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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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Collis B, Tacey M, McGrath C, Madigan V, Kainer M, Tramontana A, Aboltins C. P2/N95 fit testing and the risk of COVID-19 in Healthcare Workers. Infect Dis Health 2024; 29:8-14. [PMID: 37573216 DOI: 10.1016/j.idh.2023.07.005] [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: 04/19/2023] [Revised: 07/23/2023] [Accepted: 07/23/2023] [Indexed: 08/14/2023]
Abstract
BACKGROUND Guidelines recommend healthcare workers (HCWs) undertake fit testing of P2/N95 respirators to mitigate the risk of infectious aerosols, however few studies have assessed whether fit testing reduces COVID-19 infection. METHODS A retrospective cohort study was conducted amongst HCWs across two tertiary health services in Melbourne, Australia during a period of low community transmission. Institution-wide quantitative fit testing and detailed questionnaires assessing COVID-19 acquisition risk factors were undertaken from September 2020. HCWs diagnosed with COVID-19 in the period prior to the fit testing program (February 1st - August 31st 2020) were matched on a 1:3 ratio to HCWs who had not been diagnosed with COVID-19. Risk factors for COVID-19 acquisition, including fit testing outcome, were compared between groups. RESULTS A total of 1571 HCWs took part in fit testing programs. Seventy-two (4.6%) were diagnosed with COVID-19 within the study period. Younger age, nursing staff, close contact with a COVID-19 case, and working longer periods in wards with COVID-19 patients, were associated with COVID-19 infection. After matching for intensity of occupational exposure to infectious aerosols, close contact was the only independent variable associated with COVID-19 infection (OR 3.50, 95% CI:1.65-7.44, p = 0.001). Adequate fit test for the respirator predominately worn before the fit testing period was not associated with COVID-19 (OR 1.08, 95% CI:0.59-1.98, p = 0.815). CONCLUSION After controlling for intensity of occupational exposure to infectious aerosols, P2/N95 respirator fit testing was not associated with reduced risk of COVID-19 infection. The utility of widespread fit testing to reduce HCW COVID-19 infections should be reconsidered.
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Affiliation(s)
- Brennan Collis
- Department of Infectious Diseases, The Northern Hospital, 185 Cooper Street, Epping, Victoria, 3076, Australia.
| | - Mark Tacey
- Department of Infectious Diseases, The Northern Hospital, 185 Cooper Street, Epping, Victoria, 3076, Australia; Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Victoria, 3053, Australia
| | - Christian McGrath
- Department of Infectious Diseases, The Northern Hospital, 185 Cooper Street, Epping, Victoria, 3076, Australia
| | - Victoria Madigan
- Department of Infectious Diseases, The Northern Hospital, 185 Cooper Street, Epping, Victoria, 3076, Australia
| | - Marion Kainer
- Department of Infectious Diseases, Western Health, 176 Furlong Road, St. Albans, Victoria, 3021, Australia
| | - Adrian Tramontana
- Department of Infectious Diseases, Western Health, 176 Furlong Road, St. Albans, Victoria, 3021, Australia
| | - Craig Aboltins
- Department of Infectious Diseases, The Northern Hospital, 185 Cooper Street, Epping, Victoria, 3076, Australia; Northern Clinical School, The University of Melbourne, 185 Cooper Street, Epping, Victoria, 3076, Australia
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Joo Y, Kim DK, Jeon YG, Kim AR, Do HN, Yoon SY, Kim JS, Jung SW, Hwang HS, Moon JY, Jeong KH, Lee SH, Kang SY, Kim YG. Comparison of Humoral Response between Third and Fourth Doses of COVID-19 Vaccine in Hemodialysis Patients. Vaccines (Basel) 2023; 11:1584. [PMID: 37896987 PMCID: PMC10610999 DOI: 10.3390/vaccines11101584] [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: 09/07/2023] [Revised: 10/03/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
