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Lee HR, Kim SR, Cho MH, Kim DE, Jang SY, Lee JE, Jeong HR, Kang HJ, Song JY, Chun BC. Incidence and risk factors of COVID-19 in a tertiary hospital and the effectiveness of booster vaccination among health care workers: A retrospective cohort study, January 2020 to June 2022. Am J Infect Control 2024; 52:688-695. [PMID: 38246494 DOI: 10.1016/j.ajic.2024.01.010] [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: 10/07/2023] [Revised: 01/09/2024] [Accepted: 01/11/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Health care workers (HCWs) face a higher risk of infection and may transmit pathogens to patients during a pandemic. This study aims to evaluate infection-control measures by analyzing the incidence and risk factors of COVID-19 and estimating vaccine effectiveness (VE) at a tertiary hospital in Seoul, Republic of Korea. METHODS This study included 2,516 HCWs from January 1, 2020, to June 30, 2022. Data were analyzed to determine the incidence density and cumulative incidence; the results were compared by the age- and gender-specific standardized incidence ratios (SIR). VE was estimated with multivariate Cox proportional-hazard models as 1-adjusted hazard ratio × 100%. RESULTS SIR indicated a lower COVID-19 risk in the hospital population than in the general Korean population (SIR, 0.81; 95% confidence interval [CI]: 0.76-0.87). Multivariate Cox analysis indicated that, compared to doctors, nonmedical service supporters and other HCWs (excluding doctors and nurses) were high-risk groups (adjusted hazard ratio [95% CI], 1.72 [1.04-2.83] and 1.76 [1.20-2.58], respectively). Compared to the outpatient unit, the emergency department was a high-risk department (1.70 [1.16-2.50]). The VE of the booster dose was 55.47%, compared to no or incomplete vaccination (95% CI: 22.63-74.37). CONCLUSIONS Besides encouraging HCWs vaccination, effective infection-control measures should target high-risk groups and departments.
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Affiliation(s)
- Hae Ry Lee
- Infection Control Team, Korea University Guro Hospital, Seoul, South Korea; Department of Epidemiology and Health Informatics, Graduate School of Public Health, Korea University, Seoul, South Korea
| | - Sung Ran Kim
- Infection Control Team, Korea University Guro Hospital, Seoul, South Korea
| | - Min Hee Cho
- Infection Control Team, Korea University Guro Hospital, Seoul, South Korea
| | - Da Eun Kim
- Infection Control Team, Korea University Guro Hospital, Seoul, South Korea
| | - Su Yeon Jang
- Infection Control Team, Korea University Guro Hospital, Seoul, South Korea
| | - Jae Eun Lee
- Infection Control Team, Korea University Guro Hospital, Seoul, South Korea
| | - Hye Rin Jeong
- Infection Control Team, Korea University Guro Hospital, Seoul, South Korea
| | - Hyeon Jeong Kang
- Infection Control Team, Korea University Guro Hospital, Seoul, South Korea
| | - Joon Young Song
- Infection Control Team, Korea University Guro Hospital, Seoul, South Korea; Division of Infectious Disease, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Byung Chul Chun
- Department of Epidemiology and Health Informatics, Graduate School of Public Health, Korea University, Seoul, South Korea; Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea.
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Corral-Gudino L, Del-Amo-Merino MP, Abadía-Otero J, Merino-Velasco I, Lorenzo-Fernández Y, García-Cruces-Méndez J, Eiros-Bouza JM, Domínguez-Gil González M. Impact of age on the transmission of SARS-CoV-2 in healthcare workers : Influence of nonoccupational risk factors. Wien Klin Wochenschr 2024:10.1007/s00508-024-02346-0. [PMID: 38587544 DOI: 10.1007/s00508-024-02346-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/10/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND The incidence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV‑2) infection was highest among older adults early in the COVID-19 pandemic; however, this pattern was later reversed with young adults showing the highest incidence. The aim of this study was to identify risk factors in healthcare workers (HCWs) associated with this evolution. METHODS We conducted a survey nested within a prospective cohort study of 680 HCWs from a tertiary referral public hospital who received 2 doses of SARS-CoV‑2 vaccine in January and February 2021 (VACCICO-VAO cohort). In October 2022 all participants were invited to participate in a survey. Risk factors were tested for association with COVID-19 ever, the number of COVID-19 episodes, and the time to the first episode. RESULTS Among 350 respondents (51% response rate, 90% female, mean age 48.1 years), 323 COVID-19 episodes were diagnosed during the study period. Multivariable analysis revealed that age < 35 years vs. > 50 years (odds ratio, OR 2.12, 95% confidence interval, CI 1.27-3.51; P = 0.004) and not maintaining social distance at social events (OR: 1.82, 95% CI: 1.16-3.19; P = 0.011) were associated with a higher risk of COVID-19. Age < 35 years (hazard ratio, HR 1.70, 95% CI 1.14-2.54; P = 0.010), and not maintaining social distance (HR 1.34, 95% CI 1.05-1.72; P = 0.020) were also associated with the time to the first episode. CONCLUSIONS The youngest HCWs had the highest incidence rate of COVID-19, which was not explained by occupational risk factors or health conditions. The increase in nonoccupational exposure since the end of the lockdowns in summer 2020 could by a key factor.
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Affiliation(s)
- Luis Corral-Gudino
- Department of Internal Medicine, Dermatology and Toxicology. Hospital Universitario Rio Hortega, Valladolid. School of Medicine, Universidad de Valladolid, Avda. Ramón y Cajal, 7, 47005, Valladolid, Spain.
