional nursing practice during the pandemic, (2) support systems, (3) somatic sensations and psychological experiences, (4) difficulties and challenges, (5) coping strategies and behaviour, (6) impact on life, profession and values, and (7) needs and expectations for the future. CONCLUSION Nurses encountered considerable difficulties and challenges in caring for patients with COVID-19. Nurses caring for patients with COVID-19 need more support from organisations, families and society. It is essential to explore positive coping strategies suitable for working in different cultural backgrounds. Policymakers and decision-makers should pay attention to the experiences and voices of nurses. RELEVANCE TO CLINICAL PRACTICE It is critical for nurse managers to consider how to enhance the support system and help nurses develop adaptive coping strategies in response to COVID-19. Nurses' experiences and voices are valuable in improving health emergency response systems. PATIENT OR PUBLIC CONTRIBUTION There was no patient or public contribution.
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Affiliation(s)
- Yunting Luo
- West China School of Nursing, Sichuan University/Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China.,West China School of Nursing/West China Hospital, Sichuan University, Nursing Key Laboratory of Sichuan Province, Chengdu, China.,Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu, China
| | - Xianqiong Feng
- West China School of Nursing/West China Hospital, Sichuan University, Nursing Key Laboratory of Sichuan Province, Chengdu, China
| | - Dandan Wang
- West China School of Nursing/West China Hospital, Sichuan University, Nursing Key Laboratory of Sichuan Province, Chengdu, China
| | - Xu Qiao
- Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu, China.,West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xujia Xiao
- West China School of Nursing/West China Hospital, Sichuan University, Nursing Key Laboratory of Sichuan Province, Chengdu, China
| | - Shiqi Jia
- West China School of Nursing/West China Hospital, Sichuan University, Nursing Key Laboratory of Sichuan Province, Chengdu, China
| | - Mingyue Zheng
- Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Jan D Reinhardt
- Institute for Disaster Management and Reconstruction, Sichuan University, Chengdu, China.,Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.,Department of Rehabilitation Medicine, First Affiliated Hospital of Nanjing Medical University/Jiangsu Province Hospital, Nanjing, China
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Bobrovitz N, Noël K, Li Z, Cao C, Deveaux G, Selemon A, Clifton DA, Yanes-Lane M, Yan T, Arora RK. SeroTracker-RoB: A decision rule-based algorithm for reproducible risk of bias assessment of seroprevalence studies. Res Synth Methods 2023; 14:414-426. [PMID: 36633513 DOI: 10.1002/jrsm.1620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 11/16/2022] [Accepted: 01/03/2023] [Indexed: 01/13/2023]
Abstract
Risk of bias (RoB) assessments are a core element of evidence synthesis but can be time consuming and subjective. We aimed to develop a decision rule-based algorithm for RoB assessment of seroprevalence studies. We developed the SeroTracker-RoB algorithm. The algorithm derives seven objective and two subjective critical appraisal items from the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence studies and implements decision rules that determine study risk of bias based on the items. Decision rules were validated using the SeroTracker seroprevalence study database, which included non-algorithmic RoB judgments from two reviewers. We quantified efficiency as the mean difference in time for the algorithmic and non-algorithmic assessments of 80 randomly selected articles, coverage as the proportion of studies where the decision rules yielded an assessment, and reliability using intraclass correlations comparing algorithmic and non-algorithmic assessments for 2070 articles. A set of decision rules with 61 branches was developed using responses to the nine critical appraisal items. The algorithmic approach was faster than non-algorithmic assessment (mean reduction 2.32 min [SD 1.09] per article), classified 100% (n = 2070) of studies, and had good reliability compared to non-algorithmic assessment (ICC 0.77, 95% CI 0.74-0.80). We built the SeroTracker-RoB Excel Tool, which embeds this algorithm for use by other researchers. The SeroTracker-RoB decision-rule based algorithm was faster than non-algorithmic assessment with complete coverage and good reliability. This algorithm enabled rapid, transparent, and reproducible RoB evaluations of seroprevalence studies and may support evidence synthesis efforts during future disease outbreaks. This decision rule-based approach could be applied to other types of prevalence studies.