Dialysis patients are more likely to die or become hospitalized from coronavirus disease 2019 (COVID-19). Currently, only a few studies have evaluated the efficacy of a fourth booster vaccination in hemodialysis (HD) patients and there is not enough evidence to recommend for or against a fourth booster vaccination. This study compared the humoral response and disease severity of patients on HD who received either three or four doses of COVID-19 vaccine. A total of 88 patients were enrolled. Humoral response to vaccination was measured by quantifying immunoglobulin G levels against the receptor binding domain of SARS-CoV-2 (anti-RBD IgG) at five different times and plaque reduction neutralization tests (PRNT) at two different times after vaccination over a period of 18 months. Antibody levels were measured at approximately two-month intervals after the first and second dose, then four months after the third dose, and then one to six months after the fourth dose of vaccine. PRNT was performed two months after the second and four months after the third dose of vaccine. We classified patients into four groups according to the number of vaccine doses and presence of COVID-19 infection. Severe infection was defined as hospital admission for greater than or equal to two weeks or death. There was no difference in antibody levels between naïve and infected patients except after a fourth vaccination, which was effective for increasing antibodies in infection-naïve patients. Age, sex, body mass index (BMI), dialysis vintage, and presence of diabetes mellitus (DM) did not show a significant correlation with antibody levels. Four patients who experienced severe COVID-19 disease tended to have lower antibody levels prior to infection. A fourth dose of SARS-CoV-2 vaccine significantly elevated antibodies in infection-naïve HD patients and may be beneficial for HD patients who have not been previously infected with SARS-CoV-2 for protection against severe infection.
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Affiliation(s)
- Yoosun Joo
- Division of Nephrology, Department of Internal Medicine, Kyung Hee University College of Medicine, Kyung Hee University Hospital at Gangdong, Seoul 05278, Republic of Korea; (Y.J.); (S.W.J.); (J.-Y.M.); (S.-H.L.)
| | - Dae Kyu Kim
- Division of Nephrology, Department of Internal Medicine, Kyung Hee University College of Medicine, Kyung Hee University Medical Center, Seoul 02447, Republic of Korea; (D.K.K.); (S.-Y.Y.); (J.S.K.); (H.S.H.); (K.H.J.)
| | - Yun Gi Jeon
- Honorshill Hospital, Gimpo-si 10035, Republic of Korea;
| | - Ah-Ra Kim
- Division of Vaccine Clinical Research Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju 34142, Republic of Korea; (A.-R.K.); (H.N.D.)
| | - Hyeon Nam Do
- Division of Vaccine Clinical Research Center for Vaccine Research, National Institute of Infectious Diseases, Cheongju 34142, Republic of Korea; (A.-R.K.); (H.N.D.)
| | - Soo-Young Yoon
- Division of Nephrology, Department of Internal Medicine, Kyung Hee University College of Medicine, Kyung Hee University Medical Center, Seoul 02447, Republic of Korea; (D.K.K.); (S.-Y.Y.); (J.S.K.); (H.S.H.); (K.H.J.)
| | - Jin Sug Kim
- Division of Nephrology, Department of Internal Medicine, Kyung Hee University College of Medicine, Kyung Hee University Medical Center, Seoul 02447, Republic of Korea; (D.K.K.); (S.-Y.Y.); (J.S.K.); (H.S.H.); (K.H.J.)
| | - Su Woong Jung
- Division of Nephrology, Department of Internal Medicine, Kyung Hee University College of Medicine, Kyung Hee University Hospital at Gangdong, Seoul 05278, Republic of Korea; (Y.J.); (S.W.J.); (J.-Y.M.); (S.-H.L.)
| | - Hyeon Seok Hwang
- Division of Nephrology, Department of Internal Medicine, Kyung Hee University College of Medicine, Kyung Hee University Medical Center, Seoul 02447, Republic of Korea; (D.K.K.); (S.-Y.Y.); (J.S.K.); (H.S.H.); (K.H.J.)
| | - Ju-Young Moon
- Division of Nephrology, Department of Internal Medicine, Kyung Hee University College of Medicine, Kyung Hee University Hospital at Gangdong, Seoul 05278, Republic of Korea; (Y.J.); (S.W.J.); (J.-Y.M.); (S.-H.L.)
| | - Kyung Hwang Jeong
- Division of Nephrology, Department of Internal Medicine, Kyung Hee University College of Medicine, Kyung Hee University Medical Center, Seoul 02447, Republic of Korea; (D.K.K.); (S.-Y.Y.); (J.S.K.); (H.S.H.); (K.H.J.)