| | - María Piedad Del-Amo-Merino
- Occupational Risk Prevention Service, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y Leon (SACYL), C/Dulzaina n°2, 47012, Valladolid, Spain
| | - Jésica Abadía-Otero
- Department of Internal Medicine, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y Leon (SACYL), C/Dulzaina n°2, 47012, Valladolid, Spain
| | - Irene Merino-Velasco
- Department of Microbiology, Hospital Universitario Río Hortega Universidad de Valladolid, Gerencia Regional de Salud de Castilla y Leon (SACYL), C/Dulzaina n°2, 47012, Valladolid, Spain
| | - Yolanda Lorenzo-Fernández
- Occupational Risk Prevention Service, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y Leon (SACYL), C/Dulzaina n°2, 47012, Valladolid, Spain
| | - Jesús García-Cruces-Méndez
- Department of Preventive Medicine and Hospital Epidemiology, Hospital Universitario Río Hortega, Gerencia Regional de Salud de Castilla y Leon (SACYL), C/Dulzaina n°2, 47012, Valladolid, Spain
| | - José María Eiros-Bouza
- Department of Microbiology, Hospital Universitario Rio Hortega, Valladolid. School of Medicine, Universidad de Valladolid, Avda. Ramón y Cajal, 7, 47005, Valladolid, Spain
| | - Marta Domínguez-Gil González
- Department of Microbiology, Hospital Universitario Río Hortega Universidad de Valladolid, Gerencia Regional de Salud de Castilla y Leon (SACYL), C/Dulzaina n°2, 47012, Valladolid, Spain
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Amer F, López T, Gil-Conesa M, Carlos S, Ariño AH, Carmona-Torre F, Martínez-González MA, Fernandez-Montero A. Association between COVID-19 and outstanding academic performance at a Spanish university. Arch Public Health 2023; 81:213. [PMID: 38093341 PMCID: PMC10717459 DOI: 10.1186/s13690-023-01225-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 11/29/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND SARS-CoV-2 is the causative agent of COVID-19 identified in December 2019, an acute infectious respiratory disease that can cause persistent neurological and musculoskeletal symptoms such as headache, fatigue, myalgias difficulty concentrating, among others including acute cerebrovascular disease with a prevalence of 1-35%. The aim of this study is to evaluate the impact of COVID-19 in undergraduate students on their academic performance as an indicator of their intellectual ability and performance in a university that maintained 100% face-to-face teaching during the 2020-2021 academic year. METHODS A total of 7,039 undergraduate students were analyzed in a prospective cohort study at the University of Navarra. A questionnaire including sociodemographic and behavioral questions was sent. PCRs were performed throughout the academic year for the diagnosis of SARS-CoV-2 infection and students' academic results were provided by the academic center, adjusted descriptive and multivariate models were performed to assess the association. RESULTS A total of 658 (9.3%) participants were diagnosed with COVID-19, almost 4.0% of them achieved outstanding academic results, while uninfected students did so in 7.3%. SARS-CoV-2 infection was associated with a significant decrease in having outstanding academic results (OR = 0.57; 95% CI: 0.38-0.86). CONCLUSION Having COVID-19 disease, decreased academic performance in undergraduate students. Therefore, it is necessary to prevent infection even in the youngest sections of the population.
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Affiliation(s)
- Fares Amer
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Navarra, Spain
| | - Tamara López
- Department of Occupational Medicine, University of Navarra Clinic, Av. Pio XII, 36. 31008, Pamplona, Navarra, Spain
| | - Mario Gil-Conesa
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Navarra, Spain
| | - Silvia Carlos
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Navarra, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Navarra, Spain
| | - Arturo H Ariño
- Department of Environmental Biology, University of Navarra, Pamplona, Navarra, Spain
- Institute for Data Science and Artificial Intelligence (DATAI), University of Navarra, Pamplona, Navarra, Spain
| | - Francisco Carmona-Torre
- Navarra Institute for Health Research (IdiSNA), Pamplona, Navarra, Spain
- COVID-19 Department, University Clinic of Navarra, Pamplona, Navarra, Spain
- Infectious Diseases Service, University Clinic of Navarra, Pamplona, Navarra, Spain
| | - Miguel A Martínez-González
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Navarra, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Navarra, Spain
- Biomedical Research Network Centre for Pathophysiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, Madrid, Spain
- Department of Nutrition, Harvard T.H Chan School, Boston, MA, USA
| | - Alejandro Fernandez-Montero
- Navarra Institute for Health Research (IdiSNA), Pamplona, Navarra, Spain.
- Department of Occupational Medicine, University of Navarra Clinic, Av. Pio XII, 36. 31008, Pamplona, Navarra, Spain.
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Amer F, Gil-Conesa M, Carlos S, Ariño AH, Carmona-Torre F, Martínez-González MA, Fernandez-Montero A. Behavioral and Personal Characteristics Associated With Risk of SARS-CoV-2 Infection in a Spanish University Cohort. Am J Epidemiol 2023; 192:1463-1474. [PMID: 37045805 PMCID: PMC10472324 DOI: 10.1093/aje/kwad086] [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: 03/10/2022] [Revised: 01/04/2023] [Accepted: 04/10/2023] [Indexed: 04/14/2023] Open
Abstract
The aim of this study was to analyze the life habits and personal factors associated with increased severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) risk in a university environment with in-person lectures during the coronavirus disease 2019 (COVID-19) pandemic. To our knowledge, there are no previous longitudinal studies that have analyzed associations of behavioral and personal factors with the risk of SARS-CoV-2 infection on an entire university population. A cohort study was conducted in the 3 campuses of the University of Navarra between August 24, 2020, and May 30, 2021, including 14,496 students and employees; the final sample included 10,959. Descriptive and multivariate-adjusted models were fitted using Cox regression. A total of 1,032 (9.4%) participants were diagnosed with COVID-19 (879 students and 153 employees), almost 50% living with their families. COVID-19 was associated with living in college or residence (hazard ratio (HR) = 1.96, 95% CI: 1.45, 2.64), motor transportation (HR = 1.35, 95% CI: 1.14, 1.61), South American origin (HR = 1.43, 95% CI: 1.20, 1.72), and belonging to Madrid's campus (HR = 3.11, 95% CI: 2.47, 3.92). International students, especially from Latin America, mostly lived in university apartments or shared flats and cohabited with 4-11 people. Living in a big city (Madrid), was a significant risk factor.