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Affiliation(s)
- Niklas Bobrovitz
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Critical Care Medicine, University of Calgary, Calgary, Alberta, Canada.,Centre for Health Informatics, University of Calgary, Calgary, Alberta, Canada
| | - Kim Noël
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Zihan Li
- Faculty of Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | - Christian Cao
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Gabriel Deveaux
- Centre for Health Informatics, University of Calgary, Calgary, Alberta, Canada
| | - Anabel Selemon
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - David A Clifton
- Institute of Biomedical Engineering, University of Oxford, Oxford, UK
| | | | - Tingting Yan
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Rahul K Arora
- Centre for Health Informatics, University of Calgary, Calgary, Alberta, Canada.,Institute of Biomedical Engineering, University of Oxford, Oxford, UK
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Alfonsi V, Scarpelli S, Gorgoni M, Couyoumdjian A, Rosiello F, Sandroni C, Corsi R, Pietrantonio F, De Gennaro L. Healthcare Workers after Two Years of COVID-19: The Consequences of the Pandemic on Psychological Health and Sleep among Nurses and Physicians. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1410. [PMID: 36674167 PMCID: PMC9859438 DOI: 10.3390/ijerph20021410] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/07/2023] [Accepted: 01/10/2023] [Indexed: 05/06/2023]
Abstract
COVID-19 has challenged the health workforce worldwide. In this cross-sectional study with a retrospective assessment, we explored the impact of the pandemic on mental health and sleep among a sample of Italian nurses and medical doctors. A total of 287 healthcare workers (212 nurses and 75 physicians) completed a web survey on socio-demographic, psychological, and sleep-related aspects referring to the period before the pandemic and to the present period of February to June 2022. Comparisons between nurses and physicians revealed that the former had greater distress in response to the pandemic. Consistently, the multivariate analysis of covariance showed that even if both groups were negatively impacted by the pandemic, nurses presented a greater worsening over time regarding several psychological and sleep symptoms. Furthermore, we observed that working on the frontline represented an additional risk factor for nurses. In line with previous evidence, we also found that personal experiences with COVID-19 are significant predictors of the current health status. Our results underscore the urgent need for preventive programs among healthcare operators to increase their coping skills and prevent the long-term consequences of chronic stress, especially for high-risk professionals. Specific attention should also be devoted to programs to improve sleep quality and reduce sleep-related traumatic symptoms.
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Affiliation(s)
- Valentina Alfonsi
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Serena Scarpelli
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Maurizio Gorgoni
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | | | - Francesco Rosiello
- Internal Medicine Department, Ospedale dei Castelli, Azienda Sanitaria Locale Roma 6, Ariccia, 00040 Rome, Italy
| | - Cinzia Sandroni
- UOC Professione Infermieristica, Azienda Sanitaria Locale Roma 6, Albano, 00041 Rome, Italy
| | - Roberto Corsi
- Direzione Sanitaria Aziendale, Azienda Sanitaria Locale Roma 6, Albano, 00041 Rome, Italy
| | - Filomena Pietrantonio
- Internal Medicine Department, Ospedale dei Castelli, Azienda Sanitaria Locale Roma 6, Ariccia, 00040 Rome, Italy
- Department of Health Economics, St. Camillus International University of Health Sciences, 00131 Rome, Italy
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
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Miyadahira MY, Brizot MDL, Alexander N, Cerdeira Sabino E, Campos de Oliveira da Silva L, Hoshida MS, da Silva Sousa Oliveira AM, Silva Farche AC, Pulcineli Vieira Francisco R, Mayaud P. Monitoring SARS-CoV-2 seroprevalence over time among pregnant women admitted to delivery units: Suitability for surveillance. PLoS One 2023; 18:e0280109. [PMID: 36603011 DOI: 10.1371/journal.pone.0280109] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 12/20/2022] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES To determine SARS-CoV-2 seroprevalence over time and risk factors among pregnant women at delivery in São Paulo, Brazil; and to evaluate the suitability of pregnant women as a sentinel population for SARS-CoV-2 serosurveillance. METHODS Unselected consecutive pregnant women presenting at the labor ward of a single large hospital between July 20th 2020 to February 21st 2021 were enrolled and tested for SARS-CoV-2 serology using two assays: the rapid chromatic Wondfo One Step (for total IgA and IgG detection) and Roche Elecsys assay (detecting anti-nucleoprotein [N] IgG). SARS-CoV-2 seroprevalence was computed as smooth spline function over time with 95% confidence intervals (CI). Risk factors were evaluated for positivity by each assay. We compared timepoint seroprevalence by the two assays with four concomitant community household surveys (HHS), in which the Roche assay was used, to determine the sensitivity and relevance of the pregnant women population as sentinel population. RESULTS Overall SARS-CoV-2 seroprevalence was 28.9% (221/763) by Roche and 17.9% (137/763) by Wondfo. Reported symptoms experienced during pregnancy were all significantly correlated with being SARS-CoV-2 seropositive at delivery with any assay (with odds-ratios ranging from 3.0 [95% CI: 2.1-4.3] for coryza to 22.8 [95% CI: 12.3-46.6] for ageusia). Seropositivity by either assay was high in women at delivery in the early period of the pandemic (June 2020), compared with seropositivity in women from the concomitant HHS: 44.1% (95% CI: 21.8-66.4) for Roche, 54.1% (30.9-78.5) for Wondfo, versus 11.4% (95% CI: 9.2-13.6) for HHS. For later periods (October 2020 and January 2021), the seropositivity in women at delivery measured by Roche corresponded well with the prevalence found among women in the HHS using the same assay, whilst prevalence measured by Wondfo dropped. CONCLUSIONS Women at delivery represent a highly exposed and readily accessible population for sentinel surveillance of emerging infections such as SARS-CoV-2.
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Affiliation(s)
- Mariana Yumi Miyadahira
- Disciplina de Obstetrícia, Departamento de Obstetrícia e Ginecologia da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
| | - Maria de Lourdes Brizot
- Disciplina de Obstetrícia, Departamento de Obstetrícia e Ginecologia da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
| | - Neal Alexander
- Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Ester Cerdeira Sabino
- Departamento de Moléstias Infecciosas e Parasitárias, Instituto de Medicina Tropical da FMUSP, São Paulo, Brazil
| | | | - Mara Sandra Hoshida
- Disciplina de Obstetrícia, Departamento de Obstetrícia e Ginecologia da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
- Laboratório de Investigação Médica- LIM 57, Hospital das Clínicas da FMUSP, São Paulo, Brazil
| | - Ana Maria da Silva Sousa Oliveira
- Disciplina de Obstetrícia, Departamento de Obstetrícia e Ginecologia da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
| | - Ana Claudia Silva Farche
- Disciplina de Obstetrícia, Departamento de Obstetrícia e Ginecologia da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
| | - Rossana Pulcineli Vieira Francisco
- Disciplina de Obstetrícia, Departamento de Obstetrícia e Ginecologia da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
- Hospital Universitário da Universidade de São Paulo (USP), São Paulo, Brazil
| | - Philippe Mayaud
- Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Differences in BNT126b2 and ChAdOx1 Homologous Vaccination Antibody Response among Teachers in Poznan, Poland. Vaccines (Basel) 2023; 11:vaccines11010118. [PMID: 36679962 PMCID: PMC9862687 DOI: 10.3390/vaccines11010118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/28/2022] [Accepted: 12/31/2022] [Indexed: 01/05/2023] Open
Abstract
Children are among the best vectors to spread respiratory viruses, including emerging variants of SARS-CoV-2 due to the asymptomatic or relatively mild course of infection and simultaneously high titres of pathogens in the respiratory tract. Therefore, individuals who have constant contact with children, e.g., teachers should be vaccinated against COVID-19 as essential workers within the first phases of a vaccination campaign. In Poland, primary and secondary school teachers were vaccinated with ChAdOx1 from February 2021 with a three month interval between the two doses, while lecturers at medical universities, who are simultaneously healthcare workers, received the BNT126b2 vaccine from December 2020 with three weeks between the first and second doses. The aim of this study was to compare the antibody responses at two weeks and three months after vaccination and to estimate the vaccine effectiveness against COVID-19 among infection-naïve teachers vaccinated with mRNA and a vector vaccine. We found that the anti-SARS-CoV-2 spike protein antibodies were significantly higher among the lecturers but antibody waning was slower among the schoolteachers. However, those vaccinated with ChAdOx1 complained significantly more often of vaccine side effects. In addition, during the three months after the second vaccine dose no study participants were infected with SARS-CoV-2. The BNT126b2 vaccine gave higher antibody titres in comparison with ChAdOx1 but protection against COVID-19 in both cases was similar. Moreover, we did not find any anti-SARS-CoV-2 nucleoprotein antibodies at two weeks as well as at three months after vaccination among the study participants, which shows a very high vaccine effectiveness in the occupational group with a high SARS-CoV-2-infection risk.