| | - Sang-Ho Lee
- Division of Nephrology, Department of Internal Medicine, Kyung Hee University College of Medicine, Kyung Hee University Hospital at Gangdong, Seoul 05278, Republic of Korea; (Y.J.); (S.W.J.); (J.-Y.M.); (S.-H.L.)
| | - So-Young Kang
- Department of Laboratory Medicine, Kyung Hee University College of Medicine, Kyung Hee University Hospital at Gangdong, Seoul 05278, Republic of Korea;
| | - Yang Gyun Kim
- Division of Nephrology, Department of Internal Medicine, Kyung Hee University College of Medicine, Kyung Hee University Hospital at Gangdong, Seoul 05278, Republic of Korea; (Y.J.); (S.W.J.); (J.-Y.M.); (S.-H.L.)
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Boulos L, Curran JA, Gallant A, Wong H, Johnson C, Delahunty-Pike A, Saxinger L, Chu D, Comeau J, Flynn T, Clegg J, Dye C. Effectiveness of face masks for reducing transmission of SARS-CoV-2: a rapid systematic review. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2023; 381:20230133. [PMID: 37611625 PMCID: PMC10446908 DOI: 10.1098/rsta.2023.0133] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 05/23/2023] [Indexed: 08/25/2023]
Abstract
This rapid systematic review of evidence asks whether (i) wearing a face mask, (ii) one type of mask over another and (iii) mandatory mask policies can reduce the transmission of SARS-CoV-2 infection, either in community-based or healthcare settings. A search of studies published 1 January 2020-27 January 2023 yielded 5185 unique records. Due to a paucity of randomized controlled trials (RCTs), observational studies were included in the analysis. We analysed 35 studies in community settings (three RCTs and 32 observational) and 40 in healthcare settings (one RCT and 39 observational). Ninety-five per cent of studies included were conducted before highly transmissible Omicron variants emerged. Ninety-one per cent of observational studies were at 'critical' risk of bias (ROB) in at least one domain, often failing to separate the effects of masks from concurrent interventions. More studies found that masks (n = 39/47; 83%) and mask mandates (n = 16/18; 89%) reduced infection than found no effect (n = 8/65; 12%) or favoured controls (n = 1/65; 2%). Seven observational studies found that respirators were more protective than surgical masks, while five found no statistically significant difference between the two mask types. Despite the ROB, and allowing for uncertain and variable efficacy, we conclude that wearing masks, wearing higher quality masks (respirators), and mask mandates generally reduced SARS-CoV-2 transmission in these study populations. This article is part of the theme issue 'The effectiveness of non-pharmaceutical interventions on the COVID-19 pandemic: the evidence'.
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Affiliation(s)
- Leah Boulos
- Maritime SPOR SUPPORT Unit, Nova Scotia Health, 5790 University Avenue, Halifax, Nova Scotia B3H 1V7, Canada
- IWK Health Centre, 5980 University Avenue, Halifax, Nova Scotia B3K 6R8, Canada
| | - Janet A. Curran
- IWK Health Centre, 5980 University Avenue, Halifax, Nova Scotia B3K 6R8, Canada
- School of Nursing, Dalhousie University, 6299 South Street, Halifax, Nova Scotia B3H 4R2, Canada
| | - Allyson Gallant
- IWK Health Centre, 5980 University Avenue, Halifax, Nova Scotia B3K 6R8, Canada
- Faculty of Health, Dalhousie University, 6299 South Street, Halifax, Nova Scotia B3H 4R2, Canada
| | - Helen Wong
- IWK Health Centre, 5980 University Avenue, Halifax, Nova Scotia B3K 6R8, Canada
- Faculty of Health, Dalhousie University, 6299 South Street, Halifax, Nova Scotia B3H 4R2, Canada