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Affiliation(s)
| | | | | | | | | | | | - Alejandro Fernandez-Montero
- Correspondence to Dr. Alejandro Fernandez-Montero, Department of Occupational Medicine, University of Navarra Clinic, Avenida Pio XII, 36, 31008, Pamplona, Navarra, Spain (e-mail: )
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Kayi EA, Ottie-Boakye D, Ansa GA, Appiah-Agyekum NN. Perception of Risk and Compliance With COVID-19 Safety Guidelines: A Cross-Sectional Survey Among Healthcare Workers in Ghana. Health Serv Insights 2023; 16:11786329231180773. [PMID: 37362910 PMCID: PMC10285691 DOI: 10.1177/11786329231180773] [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: 01/09/2023] [Accepted: 05/22/2023] [Indexed: 06/28/2023] Open
Abstract
Although healthcare professionals are on the "frontline" of providing effective and quality healthcare delivery, they face several occupational risks when giving care, particularly during a global health crisis. This study examines healthcare workers' compliance with COVID-19 safety protocols and identifies factors associated with their perceived risk of COVID-19. Between October and December 2020, this cross-sectional survey utilized online and paper-type questionnaires in data collection. Non-probability sampling techniques were used in selecting clinical and non-clinical healthcare workers in various health facilities within 4 regions of Ghana. Logistic regression analysis was performed to identify the factors associated with the perceived risk of COVID-19. The results showed that healthcare workers are highly compliant with hand hygiene practices and wearing PPE. The category of health professional, number of working years, type of health facility, region of work, frequency of COVID-19 test, and compliance with hand hygiene practices were significantly associated with healthcare workers' perception of risk of COVID-19 at P < .05. Findings suggest that both individual and health system factors are significant in increasing the risk of COVID-19 among healthcare workers. Efforts at enforcing strict compliance with infection prevention should be implemented to protect all healthcare personnel.
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Affiliation(s)
- Esinam Afi Kayi
- Department of Adult Education and Human Resource Studies, University of Ghana, Accra, Ghana
| | - Doris Ottie-Boakye
- Department of Health Policy, Planning and Management, School of Public Health, College of Health Sciences, University of Ghana, Accra
| | - Gloria Akosua Ansa
- Department of Public Health, University of Ghana Health Services, Accra, Ghana
| | - Nana Nimo Appiah-Agyekum
- Department of Public Administration and Health Services Management, University of Ghana Business School, Accra, Ghana
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Norton A, Rakowska S, Galloway T, Wilson K, Rosella L, Adams M. Are at-risk sociodemographic attributes stable across COVID-19 transmission waves? Spat Spatiotemporal Epidemiol 2023; 45:100586. [PMID: 37301601 DOI: 10.1016/j.sste.2023.100586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 01/03/2023] [Accepted: 04/07/2023] [Indexed: 06/12/2023]
Abstract
COVID-19 health impacts and risks have been disproportionate across social, economic, and racial gradients (Chen et al., 2021; Thompson et al., 2021; Mamuji et al., 2021; COVID-19 and Ethnicity, 2020). By examining the first five waves of the pandemic in Ontario, we identify if Forward Sortation Area (FSAs)based measures of sociodemographic status and their relationship to COVID-19 cases are stable or vary by time. COVID-19 waves were defined using a time-series graph of COVID-19 case counts by epi-week. Percent Black visible minority, percent Southeast Asian visible minority and percent Chinese visible minority at the FSA level were then integrated into spatial error models with other established vulnerability characteristics. The models indicate that area-based sociodemographic patterns associated with COVID-19 infection change over time. If sociodemographic characteristics are identified as high risk (increased COVID-19 case rates) increased testing, public health messaging, and other preventative care may be implemented to protect populations from the inequitable burden of disease.
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Affiliation(s)
- Amanda Norton
- Department of Geography, Geomatics & Environment, University of Toronto Mississauga, DV3284, 3359 Mississauga Road, Mississauga, ON L5L 1C6, Canada
| | - Scarlett Rakowska
- Department of Geography, Geomatics & Environment, University of Toronto Mississauga, DV3284, 3359 Mississauga Road, Mississauga, ON L5L 1C6, Canada
| | - Tracey Galloway
- Department of Anthropology, University of Toronto Mississauga, HSC354, 3359 Mississauga Road, Mississauga, ON L5L 1C6, Canada
| | - Kathleen Wilson
- Department of Geography, Geomatics & Environment, University of Toronto Mississauga, DV3284, 3359 Mississauga Road, Mississauga, ON L5L 1C6, Canada
| | - Laura Rosella
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, 155 College St, Health Sciences Bldg., 6th floor, Toronto, ON M5T 3M7, Canada
| | - Matthew Adams
- Department of Geography, Geomatics & Environment, University of Toronto Mississauga, DV3284, 3359 Mississauga Road, Mississauga, ON L5L 1C6, Canada.
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Khatoon A, Aslam R, Bilal S, Naz S, Zaffar F, Khan SA, Ramzan RM, Noreen S, Phoolzaib K, Batool Z, Saleem K, Rasheed S. Assessment of risk factors and preventive measure compliance against COVID-19 among healthcare workers at tertiary care hospital: a retrospective study. GMS HYGIENE AND INFECTION CONTROL 2023; 18:Doc09. [PMID: 37261056 PMCID: PMC10227496 DOI: 10.3205/dgkh000435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Introduction SARS-CoV-2 has created a significant challenge to healthcare systems, since the disease has spread rapidly, outweighing hospital capacity and exposing Health Care Workers (HCWs) to the risk of infection. The main objective of this study shows the HCW's self-reported use of Personal Protective Equipment (PPE), symptoms, and exposure to revealed and suspected people during the pandemic, as well as the implementation of infection prevention and control (IPC) guidelines that effectively limit the spread of the infection among healthcare personnel. Method A single-center retrospective cohort study has been done at a tertiary care hospital. There were 3,651 hospital employees of these 1,890 HCWs and 1,761 nonclinical staff among those who were proven or suspected COVID-19 cases and had symptoms were included. The data was gathered using a standardized self-assessment questionnaire. Information about quarantine protocol and line listing was collected through telephonic conversations. Result The majority of the participants were males (66%). The average age was 32.1±7.62. Out of 432 HCWs, 32.9% with positive SARS-CoV-2 PCR findings were nurses, 19.2% were doctors, and 47.9% were non-clinical employees from the hospital's inpatient and outpatient departments. 31.5% had a higher-risk exposure, 64.1% had a moderate-risk exposure, and 4.4% of practitioners with COVID-19 had a lower-risk exposure. A statistically significant association was found between COVID-19 disease and adherence to PPE and risk exposure. Conclusion This study represents the healthcare workers' experience with COVID-19 patients in the early stages of the pandemic and emphasizes the measures required to overcome the problems, however, this study highlights that HCWs are being progressively infected with COVID-19 as a result of inadequate/ inappropriate PPE wear.