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Wilson-Aggarwal JK, Gotts N, Arnold K, Spyer MJ, Houlihan CF, Nastouli E, Manley E. Assessing spatiotemporal variability in SARS-CoV-2 infection risk for hospital workers using routinely-collected data. PLoS One 2023; 18:e0284512. [PMID: 37083855 PMCID: PMC10121006 DOI: 10.1371/journal.pone.0284512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 04/02/2023] [Indexed: 04/22/2023] Open
Abstract
The COVID-19 pandemic has emphasised the need to rapidly assess infection risks for healthcare workers within the hospital environment. Using data from the first year of the pandemic, we investigated whether an individual's COVID-19 test result was associated with behavioural markers derived from routinely collected hospital data two weeks prior to a test. The temporal and spatial context of behaviours were important, with the highest risks of infection during the first wave, for staff in contact with a greater number of patients and those with greater levels of activity on floors handling the majority of COVID-19 patients. Infection risks were higher for BAME staff and individuals working more shifts. Night shifts presented higher risks of infection between waves of COVID-19 patients. Our results demonstrate the epidemiological relevance of deriving markers of staff behaviour from electronic records, which extend beyond COVID-19 with applications for other communicable diseases and in supporting pandemic preparedness.
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Affiliation(s)
| | - Nick Gotts
- School of Geography, University of Leeds, Woodhouse, Leeds, United Kingdom
| | - Kellyn Arnold
- School of Geography, University of Leeds, Woodhouse, Leeds, United Kingdom
| | - Moira J Spyer
- Department of Clinical Virology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
- Department of Infection, Immunity and Inflammation, UCL GOS Institute of Child Health University College London, London, United Kingdom
| | - Catherine F Houlihan
- Department of Clinical Virology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
- Department of Infection and Immunity, University College London, London, United Kingdom
| | - Eleni Nastouli
- Department of Clinical Virology, University College London Hospitals NHS Foundation Trust, London, United Kingdom
- Department of Infection, Immunity and Inflammation, UCL GOS Institute of Child Health University College London, London, United Kingdom
| | - Ed Manley
- School of Geography, University of Leeds, Woodhouse, Leeds, United Kingdom
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SARS-CoV-2 Seroprevalence in Employees of Four Essential Non-Health Care Sectors at Moderate/High Risk of Exposure to Coronavirus Infection: Data From the "First Wave". J Occup Environ Med 2023; 65:10-15. [PMID: 36094075 PMCID: PMC9835238 DOI: 10.1097/jom.0000000000002690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence in Swiss non-health care employees at a moderate to high risk of exposure: bus drivers and supermarket, laundry service, and mail-sorting center employees. METHODS Data on 455 essential workers included demographics, SARS-CoV-2 exposure and use of protective measures. Anti-SARS-CoV-2 immunoglobulins G and A targeting the spike protein were measured between May and July 2020. RESULTS The overall crude seroprevalence estimate (15.9%; 95% confidence interval [CI], 12.6% to 19.7%) among essential workers was not significantly higher than that of the general working-age population (11.2%; 95% CI, 7.1% to 15.2%). Seroprevalence ranged from 11.9% (95% CI, 6.3% to 19.8%) among bus drivers to 22.0% (95% CI, 12.6% to 19.7%) among food supermarket employees. CONCLUSIONS We found no significant difference in seroprevalence between our sample of essential workers and local working-age population during the first lockdown phase of the COVID-19 pandemic. Having a seropositive housemate was the strongest predictor of SARS-CoV-2 seropositivity.