| | - Catherine Johnson
- IWK Health Centre, 5980 University Avenue, Halifax, Nova Scotia B3K 6R8, Canada
- Department of Health and Rehabilitation Services, Western University, 1151 Richmond Street, London, Ontario N6A 3K7, Canada
| | | | - Lynora Saxinger
- Division of Infectious Diseases, Departments of Medicine and Medical Microbiology and Immunology, University of Alberta, 116 Street & 85 Avenue, Edmonton, Alberta T6G 2R3, Canada
| | - Derek Chu
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4L8, Canada
- Department of Medicine, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4L8, Canada
- The Research Institute of St Joe's Hamilton, St Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, Ontario L8N A46, Canada
| | - Jeannette Comeau
- Division of Infectious Diseases, Dalhousie University, 6299 South Street, Halifax, Nova Scotia B3H 4R2, Canada
| | - Trudy Flynn
- Patient/Public Partner, University of Oxford, 11A Mansfield Road, Oxford OX1 3SZ, UK
| | - Julie Clegg
- Patient/Public Partner, University of Oxford, 11A Mansfield Road, Oxford OX1 3SZ, UK
| | - Christopher Dye
- Department of Biology, University of Oxford, 11A Mansfield Road, Oxford OX1 3SZ, UK
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Bansal A, Trieu MC, Mohn KGI, Madsen A, Olofsson JS, Sandnes HH, Sævik M, Søyland H, Hansen L, Onyango TB, Tøndel C, Brokstad KA, Syre H, Riis ÅG, Langeland N, Cox RJ. Risk assessment and antibody responses to SARS-CoV-2 in healthcare workers. Front Public Health 2023; 11:1164326. [PMID: 37546332 PMCID: PMC10402899 DOI: 10.3389/fpubh.2023.1164326] [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: 02/12/2023] [Accepted: 06/22/2023] [Indexed: 08/08/2023] Open
Abstract
Background Preventing infection in healthcare workers (HCWs) is crucial for protecting healthcare systems during the COVID-19 pandemic. Here, we investigated the seroepidemiology of SARS-CoV-2 in HCWs in Norway with low-transmission settings. Methods From March 2020, we recruited HCWs at four medical centres. We determined infection by SARS-CoV-2 RT-PCR and serological testing and evaluated the association between infection and exposure variables, comparing our findings with global data in a meta-analysis. Anti-spike IgG antibodies were measured after infection and/or vaccination in a longitudinal cohort until June 2021. Results We identified a prevalence of 10.5% (95% confidence interval, CI: 8.8-12.3) in 2020 and an incidence rate of 15.0 cases per 100 person-years (95% CI: 12.5-17.8) among 1,214 HCWs with 848 person-years of follow-up time. Following infection, HCWs (n = 63) mounted durable anti-spike IgG antibodies with a half-life of 4.3 months since their seropositivity. HCWs infected with SARS-CoV-2 in 2020 (n = 46) had higher anti-spike IgG titres than naive HCWs (n = 186) throughout the 5 months after vaccination with BNT162b2 and/or ChAdOx1-S COVID-19 vaccines in 2021. In a meta-analysis including 20 studies, the odds ratio (OR) for SARS-CoV-2 seropositivity was significantly higher with household contact (OR 12.6; 95% CI: 4.5-35.1) and occupational exposure (OR 2.2; 95% CI: 1.4-3.2). Conclusion We found high and modest risks of SARS-CoV-2 infection with household and occupational exposure, respectively, in HCWs, suggesting the need to strengthen infection prevention strategies within households and medical centres. Infection generated long-lasting antibodies in most HCWs; therefore, we support delaying COVID-19 vaccination in primed HCWs, prioritising the non-infected high-risk HCWs amid vaccine shortage.