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Affiliation(s)
- Arifa Khatoon
- Infection Control Department, Indus Hospital & Health Network, Karachi, Pakistan
| | - Reema Aslam
- Infection Control Department, Indus Hospital & Health Network, Karachi, Pakistan
| | - Shabnam Bilal
- Infection Control Department, Indus Hospital & Health Network, Karachi, Pakistan
| | - Sadia Naz
- Infection Control Department, Indus Hospital & Health Network, Karachi, Pakistan
| | - Farhan Zaffar
- Infection Control Department, Indus Hospital & Health Network, Karachi, Pakistan
| | - Shahbaz Ahmed Khan
- Infection Control Department, Indus Hospital & Health Network, Karachi, Pakistan
| | - Rao Muhammad Ramzan
- Infection Control Department, Indus Hospital & Health Network, Karachi, Pakistan
| | - Saima Noreen
- Infection Control Department, Indus Hospital & Health Network, Karachi, Pakistan
| | - Kiran Phoolzaib
- Infection Control Department, Indus Hospital & Health Network, Karachi, Pakistan
| | - Zahra Batool
- Infection Control Department, Indus Hospital & Health Network, Karachi, Pakistan
| | - Kahsma Saleem
- Infection Control Department, Indus Hospital & Health Network, Karachi, Pakistan
| | - Saba Rasheed
- Infection Control Department, Indus Hospital & Health Network, Karachi, Pakistan
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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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9
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Lan FY, Kasteler SD, Sidossis A, Iliaki E, Buley J, Nathan N, Osgood R, Bruno-Murtha LA, Kales SN. Immunity Acquired From the First Wave of COVID-19 Against Reinfections Up to Omicron Predominance. Mayo Clin Proc 2023; 98:202-203. [PMID: 36603950 PMCID: PMC9640383 DOI: 10.1016/j.mayocp.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 10/02/2022] [Accepted: 11/03/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Fan-Yun Lan
- Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA; Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA; Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Health and Welfare Policy, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Stephen D Kasteler
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA; Air Force Institute of Technology, Wright-Patterson AFB, OH
| | - Amalia Sidossis
- Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA; Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA
| | - Eirini Iliaki
- Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA; Infection Prevention and Infectious Diseases, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA
| | - Jane Buley
- Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA
| | - Neetha Nathan
- Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA
| | - Rebecca Osgood
- Pathology, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA; Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Lou Ann Bruno-Murtha
- Infection Prevention and Infectious Diseases, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA
| | - Stefanos N Kales
- Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA; Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA
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10
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Hâncean MG, Lerner J, Perc M, Oană I, Bunaciu DA, Stoica AA, Ghiţă MC. Occupations and their impact on the spreading of COVID-19 in urban communities. Sci Rep 2022; 12:14115. [PMID: 35982107 PMCID: PMC9387884 DOI: 10.1038/s41598-022-18392-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 08/10/2022] [Indexed: 11/09/2022] Open
Abstract
The current pandemic has disproportionally affected the workforce. To improve our understanding of the role that occupations play in the transmission of COVID-19, we analyse real-world network data that were collected in Bucharest between August 1st and October 31st 2020. The data record sex, age, and occupation of 6895 patients and the 13,272 people they have interacted with, thus providing a social network from an urban setting through which COVID-19 has spread. Quite remarkably, we find that medical occupations have no significant effect on the spread of the virus. Instead, we find common transmission chains to start with infected individuals who hold jobs in the private sector and are connected with non-active alters, such as spouses, siblings, or elderly relatives. We use relational hyperevent models to assess the most likely homophily and network effects in the community transmission. We detect homophily with respect to age and anti-homophily with respect to sex and employability. We note that, although additional data would be welcomed to perform more in-depth network analyses, our findings may help public authorities better target under-performing vaccination campaigns.
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Affiliation(s)
- Marian-Gabriel Hâncean
- Department of Sociology, University of Bucharest, Panduri 90-92, 050663, Bucharest, Romania.
| | - Jürgen Lerner
- Department of Computer and Information Science, University of Konstanz, 78457, Konstanz, Germany.,Human Technology Center, RWTH Aachen University, 52062, Aachen, Germany
| | - Matjaž Perc
- Faculty of Natural Sciences and Mathematics, University of Maribor, Koroška cesta 160, 2000, Maribor, Slovenia.,Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, 404332, Taiwan.,Alma Mater Europaea, Slovenska ulica 17, 2000, Maribor, Slovenia.,Complexity Science Hub Vienna, Josefstädterstraße 39, 1080, Vienna, Austria
| | - Iulian Oană
- Department of Sociology, University of Bucharest, Panduri 90-92, 050663, Bucharest, Romania
| | - David-Andrei Bunaciu
- Department of Sociology, University of Bucharest, Panduri 90-92, 050663, Bucharest, Romania
| | | | - Maria-Cristina Ghiţă
- Department of Sociology, University of Bucharest, Panduri 90-92, 050663, Bucharest, Romania
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11
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Opoku MM, Asante KP, Gyaase S, Teviu EA, Amponsah K, Twum A, Kusi KF, Ampofo AK, Adomako-Boateng F. Risk factors for COVID-19 Virus Infection among Health Workers: A Case-control study in the Bono East Region of Ghana. Am J Infect Control 2022; 51:498-505. [PMID: 35970420 PMCID: PMC9373466 DOI: 10.1016/j.ajic.2022.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/03/2022] [Accepted: 08/04/2022] [Indexed: 11/05/2022]
Abstract
Background Disproportionately high rates of COVID-19 infection among health workers prompts the need to identify the risk factors to help guide the design and implementation of interventions. The aim of this study was to characterize the risk factors for COVID-19 infection among health workers. Methods A case-control study was designed to recruit 154 health workers who tested positive for the COVID-19 virus and 308 who tested negative from 8 hospitals and 11 health directorates in the Bono East Region of Ghana. Crude and adjusted logistic regression analysis was used to determine risk factors. Results Hand hygiene compliance for the recommended moments ranged from 55.3% to 77.4%. Personal protective equipments (PPE) use was 59.5% when patients’ COVID-19 status was unknown and at least 90.7% when patient was positive. We identified years of practice experience (adjusted odds ratio (AOR) = 1.81; 95% CI: 1.07, 3.07; P = .028), adherence to infection prevention and control (IPC) when in contact with patients whose COVID-19 status is unspecified (AOR = 1.71; 95% CI: 1.09, 2.70; P = .020) and type of facility (AOR = 1.69, 95% CI: 1.09, 2.62; P = .019) as risk factors. Conclusion The findings underscore the need for health workers to improve in COVID-19 risk perception.