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Abstract
The outbreak of the coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become an evolving global health crisis. Currently, a number of risk factors have been identified to have a potential impact on increasing the morbidity of COVID-19 in adults, including old age, male sex, pre-existing comorbidities, and racial/ethnic disparities. In addition to these factors, changes in laboratory indices and pro-inflammatory cytokines, as well as possible complications, could indicate the progression of COVID-19 into a severe and critical stage. Children predominantly suffer from mild illnesses due to COVID-19. Similar to adults, the main risk factors in pediatric patients include age and pre-existing comorbidities. In contrast, supplementation with a healthy diet and sufficient nutrition, COVID-19 vaccination, and atopic conditions may act as protective factors against the infection of SARS-CoV-2. COVID-19 vaccination not only protects vulnerable individuals from SARS-CoV-2 infection, more importantly, it may also reduce the development of severe disease and death due to COVID-19. Currently used therapies for COVID-19 are off-label and empiric, and their impacts on the severity and mortality of COVID-19 are still unclear. The interaction between asthma and COVID-19 may be bidirectional and needs to be clarified in more studies. In this review, we highlight the clinical evidence supporting the rationale for the risk and protective factors for the morbidity, severity, and mortality of COVID-19.
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Gholami M, Fawad I, Shadan S, Rowaiee R, Ghanem H, Khamis AH, Ho SB. The COVID-19 Pandemic and Health and Care Workers: Findings From a Systematic Review and Meta-Analysis (2020-2021). Int J Public Health 2023; 68:1605421. [PMID: 36938301 PMCID: PMC10020210 DOI: 10.3389/ijph.2023.1605421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 02/21/2023] [Indexed: 03/06/2023] Open
Abstract
Objectives: The COVID-19 pandemic has greatly impacted health and care workers (HCW) globally, whom are considered at greater risk of infection and death. This study aims to document emerging evidence on disease prevalence, clinical outcomes, and vaccination rates of HCWs. Methods: Three databases were surveyed resulting on 108 final articles between July-December 2020 (period 1) and January-June 2021 (period 2). Results: Amongst the overall 980,000 HCWs identified, in period 1, the estimates were 6.1% (95% CI, 4.1-8.8) for the PCR positivity rate. Regarding outcomes, the hospitalization prevalence was 1.6% (95% CI, 0.7-3.9), and mortality rate of 0.3% (95% CI, 0.1-0.8). In period 2, the PCR positivity rate was 8.1% (95% CI, 4.6-13.8). Analysis of outcomes revealed a hospitalization rate of 0.7% (95% CI 0.3-1.8), and average mortality rate of 0.3% (95% CI 0.1-0.9). Our analysis indicated a HCW vaccination rate of 59.0% (95% CI, 39.4-76.1). Conclusion: Studies from the latter half of 2020 to the first half of 2021 showed a slight increasing trend in PCR positivity among HCW, along with improved clinical outcomes in the 1-year period of exposure. These results correlate well with the improving uptake of COVID-19 vaccination globally.