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Affiliation(s)
- Amit Bansal
- Department of Clinical Science, Influenza Centre, University of Bergen, Bergen, Norway
| | - Mai-Chi Trieu
- Department of Clinical Science, Influenza Centre, University of Bergen, Bergen, Norway
| | - Kristin G. I. Mohn
- Department of Clinical Science, Influenza Centre, University of Bergen, Bergen, Norway
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Anders Madsen
- Department of Clinical Science, Influenza Centre, University of Bergen, Bergen, Norway
| | - Jan Stefan Olofsson
- Department of Clinical Science, Influenza Centre, University of Bergen, Bergen, Norway
| | | | - Marianne Sævik
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Hanne Søyland
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
| | - Lena Hansen
- Department of Clinical Science, Influenza Centre, University of Bergen, Bergen, Norway
| | | | - Camilla Tøndel
- Department of Clinical Science, Influenza Centre, University of Bergen, Bergen, Norway
- Department of Paediatrics, Haukeland University Hospital, Bergen, Norway
| | - Karl Albert Brokstad
- Department of Clinical Science, Influenza Centre, University of Bergen, Bergen, Norway
- Department of Safety, Chemistry and Biomedical Laboratory Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | | | - Heidi Syre
- Department of Medical Microbiology, Stavanger University Hospital, Stavanger, Norway
| | - Åse Garløv Riis
- Department of Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Nina Langeland
- Department of Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Rebecca Jane Cox
- Department of Clinical Science, Influenza Centre, University of Bergen, Bergen, Norway
- Department of Microbiology, Haukeland University Hospital, Bergen, Norway
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Soegiarto G, Mahdi BA, Wulandari L, Fahmita KD, Hadmoko ST, Gautama HI, Prasetyaningtyas D, Prasetyo ME, Negoro PP, Arafah N, Purnomosari D, Tinduh D, Husada D, Baskoro A, Fetarayani D, Nurani WK, Oceandy D. Evaluation of Antibody Response and Adverse Effects following Heterologous COVID-19 Vaccine Booster with mRNA Vaccine among Healthcare Workers in Indonesia. Vaccines (Basel) 2023; 11:1160. [PMID: 37514976 PMCID: PMC10386191 DOI: 10.3390/vaccines11071160] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/19/2023] [Accepted: 06/23/2023] [Indexed: 07/30/2023] Open
Abstract
Background: The administration of the third (or booster) dose of COVID-19 vaccine is important in maintaining protection against SARS-CoV-2 infection or the severity of the disease. In Indonesia, health care workers (HCWs) are among the first to receive a booster dose of the COVID-19 vaccine. In this study, we evaluated the antibody response and adverse events following heterologous booster vaccine using mRNA-1273 among HCWs that were fully vaccinated with inactivated viral vaccine as the priming doses. Methods: 75 HCWs at Dr. Soetomo General Hospital in Surabaya, Indonesia, participated in this study. The level of antibody against the SARS-CoV-2 receptor binding domain was analyzed at 1, 3, and 5 months following the second priming dose and at 1, 3, and 5 months after the booster dose. Results: We found a significantly higher level of antibody response in subjects receiving a booster dose of the mRNA-1273 vaccine compared to those receiving an inactivated viral vaccine as a booster. Interestingly, participants with hypertension and a history of diabetes mellitus showed a lower antibody response following the booster dose. There was a higher frequency of adverse events following injection with the mRNA-1273 vaccine compared to the inactivated viral vaccine, although the overall adverse events were considered minor. Conclusions: A heterologous booster dose using mRNA vaccine resulted in a high antibody response; however, participants with hypertension and diabetes mellitus displayed a lower antibody response.
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Affiliation(s)
- Gatot Soegiarto
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Academic Hospital, Surabaya 60132, Indonesia
- Postgraduate School, Master Program on Immunology, Universitas Airlangga, Surabaya 60132, Indonesia
| | - Bagus Aulia Mahdi
- Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Academic Hospital, Surabaya 60132, Indonesia
| | - Laksmi Wulandari
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Academic Hospital, Surabaya 60132, Indonesia
| | - Karin Dhia Fahmita
- Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Academic Hospital, Surabaya 60132, Indonesia
| | - Satrio Tri Hadmoko
- Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Academic Hospital, Surabaya 60132, Indonesia
| | - Hendra Ikhwan Gautama
- Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Academic Hospital, Surabaya 60132, Indonesia
| | - Dewi Prasetyaningtyas
- Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Academic Hospital, Surabaya 60132, Indonesia
| | - Muhammad Edwin Prasetyo
- Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Academic Hospital, Surabaya 60132, Indonesia
| | - Pujo Prawiro Negoro
- Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Academic Hospital, Surabaya 60132, Indonesia
| | - Nur Arafah
- Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Academic Hospital, Surabaya 60132, Indonesia
| | - Dewajani Purnomosari
- Department of Histology and Cell Biology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
| | - Damayanti Tinduh