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Affiliation(s)
- Michael Mireku Opoku
- Department of Epidemiology and Disease Control, School of Public Health, University of Ghana.
| | - Kwaku Poku Asante
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service Kintampo North Muicipality, Bono East Region Ghana
| | - Stephaney Gyaase
- Kintampo Health Research Centre, Research and Development Division, Ghana Health Service Kintampo North Muicipality, Bono East Region Ghana
| | | | | | - Anthony Twum
- Sene West District Hospital, Ghana Health Service, Ghana Health Service
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12
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Clinical and occupational risk factors for coronavirus disease 2019 (COVID-19) in healthcare personnel. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2022; 2:e123. [PMID: 36505949 PMCID: PMC9727206 DOI: 10.1017/ash.2022.250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/25/2022] [Accepted: 04/28/2022] [Indexed: 12/15/2022]
Abstract
Objective To identify characteristics associated with positive severe acute respiratory coronavirus virus 2 (SARS-CoV-2) polymerase chain reaction (PCR) tests in healthcare personnel. Design Retrospective cohort study. Setting A multihospital healthcare system. Participants Employees who reported SARS-CoV-2 exposures and/or symptoms of coronavirus disease 2019 (COVID-19) between March 30, 2020, and September 20, 2020, and were subsequently referred for SARS-CoV-2 PCR testing. Methods Data from exposure and/or symptom reports were linked to the corresponding SARS-CoV-2 PCR test result. Employee demographic characteristics, occupational characteristics, SARS-CoV-2 exposure history, and symptoms were evaluated as potential risk factors for having a positive SARS-CoV-2 PCR test. Results Among 6,289 employees who received SARS-CoV-2 PCR testing, 873 (14%) had a positive test. Independent risk factors for a positive PCR included: working in a patient care area (relative risk [RR], 1.82; 95% confidence interval [CI], 1.37-2.40), having a known SARS-CoV-2 exposure (RR, 1.20; 95% CI, 1.04-1.37), reporting a community versus an occupational exposure (RR, 1.87; 95% CI, 1.49-2.34), and having an infected household contact (RR, 2.47; 95% CI, 2.11-2.89). Nearly all HCP (99%) reported symptoms. Symptoms associated with a positive PCR in a multivariable analysis included loss of sense of smell (RR, 2.60; 95% CI, 2.09-3.24) or taste (RR, 1.75; 95% CI, 1.40-2.20), cough (RR, 1.95; 95% CI, 1.40-2.20), fever, and muscle aches. Conclusions In this cohort of >6,000 healthcare system and academic medical center employees early in the pandemic, community exposures, and particularly household exposures, were associated with greater risk of SARS-CoV-2 infection than occupational exposures. This work highlights the importance of COVID-19 prevention in the community and in healthcare settings to prevent COVID-19.
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13
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Nafilyan V, Pawelek P, Ayoubkhani D, Rhodes S, Pembrey L, Matz M, Coleman M, Allemani C, Windsor-Shellard B, van Tongeren M, Pearce N. Occupation and COVID-19 mortality in England: a national linked data study of 14.3 million adults. Occup Environ Med 2022; 79:433-441. [PMID: 34965981 PMCID: PMC8718934 DOI: 10.1136/oemed-2021-107818] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 12/09/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To estimate occupational differences in COVID-19 mortality and test whether these are confounded by factors such as regional differences, ethnicity and education or due to non-workplace factors, such as deprivation or prepandemic health. METHODS Using a cohort study of over 14 million people aged 40-64 years living in England, we analysed occupational differences in death involving COVID-19, assessed between 24 January 2020 and 28 December 2020.We estimated age-standardised mortality rates (ASMRs) per 100 000 person-years at risk stratified by sex and occupation. We estimated the effect of occupation on COVID-19 mortality using Cox proportional hazard models adjusted for confounding factors. We further adjusted for non-workplace factors and interpreted the residual effects of occupation as being due to workplace exposures to SARS-CoV-2. RESULTS In men, the ASMRs were highest among those working as taxi and cab drivers or chauffeurs at 119.7 deaths per 100 000 (95% CI 98.0 to 141.4), followed by other elementary occupations at 106.5 (84.5 to 132.4) and care workers and home carers at 99.2 (74.5 to 129.4). Adjusting for confounding factors strongly attenuated the HRs for many occupations, but many remained at elevated risk. Adjusting for living conditions reduced further the HRs, and many occupations were no longer at excess risk. For most occupations, confounding factors and mediators other than workplace exposure to SARS-CoV-2 explained 70%-80% of the excess age-adjusted occupational differences. CONCLUSIONS Working conditions play a role in COVID-19 mortality, particularly in occupations involving contact with patients or the public. However, there is also a substantial contribution from non-workplace factors.