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Affiliation(s)
- Mandana Gholami
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Iman Fawad
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Sidra Shadan
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Rashed Rowaiee
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - HedaietAllah Ghanem
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Amar Hassan Khamis
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Samuel B. Ho
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
- Department of Medicine, Mediclinic City Hospital, Dubai, United Arab Emirates
- *Correspondence: Samuel B. Ho,
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Kharroubi G, Cherif I, Ghawar W, Dhaouadi N, Yazidi R, Chaabane S, Snoussi MA, Salem S, Ben Hammouda W, Ben Hammouda S, Gharbi A, Bel Haj Hmida N, Rourou S, Dellagi K, Barbouche MR, Benabdessalem C, Ben Ahmed M, Bettaieb J. Incidence and risk factors of SARS-CoV-2 infection among workers in a public health laboratory in Tunisia. Arch Virol 2023; 168:69. [PMID: 36658402 PMCID: PMC9851900 DOI: 10.1007/s00705-022-05636-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/15/2022] [Indexed: 01/21/2023]
Abstract
The aim of this study was to measure the extent of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among workers at the Institut Pasteur de Tunis (IPT), a public health laboratory involved in the management of the COVID-19 pandemic in Tunisia, and to identify risk factors for infection in this occupational setting. A cross-sectional survey was conducted on IPT workers not vaccinated against coronavirus disease 2019 (COVID-19). Participants completed a questionnaire that included a history of reverse transcription-polymerase chain reaction (RT-PCR)-confirmed SARS-CoV-2 infection. Immunoglobulin G antibodies against the receptor-binding domain of the spike antigen (anti-S-RBD IgG) and the nucleocapsid protein (anti-N IgG) of the SARS-CoV-2 virus were detected by enzyme-linked immunoassay (ELISA). A multivariate analysis was used to identify factors significantly associated with SARS-CoV-2 infection. A total of 428 workers were enrolled in the study. The prevalence of anti-S-RBD and/or anti-N IgG antibodies was 32.9% [28.7-37.4]. The cumulative incidence of SARS-CoV-2 infection (positive serology and/or previous positive RT-PCR test) was 40.0% [35.5-44.9], while the proportion with asymptomatic infection was 32.9%. One-third of the participants with RT-PCR-confirmed infection tested seronegative more than 90 days postinfection. Participants aged over 40 and laborers were more susceptible to infection (adjusted OR [AOR] = 1.65 [1.08-2.51] and AOR = 2.67 [1.45-4.89], respectively), while tobacco smokers had a lower risk of infection (AOR = 0.54 [0.29-0.97]). The SARS-CoV-2 infection rate among IPT workers was not significantly different from that detected concurrently in the general population. Hence, the professional activities conducted in this public health laboratory did not generate additional risk to that incurred outside the institute in day-to-day activities.
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Affiliation(s)
- Ghassen Kharroubi
- Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, 13 Place Pasteur BP-74, 1002 Tunis Belvedere, Tunisia ,Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Ines Cherif
- Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, 13 Place Pasteur BP-74, 1002 Tunis Belvedere, Tunisia ,Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Wissem Ghawar
- Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, 13 Place Pasteur BP-74, 1002 Tunis Belvedere, Tunisia ,Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Nawel Dhaouadi
- Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, 13 Place Pasteur BP-74, 1002 Tunis Belvedere, Tunisia
| | - Rihab Yazidi
- Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, 13 Place Pasteur BP-74, 1002 Tunis Belvedere, Tunisia ,Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Sana Chaabane
- Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, 13 Place Pasteur BP-74, 1002 Tunis Belvedere, Tunisia ,Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Mohamed Ali Snoussi
- Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, 13 Place Pasteur BP-74, 1002 Tunis Belvedere, Tunisia ,Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Sadok Salem
- Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, 13 Place Pasteur BP-74, 1002 Tunis Belvedere, Tunisia ,Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Wafa Ben Hammouda
- Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Sonia Ben Hammouda
- Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Adel Gharbi
- Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, 13 Place Pasteur BP-74, 1002 Tunis Belvedere, Tunisia ,Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Nabil Bel Haj Hmida
- Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, 13 Place Pasteur BP-74, 1002 Tunis Belvedere, Tunisia ,Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Samia Rourou
- Laboratory of Molecular Microbiology, Vaccinology and Biotechnology Development, Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Koussay Dellagi
- Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia ,grid.428999.70000 0001 2353 6535Pasteur Network, Institut Pasteur, Paris, France
| | - Mohamed-Ridha Barbouche
- Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Chaouki Benabdessalem
- Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Melika Ben Ahmed
- Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Jihène Bettaieb
- Department of Medical Epidemiology, Institut Pasteur de Tunis, University of Tunis El Manar, 13 Place Pasteur BP-74, 1002, Tunis Belvedere, Tunisia. .,Laboratory of Transmission, Control and Immunobiology of Infections (LR11IPT02), Institut Pasteur de Tunis, University of Tunis El Manar, Tunis, Tunisia.