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Academic Hospital, Surabaya 60132, Indonesia
| | - Dominicus Husada
- Department of Child Health, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Academic Hospital, Surabaya 60132, Indonesia
| | - Ari Baskoro
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Academic Hospital, Surabaya 60132, Indonesia
| | - Deasy Fetarayani
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Academic Hospital, Surabaya 60132, Indonesia
| | - Wita Kartika Nurani
- Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Academic Hospital, Surabaya 60132, Indonesia
| | - Delvac Oceandy
- Division of Cardiovascular Sciences, Faculty of Biology Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester M13 9PT, UK
- Department of Biomedical Science, Faculty of Medicine, Universitas Airlangga, Surabaya 60132, Indonesia
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Chou R, Dana T. Major Update: Masks for Prevention of SARS-CoV-2 in Health Care and Community Settings-Final Update of a Living, Rapid Review. Ann Intern Med 2023; 176:827-835. [PMID: 37186920 PMCID: PMC10234287 DOI: 10.7326/m23-0570] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Optimal use of masks for preventing COVID-19 is unclear. PURPOSE To update an evidence synthesis on N95, surgical, and cloth mask effectiveness in community and health care settings for preventing SARS-CoV-2 infection. DATA SOURCES MEDLINE, EMBASE, medRxiv (3 June 2022 to 2 January 2023), and reference lists. STUDY SELECTION Randomized trials of interventions to increase mask use and risk for SARS-CoV-2 infection and observational studies of mask use that controlled for potential confounders. DATA EXTRACTION Two investigators sequentially abstracted study data and rated quality. DATA SYNTHESIS Three randomized trials and 21 observational studies were included. In community settings, mask use may be associated with a small reduced risk for SARS-CoV-2 infection versus no mask use, on the basis of 2 randomized trials and 7 observational studies. In routine patient care settings, surgical masks and N95 respirators may be associated with similar risk for SARS-CoV-2 infection, on the basis of 1 new randomized trial with some imprecision and 4 observational studies. Evidence from observational studies was insufficient to evaluate other mask comparisons due to methodological limitations and inconsistency. LIMITATION Few randomized trials, studies had methodological limitations and some imprecision, suboptimal adherence and pragmatic aspects of randomized trials potentially attenuated benefits, very limited evidence on harms, uncertain applicability to Omicron variant predominant era, meta-analysis not done due to heterogeneity, unable to formally assess for publication bias, and restricted to English-language articles. CONCLUSION Updated evidence suggests that masks may be associated with a small reduction in risk for SARS-CoV-2 infection in community settings. Surgical masks and N95 respirators may be associated with similar infection risk in routine patient care settings, but a beneficial effect of N95 respirators cannot be ruled out. PRIMARY FUNDING SOURCE None.
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Affiliation(s)
- Roger Chou
- Pacific Northwest Evidence-based Practice Center and the Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon (R.C., T.D.)
| | - Tracy Dana
- Pacific Northwest Evidence-based Practice Center and the Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon (R.C., T.D.)
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Richez B, Cantarel C, Durrieu F, Soubeyran I, Blanchi J, Pernot S, Chakiba Brugère C, Roubaud G, Cousin S, Etienne G, Floquet A, Babre F, Rivalan J, Lalet C, Narbonne M, Belaroussi Y, Bellera C, Mathoulin-Pélissier S. One-Year Follow-Up of Seroprevalence of SARS-CoV-2 Infection and Anxiety among Health Workers of a French Cancer Center: The PRO-SERO-COV Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5949. [PMID: 37297553 PMCID: PMC10252859 DOI: 10.3390/ijerph20115949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023]
Abstract
Infection of SARS-CoV-2 among health workers (HWs) in contact with cancer patients has been a major issue since the beginning of the pandemic. We aimed to assess the serological immune status of SARS-CoV-2 infection among these HWs. A prospective cohort study was initiated in the comprehensive cancer center of the Nouvelle-Aquitaine region (NA, France). Volunteer HWs working on March 2020 without active infection or symptoms of COVID-19 completed a self-questionnaire and had a blood test at inclusion, at 3 and 12 months. Positive serological status of SARS-CoV-2 infection was defined by anti-nucleocapsid antibodies and/or IgG anti-spike antibodies, except at 12 months due to vaccine. Half of the HWs were included (N = 517) and 89% were followed for three months (N = 500) and one year (N = 462). Seroprevalence of SARS-CoV-2 infection was 3.5% (95% CI: 1.9-5.1), 6.2% (95% CI: 4.1-8.3), and 10% (95% CI: 7.2-12.7) on June-September 2020, September 2020-January 2021, and June-October 2021, respectively. At 12 months, 93.3% had detectable antibodies with 80% vaccinated in the first three months of vaccine availability. The COVID-19-free policy of the institution, respect for barrier gestures, high and early vaccination of HWs, and low prevalence of SARS-CoV-2 in NA may explain the low rate of seropositivity among the HWs of the Institut Bergonié.