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Affiliation(s)
- Vahe Nafilyan
- Health Analysis Division, Office for National Statistics, Newport, UK
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, London, UK
| | - Piotr Pawelek
- Methodology Division, Office for National Statistics, Newport, Newport, UK
| | - Daniel Ayoubkhani
- Methodology Division, Office for National Statistics, Newport, Newport, UK
| | - Sarah Rhodes
- Centre for Biostatistics, School of Health Sciences, Faculty of Biology, Medicine and Health, School of Health Sciences, The University of Manchester, Manchester, Manchester, UK
| | - Lucy Pembrey
- Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Melissa Matz
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, London, UK
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Michel Coleman
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Claudia Allemani
- Cancer Survival Group, Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Martie van Tongeren
- Centre for Occupational and Environmental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, Greater Manchester, UK
| | - Neil Pearce
- Epidemiology and Population Health, London School of Hygiene, London, UK
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14
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Liberman JN, Pesa J, Petrillo MP, Ruetsch C. Factors associated with COVID-19 Infection among a national population of individuals with schizophrenia or schizoaffective disorder in the United States. BMC Psychiatry 2022; 22:376. [PMID: 35655167 PMCID: PMC9161755 DOI: 10.1186/s12888-022-04026-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 05/30/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Individuals with schizophrenia are a vulnerable and under-served population who are also at risk for severe morbidity and mortality following COVID-19 infection. Our research was designed to identify factors that put individuals with schizophrenia at increased risk of COVID-19 infection. METHODS This study was a retrospective cohort analysis of medical and pharmacy claims among 493,796 individuals residing in the United States with schizophrenia or schizoaffective disorder, between January 1, 2019 and June 30, 2020. A confirmed diagnosis of COVID-19 infection by September 30, 2020 was regressed on demographics, social determinants, comorbidity, and pre-pandemic (December 2019 - February 2020) healthcare utilization characteristics. RESULTS A total of 35,249 (7.1%) individuals were diagnosed with COVID-19. Elevated odds of COVID-19 infection were associated with age, increasing consistently from 40-49 years (OR: 1.16) to 80+ years (OR:5.92), male sex (OR: 1.08), Medicaid (OR: 2.17) or Medicare (OR: 1.23) insurance, African American race (OR: 1.42), Hispanic ethnicity (OR: 1.23), and higher Charlson Comorbidity Index. Select psychiatric comorbidities (depressive disorder, adjustment disorder, bipolar disorder, anxiety, and sleep-wake disorder) were associated with elevated odds of infection, while alcohol use disorder and PTSD were associated with lower odds. A pre-pandemic psychiatry (OR:0.56) or community mental health center (OR:0.55) visit were associated with lower odds as was antipsychotic treatment with long-acting injectable antipsychotic (OR: 0.72) and oral antipsychotic (OR: 0.62). CONCLUSIONS Among individuals with schizophrenia, risk of COVID-19 infection was substantially higher among those with fewer economic resources, with greater medical and psychiatric comorbidity burden, and those who resided in African American or Hispanic communities. In contrast, individuals actively engaged in psychiatric treatment had substantially lower likelihood of infection. These results provide insights for healthcare providers that can translate into improved identification of at-risk individuals and interventions to reduce the risk and consequences of COVID-19 infection.
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15
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Lan FY, Sidossis A, Iliaki E, Buley J, Nathan N, Bruno-Murtha LA, Kales SN. Continued effectiveness of COVID-19 vaccination among urban healthcare workers during delta variant predominance. BMC Infect Dis 2022; 22:457. [PMID: 35549891 PMCID: PMC9097140 DOI: 10.1186/s12879-022-07434-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 04/26/2022] [Indexed: 11/18/2022] Open
Abstract
Background Data on COVID-19 vaccine effectiveness (VE) among healthcare workers (HCWs) during periods of delta variant predominance are limited. Methods We followed a population of urban Massachusetts HCWs (45% non-White) subject to epidemiologic surveillance. We accounted for covariates such as demographics and community background infection incidence, as well as information bias regarding COVID-19 diagnosis and vaccination status. Results During the study period (December 16, 2020 to September 30, 2021), 4615 HCWs contributed to a total of 1,152,486 person-days at risk (excluding 309 HCWs with prior infection) and had a COVID-19 incidence rate of 5.2/10,000 (114 infections out of 219,842 person-days) for unvaccinated person-days and 0.6/10,000 (49 infections out of 830,084 person-days) for fully vaccinated person-days, resulting in an adjusted VE of 82.3% (95% CI 75.1–87.4%). For the secondary analysis limited to the period of delta variant predominance in Massachusetts (i.e., July 1 to September 30, 2021), we observed an adjusted VE of 76.5% (95% CI 40.9–90.6%). Independently, we found no re-infection among those with prior COVID-19, contributing to 74,557 re-infection-free person-days, adding to the evidence base for the robustness of naturally acquired immunity. Conclusions We found a VE of 76.5% against the delta variant. Our work also provides further evidence of naturally acquired immunity.
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Affiliation(s)
- Fan-Yun Lan
- Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Macht Building 427, 1493 Cambridge Street, Cambridge, MA, 02139, USA.,Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA, USA.,Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Amalia Sidossis
- Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Macht Building 427, 1493 Cambridge Street, Cambridge, MA, 02139, USA.,Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA, USA
| | - Eirini Iliaki
- Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Macht Building 427, 1493 Cambridge Street, Cambridge, MA, 02139, USA.,Infection Prevention and Infectious Diseases, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA
| | - Jane Buley
- Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Macht Building 427, 1493 Cambridge Street, Cambridge, MA, 02139, USA
| | - Neetha Nathan
- Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Macht Building 427, 1493 Cambridge Street, Cambridge, MA, 02139, USA
| | - Lou Ann Bruno-Murtha
- Infection Prevention and Infectious Diseases, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA
| | - Stefanos N Kales
- Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Macht Building 427, 1493 Cambridge Street, Cambridge, MA, 02139, USA. .,Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA, USA.
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16
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Jiang L, Tang K, Irfan O, Li X, Zhang E, Bhutta Z. Epidemiology, Clinical Features, and Outcomes of Multisystem Inflammatory Syndrome in Children (MIS-C) and Adolescents—a Live Systematic Review and Meta-analysis. CURRENT PEDIATRICS REPORTS 2022; 10:19-30. [PMID: 35540721 PMCID: PMC9072767 DOI: 10.1007/s40124-022-00264-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/23/2022] [Indexed: 12/15/2022]
Abstract
Purpose of Review A multisystem inflammatory condition occurring in children and adolescents with COVID-19 has become increasingly recognized and widely studied globally. This review aims to investigate and synthesize evolving evidence on its clinical characteristics, management, and outcomes in pediatric patients. Recent Findings We retrieved data from PubMed, EMBASE, Cochrane Library, WHO COVID-19 Database, Google Scholar, and preprint databases, covering a timeline from December 1, 2019, to July 31, 2021. A total of 123 eligible studies were included in the final descriptive and risk factor analyses. We comprehensively reviewed reported multisystem inflammatory syndrome in children (MIS-C) cases from published and preprint studies of various designs to provide an updated evidence on epidemiology, clinical, laboratory and imaging findings, management, and short-term outcomes. Latest evidence suggests that African black and non-Hispanic white are the two most common ethnic groups, constituting 24.89% (95% CI 23.30–26.48%) and 25.18% (95% CI 23.51–26.85%) of the MIS-C population, respectively. Typical symptoms of MIS-C include fever (90.85%, 95% CI 89.86–91.84%), not-specified gastrointestinal symptoms (51.98%, 95% CI 50.13–53.83%), rash (49.63%, 95% CI 47.80–51.47%), abdominal pain (48.97%, 95% CI 47.09–50.85%), conjunctivitis (46.93%, 95% CI 45.17–48.69%), vomiting (43.79%, 95% CI 41.90–45.68%), respiratory symptoms (41.75%, 95% CI 40.01–43.49%), and diarrhea (40.10%, 95% CI 38.23–41.97%). MIS-C patients are less likely to develop conjunctivitis (OR 0.27, 95% CI 0.11–0.67), cervical adenopathy (OR 0.21, 95% CI 0.07–0.68), and rash (OR 0.44, 95% CI 0.26–0.77), in comparison with Kawasaki disease patients. Our review revealed that the majority of MIS-C cases (95.21%) to be full recovered while only 2.41% died from this syndrome. We found significant disparity between low- and middle-income countries and high-income countries in terms of clinical outcomes. Summary MIS-C, which appears to be linked to COVID-19, may cause severe inflammation in organs and tissues. Although there is emerging new evidence about the characteristics of this syndrome, its risk factors, and clinical prognosis, much remains unknown about the causality, the optimal prevention and treatment interventions, and long-term outcomes of the MIS-C patients. Supplementary Information The online version contains supplementary material available at 10.1007/s40124-022-00264-1.