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Taskin MH, Yazici Z, Barry G. A prevalence study of COVID-19 among healthcare workers in a pandemic hospital in the Samsun province of Turkey. PLoS One 2022; 17:e0279067. [PMID: 36548268 PMCID: PMC9778555 DOI: 10.1371/journal.pone.0279067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
Among populations globally, many healthcare workers have been disproportionally impacted by the COVID-19 pandemic because of their above average exposure to people infected with SARS-CoV-2. Exposure to asymptomatic or pre-symptomatic individuals is particularly challenging, if those individuals continue to work, not knowing that they are potentially infectious. This study aimed to measure the level of asymptomatic infection in a cohort of workers in a healthcare setting in Turkey during the second major wave of infection in late 2020. Blood samples were collected and tested by electrochemiluminescence immunoassay for SARS-CoV-2 IgM and IgG antibodies. Nasal and throat swabs were performed in a subset of this cohort and RT-qPCR was used to search for the presence of SARS-CoV-2 RNA. The results showed that approximately 23% of the cohort were positive for anti-SARS-CoV-2 IgM antibodies and approximately 22% were positive for anti-SARS-CoV-2 IgG antibodies despite no reported history of COVID-19 symptoms. Just less than 30% of a subset of the group were positive for the presence of SARS-CoV-2 RNA indicating the likelihood of a current or recent infection, again despite a lack of typical COVID-19 associated symptoms. This study indicates a high rate of asymptomatic infection and highlights the need for regular testing of groups such as healthcare workers when community prevalence of disease is high and there is a desire to limit entry of virus into settings where vulnerable people may be present, because symptoms cannot be relied on as indicators of infection or infectiousness.
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Affiliation(s)
- Mehmet Hakan Taskin
- Department of Medical Microbiology, Samsun Training and Research Hospital, University of Health Sciences, Samsun, Turkey
| | - Zafer Yazici
- Department of Virology, Faculty of Veterinary Medicine, Ondokuz Mayis University, Samsun, Turkey,* E-mail: (GB); (ZY)
| | - Gerald Barry
- School of Veterinary Medicine, University College Dublin, Dublin, Ireland,* E-mail: (GB); (ZY)
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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] [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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CALIMERI SEBASTIANO, LO GIUDICE DANIELA, BUDA AGATA, LAGANÀ ANTONIO, FACCIOLÀ ALESSIO, DI PIETRO ANGELA, VISALLI GIUSEPPA. Role of the 1 st booster dose of COVID-19 vaccine in the protection against the infection: A fundamental public health tool. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2022; 63:E520-E526. [PMID: 36891000 PMCID: PMC9986990 DOI: 10.15167/2421-4248/jpmh2022.63.4.2742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 11/29/2022] [Indexed: 03/10/2023]
Abstract
Introduction The COVID-19 pandemic is having a huge impact on human health with high morbidity and mortality rates worldwide. Healthcare Workers (HCWs) are one of the most at risk categories to contract the infection. Effective anti-COVID-19 vaccines were approved in a very short time. Making the 1st booster dose is essential to induce a good protection against the infection. Methods We conducted a retrospective sero-epidemiological survey of already existing data concerning the antibody response of a HCWs sample vaccinated with the primary cycle and the 1st booster dose of the Pfizer-BioNTech COVID-19 mRNA vaccine and, specifically, after three weeks from the third dose of vaccination. Results In our analysis, after the primary cycle, a 95.15% efficacy was detected. Among the non-responders, women were significantly more frequent (69.56%). Moreover, we found a significant reverse correlation between the immune response and the age of the sample, especially in women. However, the 1st booster dose completely cancelled these differences. Conclusions Our data are perfectly in line with what has been declared by the conducted studies in terms of efficacy. However, it is important to highlight that people with only the primary cycle are at high risk to contract the COVID-19 infection. Therefore, it is necessary to not consider people vaccinated with the primary cycle completely risk-free and to stress the importance to perform the 1st booster dose.
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Affiliation(s)
- SEBASTIANO CALIMERI
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - DANIELA LO GIUDICE
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - AGATA BUDA
- Virology Operative Unit, University Hospital “G. Martino”, Messina
| | - ANTONIO LAGANÀ
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
- Istituto Clinico Polispecialistico C.O.T. Cure Ortopediche Traumatologiche S.p.A, Messina, Italy
| | - ALESSIO FACCIOLÀ
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
- Correspondence: Alessio Facciolà, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy. E-mail:
| | - ANGELA DI PIETRO
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - GIUSEPPA VISALLI
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
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