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Affiliation(s)
- Brice Richez
- Department of Anesthesia—Intensive Care, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Coralie Cantarel
- Inserm CIC1401, Clinical and Epidemiological Research Unit, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Françoise Durrieu
- Department of Biopathology, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Isabelle Soubeyran
- Department of Biopathology, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Julie Blanchi
- Department of Biopathology, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Simon Pernot
- Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Camille Chakiba Brugère
- Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Guilhem Roubaud
- Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Sophie Cousin
- Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Gabriel Etienne
- Hematology Department, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Anne Floquet
- Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Florence Babre
- Department of Anesthesia—Intensive Care, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Julie Rivalan
- Department of Anesthesia—Intensive Care, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Caroline Lalet
- Inserm CIC1401, Clinical and Epidemiological Research Unit, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Marine Narbonne
- Department PRISME, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Yaniss Belaroussi
- Inserm CIC1401, Clinical and Epidemiological Research Unit, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
| | - Carine Bellera
- Inserm CIC1401, Clinical and Epidemiological Research Unit, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
- Epicene Team, UMR 1219, Bordeaux Population Health Research Center, University Bordeaux, Inserm, F-33000 Bordeaux, France
| | - Simone Mathoulin-Pélissier
- Inserm CIC1401, Clinical and Epidemiological Research Unit, Institut Bergonié, Comprehensive Cancer Center, F-33000 Bordeaux, France
- Epicene Team, UMR 1219, Bordeaux Population Health Research Center, University Bordeaux, Inserm, F-33000 Bordeaux, France
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9
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Sansom SE, Barbian H, Hayden MK, Fukuda C, Moore NM, Thotapalli L, Baied EJ, Kim DY, Snitkin E, Lin MY. Genomic Investigation to Identify Sources of Severe Acute Respiratory Syndrome Coronavirus 2 Infection Among Healthcare Personnel in an Acute Care Hospital. Open Forum Infect Dis 2022; 9:ofac581. [PMID: 36467294 PMCID: PMC9709631 DOI: 10.1093/ofid/ofac581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 10/28/2022] [Indexed: 12/05/2022] Open
Abstract
Background Identifying the source of healthcare personnel (HCP) coronavirus disease 2019 (COVID-19) is important to guide occupational safety efforts. We used a combined whole genome sequencing (WGS) and epidemiologic approach to investigate the source of HCP COVID-19 at a tertiary-care center early in the COVID-19 pandemic. Methods Remnant nasopharyngeal swab samples from HCP and patients with polymerase chain reaction-proven COVID-19 from a period with complete sample retention (14 March 2020 to 10 April 2020) at Rush University Medical Center in Chicago, Illinois, underwent viral RNA extraction and WGS. Genomes with >90% coverage underwent cluster detection using a 2 single-nucleotide variant genetic distance cutoff. Genomic clusters were evaluated for epidemiologic linkages, with strong linkages defined by evidence of time/location overlap. Results We analyzed 1031 sequences, identifying 49 clusters that included ≥1 HCP (265 patients, 115 HCP). Most HCP infections were not healthcare associated (88/115 [76.5%]). We did not identify any strong epidemiologic linkages for patient-to-HCP transmission. Thirteen HCP cases (11.3%) were attributed to a potential patient source (weak evidence involving nonclinical staff that lacked location data to prove or disprove contact with patients in same cluster). Fourteen HCP cases (12.2%) were attributed to HCP source (11 with strong evidence). Conclusions Using genomic and epidemiologic data, we found that most HCP severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections were not healthcare associated. We did not find strong evidence of patient-to-HCP transmission of SARS-CoV-2.