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Affiliation(s)
- Li Jiang
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada
| | - Kun Tang
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Omar Irfan
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada
| | - Xuan Li
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Enyao Zhang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical, Peking University, Beijing, China
| | - Zulfiqar Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada
- Institute for Global Health & Development, the Aga Khan University, Karachi, Pakistan
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17
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Speiser E, Pinto Zipp G, DeLuca DA, Cupertino AP, Arana-Chicas E, Gourna Paleoudis E, Kligler B, Cartujano-Barrera F. Knowledge, attitudes and behaviors of Latinas in cleaning occupations in northern New Jersey: a cross-sectional mixed methods study. J Occup Med Toxicol 2021; 16:52. [PMID: 34872565 PMCID: PMC8646340 DOI: 10.1186/s12995-021-00343-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 10/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the United States, 88.3% of all 1,163,000 maids and housekeeping cleaners are female, and approximately half of them Latinas. Latinas are understudied and underrepresented in health research, particularly involving chemical exposure in cleaning practices, lack of job training, and inadequate access to personal protective equipment. The purpose of this study is twofold: 1) to examine the knowledge (via training experiences), attitudes and behaviors of a heterogeneous group of Latinas who clean occupationally and 2) to assess their cleaning practices at work and at home. METHODS This mixed-method study consisted of two phases: 1) three focus groups to explore knowledge (via training experiences), attitudes, and behaviors regarding cleaning practices (N = 15) and 2) a 43-question cross-sectional survey. Focus group audio recordings were analyzed using descriptive and in vivo coding and then coded inductively to explore thematic analysis. Statistical analysis of the survey evaluated means, frequency and percentage for each of the responses. RESULTS Participants (n = 9) were women (mean age = 48.78 and SD = 6.72) from South America (n = 5), Mexico (n = 1), El Salvador (n = 1) and Dominican Republic (n = 2). The mean length of time living in the US was 18.78 years and over half (55.6%) worked in the cleaning industry for 10 or more years. Findings from the three focus groups (n = 15) included that training in cleaning often occurred informally at a very young age at home. Participants reported cleaning in groups where tasks are rotated and/or shared. Most were the primary person cleaning at home, suggesting increased exposure. Gloves and masks were the most frequently used PPE, but use was not consistent. For participants who purchase their own products, driving factors included price, smell and efficacy. Some participants used products supplied or preferred by the employer. CONCLUSIONS Latinas in cleaning occupations face a range of social and health barriers including lack of safety and health training, inadequate PPE and low literacy. To address these issues, the development of an intervention is warranted to provide training and resources for this critical population of essential workers.
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Affiliation(s)
- Erin Speiser
- The Deirdre Imus Environmental Health Center®, Hackensack University Medical Center, Hackensack, NJ USA
| | - Genevieve Pinto Zipp
- Department of Interprofessional Health Sciences & Health Administration, School of Health and Medical Sciences, Seton Hall University, Nutley, NJ USA
| | - Deborah A. DeLuca
- Department of Interprofessional Health Sciences & Health Administration, School of Health and Medical Sciences, Seton Hall University, Nutley, NJ USA
| | - Ana Paula Cupertino
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY USA
| | - Evelyn Arana-Chicas
- James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY USA
| | | | - Benjamin Kligler
- The Deirdre Imus Environmental Health Center®, Hackensack University Medical Center, Hackensack, NJ USA
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18
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Iliaki E, Lan FY, Christophi CA, Guidotti G, Jobrack AD, Buley J, Osgood R, Bruno-Murtha LA, Kales SN. COVID-19 Vaccine Effectiveness in a Diverse Urban Health Care Worker Population. Mayo Clin Proc 2021; 96:3180-3182. [PMID: 34863402 PMCID: PMC8523483 DOI: 10.1016/j.mayocp.2021.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 10/11/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Eirini Iliaki
- Occupational Medicine, Infection Prevention and Infectious Diseases, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA
| | - Fan-Yun Lan
- Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA; Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA; Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Costas A Christophi
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus; Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA
| | - Guido Guidotti
- Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA; Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA
| | - Alexander D Jobrack
- Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA; Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA
| | - Jane Buley
- Neetha Nathan, Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA
| | - Rebecca Osgood
- Pathology, Cambridge Health Alliance, Harvard Medical School, Cambridge MA; Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Lou Ann Bruno-Murtha
- Infection Prevention and Infectious Diseases, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA
| | - Stefanos N Kales
- Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA; Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA
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19
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Lepak AJ, Buys A, Stevens L, LeClair-Netzel M, Anderson L, Osman F, Brennan MB, Bartels CM, Safdar N. COVID-19 in Health Care Personnel: Significance of Health Care Role, Contact History, and Symptoms in Those Who Test Positive for SARS-CoV-2 Infection. Mayo Clin Proc 2021; 96:2312-2322. [PMID: 34366140 PMCID: PMC8249700 DOI: 10.1016/j.mayocp.2021.06.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 04/14/2021] [Accepted: 06/25/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To identify significant factors that help predict whether health care personnel (HCP) will test positive for severe acute respiratory coronavirus 2 (SARS-CoV-2). PATIENTS AND METHODS We conducted a prospective cohort study among 7015 symptomatic HCP from March 25, 2020, through November 11, 2020. We analyzed the associations between health care role, contact history, symptoms, and a positive nasopharyngeal swab SARS-CoV-2 polymerase chain reaction test results, using univariate and multivariable modelling. RESULTS Of the symptomatic HCP, 624 (8.9%) were positive over the study period. On multivariable analysis, having a health care role other than physician or advanced practice provider, contact with family or community member with known or suspected coronavirus disease 2019 (COVID-19), and seven individual symptoms (cough, anosmia, ageusia, fever, myalgia, chills, and headache) were significantly associated with higher adjusted odds ratios for testing positive for SARS-CoV-2. For each increase in symptom number, the odds of testing positive nearly doubled (odds ratio, 1.93; 95% CI, 1.82 to 2.07, P<.001). CONCLUSION Symptomatic HCP have higher adjusted odds of testing positive for SARS-CoV-2 based on three distinct factors: (1) nonphysician/advanced practice provider role, (2) contact with a family or community member with suspected or known COVID-19, and (3) specific symptoms and symptom number. Differences among health care roles, which persisted after controlling for contacts, may reflect the influence of social determinants. Contacts with COVID-19-positive patients and/or HCP were not associated with higher odds of testing positive, supporting current infection control efforts. Targeted symptom and contact questionnaires may streamline symptomatic HCP testing for COVID-19.
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Key Words
- app, advanced practice provider
- astm, american society for testing and materials (formerly)
- cdc, centers for disease control and prevention
- covid-19, coronavirus disease 2019
- hcp, health care personnel
- irb, institutional review board
- ma, medical assistant
- np, nasopharyngeal
- or, odds ratio
- pcr, polymerase chain reaction
- ppe, personal protective equipment
- rt-pcr, real-time polymerase chain reaction
- sars-cov-2, severe acute respiratory syndrome coronavirus 2
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Affiliation(s)
- Alexander J Lepak
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
| | - Ashley Buys
- Infection Control Department, UW Health University Hospital, Madison, WI, USA
| | - Linda Stevens
- Nursing Quality and Safety, UW Health University Hospital, Madison, WI, USA
| | | | - Laura Anderson
- Infection Control, University of Wisconsin Medical Foundation, Inc, Madison, WI, USA
| | - Fauzia Osman
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Meghan B Brennan
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Christie M Bartels
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Nasia Safdar
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; William S. Middleton Memorial Veterans Affairs Medical Center, Madison, WI, USA
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20
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Chou R, Dana T, Buckley DI, Selph S, Fu R, Totten AM. Update Alert 8: Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers. Ann Intern Med 2021; 174:W48-W49. [PMID: 33780293 PMCID: PMC8017477 DOI: 10.7326/l21-0143] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Roger Chou
- Pacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, Oregon
| | - Tracy Dana
- Pacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, Oregon
| | - David I Buckley
- Pacific Northwest Evidence-based Practice Center and School of Public Health, Oregon Health & Science University-Portland State University, Portland, Oregon
| | - Shelley Selph
- Pacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, Oregon
| | - Rongwei Fu
- Pacific Northwest Evidence-based Practice Center and School of Public Health, Oregon Health & Science University-Portland State University, Portland, Oregon
| | - Annette M Totten
- Pacific Northwest Evidence-based Practice Center and Oregon Health & Science University, Portland, Oregon
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21
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Bruno-Murtha LA, Osgood R, Lan FY, Buley J, Nathan N, Weiss M, MacDonald M, Kales SN, Sayah AJ. SARS-CoV-2 antibody seroprevalence after the first wave among workers at a community healthcare system in the Greater Boston area. Pathog Glob Health 2021; 115:331-334. [PMID: 33729103 PMCID: PMC8547825 DOI: 10.1080/20477724.2021.1901041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
SARS-CoV-2 antibody seroprevalence among health-care workers (HCW) can assess past exposure and possible immunity, which varies across different regions, populations and times. We investigated the seroprevalence among HCW in Massachusetts (a region suffering high COVID-19 mortality) at the end of first wave of the SARS-CoV-2 pandemic. All HCW at Cambridge Health Alliance were invited to participate in this cross-sectional survey in June 2020. Those who volunteered, consented and provided a blood sample were included. Dried blood specimens from finger-prick sampling collected either at home by each HCW or onsite by the study team were analyzed for anti-SARS-CoV-2 IgM and IgG to the virus’ receptor binding domain, using an enzyme-linked immunosorbent assay. IgM and IgG antibody abundance were categorized based on the number of standard deviations above the cross-reacting levels found in existing, pre-pandemic blood samples previously obtained by the Ragon Institute and analyzed by the Broad Institute (Cambridge, MA). Seroprevalence estimates were made based on ‘positive’ IgM or IgG using ‘low’ (>6 SD), ‘medium’ (>4.5 SD), and ‘high’ prevalence cutoffs (>3 SD). A total of 433 out of 5,204 eligible HCWs consented and provided samples. Participating HCWs had a lower cumulative incidence (from the start of the pandemic up to the bloodspot collections) of SARS-CoV-2 RT-PCR positivity (1.85%) compared to non-participants (3.29%). The low, medium, and high seroprevalence estimates were 8.1%, 11.3%, and 14.5%, respectively. The weighted estimates based on past PCR positivity were 13.9%, 19.4%, and 24.9%, respectively, for the entire healthcare system population after accounting for participation bias.
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Affiliation(s)
- Lou Ann Bruno-Murtha
- Department of Medicine and Quality, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA
| | - Rebecca Osgood
- Department of Pathology, Cambridge Health Alliance Harvard Medical School, Cambridge, MA, USA
| | - Fan-Yun Lan
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA, USA.,Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA
| | - Jane Buley
- Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA
| | - Neetha Nathan
- Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA
| | - Michelle Weiss
- Information Technology, Cambridge Health Alliance, Cambridge, MA, USA
| | - Mary MacDonald
- Information Technology, Cambridge Health Alliance, Cambridge, MA, USA
| | - Stefanos N Kales
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA, USA.,Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA
| | - Assaad J Sayah
- Department of Emergency Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA.,Cambridge Department of Public Health, Cambridge, MA, USA
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