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Affiliation(s)
- Sarah E Sansom
- Department of Internal Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA
| | - Hannah Barbian
- Department of Internal Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA
| | - Mary K Hayden
- Department of Internal Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA
| | - Christine Fukuda
- Department of Internal Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA
| | - Nicholas M Moore
- Department of Internal Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA
| | - Lahari Thotapalli
- Department of Internal Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA
| | - Elias J Baied
- Department of Internal Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA
| | - Do Young Kim
- Department of Internal Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA
| | - Evan Snitkin
- Department of Medicine, Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Michael Y Lin
- Department of Internal Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA
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10
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Chou R, Dana T, Jungbauer R. Update Alert 8: Masks for Prevention of Respiratory Virus Infections, Including SARS-CoV-2, in Health Care and Community Settings. Ann Intern Med 2022; 175:W108-W109. [PMID: 35878407 PMCID: PMC9380719 DOI: 10.7326/l22-0272] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Affiliation(s)
- Roger Chou
- Pacific Northwest Evidence-based Practice Center, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon
| | - Tracy Dana
- Pacific Northwest Evidence-based Practice Center, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon
| | - Rebecca Jungbauer
- Pacific Northwest Evidence-based Practice Center, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon
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11
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Chou R, Dana T, Buckley DI, Selph S, Fu R, Totten AM. Update Alert 11: Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers. Ann Intern Med 2022; 175:W83-W84. [PMID: 35816711 PMCID: PMC9380720 DOI: 10.7326/l22-0235] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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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12
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Mannan N, Raihan R, Parvin US, Fazle Akbar SM, Reza MS, Islam S, Kundu J, Noman AA, Fakhruddin M, Billaha M, Anik M, Hasan T, Tudu N, Rahim A, Mim F, Rahman Khan MJ. Detection of SARS-CoV-2 RNA by Reverse Transcription-Polymerase Chain Reaction (RT-PCR) on Self-Collected Nasal Swab Compared With Professionally Collected Nasopharyngeal Swab. Cureus 2022; 14:e25618. [PMID: 35784954 PMCID: PMC9249011 DOI: 10.7759/cureus.25618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2022] [Indexed: 11/06/2022] Open
Abstract
Background: Self-collection of nasal swabs for the detection of SARS-CoV-2 RNA by reverse transcription-polymerase chain reaction (RT-PCR) would considerably increase the testing capability and decrease the risk of transmission among healthcare workers (HCW) and the use of personal protective equipment (PPE). Objectives: This study aimed to evaluate the performance of self-collected nasal swabs compared with professionally collected nasopharyngeal (NP) swabs for detection of SARS-CoV-2 RNA by RT-PCR. Materials and methods: We performed a cross-sectional study where the suspected cases of coronavirus disease 2019 (COVID-19) were instructed about the self-collection of nasal swabs from their mid-turbinate. The results were compared to a nasopharyngeal swab collected by a trained healthcare worker in the same patient at the same sitting. Results: We enrolled 100 participants, of which, 69 (69%) were male and 31 (31%) were female. The median age of the study participant was 36 years. Of the participants, 58 (58%) were symptomatic, and the commonest clinical presentation was cough, which was present in 42 (42%) participants. Out of 100 samples, 31 (31%) professionally collected nasopharyngeal swabs and 28 (28%) self-collected nasal swabs were positive for SARS-CoV-2 by RT-PCR. Out of 31 professionally collected positive samples, three samples were negative in self-collection. Out of 28 self-collected positive samples, no sample was negative in the professional collection. The sensitivity and specificity of self-collected nasal swabs compared to professionally collected nasopharyngeal swabs were 90.32% and 100.00%, respectively. The sensitivity of self-collected nasal was 100% when the cycle threshold (Ct) value of the professionally collected NP swab was less than 30. Conclusion: Our study showed that self-collected nasal swabs' sensitivities were similar to professionally collected NP swabs with a high viral load (low Ct value). Hence, this method could be used when the patient is symptomatic and come to the health providers in the early stage of COVID-19 illness.
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