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Novelli V, Fassio F, Resani G, Bussa M, Durbano A, Meloni A, Oliva G, Cutti S, Girardi D, Odone A, Villani S, Marena C, Muzzi A, Monti MC. Clinical Characteristics and Potential Risk Factors Associated with the SARS-CoV-2 Infection: Survey on a Health Care Workers (HCWs) Population in Northern Italy. IJERPH 2022; 19:ijerph19138194. [PMID: 35805853 PMCID: PMC9266542 DOI: 10.3390/ijerph19138194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/01/2022] [Accepted: 07/02/2022] [Indexed: 11/16/2022]
Abstract
During the two years of the COVID-19 pandemic, more than 400 million cases all over the world have been identified. Health care workers were among the first to deal with this virus and consequently a high incidence of infection was reported in this population. The aim of the survey was to investigate health care workers’ (HCWs) clinical characteristics and potential risk factors associated with the SARS-CoV-2 infection in a referral hospital in Northern Italy after the first and second waves of the pandemic. We administered a questionnaire during the flu vaccination campaign that took place at the end of 2020; among 1386 vaccinated HCWs, data was collected and analyzed for 1065 subjects. 182 HCWs (17%) declared that they had tested positive on at least a molecular or a serological test since the beginning of the pandemic. Comparing the infected vs. not infected HCWs, median age, BMI, smoking habit, presence of hypertension or other comorbidities were not significantly different, while having worked in a COVID ward was associated with the infection (ORadj = 1.54, 95% CI: 1.07–2.20). Respondents declared that more than 70% of contacts occurred in the hospital with patients or colleagues, while about 15% in domestic environments. Among the infected, the most reported symptoms were fever (62.1%), asthenia (60.3%), anosmia/ageusia (53.5%), arthralgia/myalgia (48.3%), headache or other neurological symptoms (46.6%), cough (43.1%) and flu-like syndrome (41.4%). The percentage of subjects who have been infected with SARS-CoV-2 seems to be higher in HCWs than in the general population; hence, in hospitals, protective measures and preventive strategies to avoid the spreading of the contagion remain crucial.
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Affiliation(s)
- Viola Novelli
- Medical Direction, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (V.N.); (G.R.); (A.D.); (S.C.); (D.G.); (C.M.); (A.M.)
| | - Federico Fassio
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (M.B.); (S.V.); (M.C.M.)
- Correspondence:
| | - Guido Resani
- Medical Direction, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (V.N.); (G.R.); (A.D.); (S.C.); (D.G.); (C.M.); (A.M.)
- Unit of Hygiene, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (A.M.); (G.O.); (A.O.)
| | - Martino Bussa
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (M.B.); (S.V.); (M.C.M.)
| | - Alessandro Durbano
- Medical Direction, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (V.N.); (G.R.); (A.D.); (S.C.); (D.G.); (C.M.); (A.M.)
| | - Alessandro Meloni
- Unit of Hygiene, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (A.M.); (G.O.); (A.O.)
| | - Giovanni Oliva
- Unit of Hygiene, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (A.M.); (G.O.); (A.O.)
| | - Sara Cutti
- Medical Direction, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (V.N.); (G.R.); (A.D.); (S.C.); (D.G.); (C.M.); (A.M.)
| | - Daniela Girardi
- Medical Direction, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (V.N.); (G.R.); (A.D.); (S.C.); (D.G.); (C.M.); (A.M.)
- Unit of Hygiene, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (A.M.); (G.O.); (A.O.)
| | - Anna Odone
- Unit of Hygiene, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (A.M.); (G.O.); (A.O.)
| | - Simona Villani
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (M.B.); (S.V.); (M.C.M.)
| | - Carlo Marena
- Medical Direction, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (V.N.); (G.R.); (A.D.); (S.C.); (D.G.); (C.M.); (A.M.)
| | - Alba Muzzi
- Medical Direction, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (V.N.); (G.R.); (A.D.); (S.C.); (D.G.); (C.M.); (A.M.)
| | - Maria Cristina Monti
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (M.B.); (S.V.); (M.C.M.)
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Colaneri M, Novelli V, Cutti S, Muzzi A, Resani G, Monti MC, Rona C, Grugnetti AM, Rettani M, Rovida F, Zuccaro V, Triarico A, Marena C. The experience of the health care workers of a severely hit SARS-CoV-2 referral Hospital in Italy: incidence, clinical course and modifiable risk factors for COVID-19 infection. J Public Health (Oxf) 2021; 43:26-34. [PMID: 33140084 PMCID: PMC7665642 DOI: 10.1093/pubmed/fdaa195] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 09/30/2020] [Accepted: 10/07/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, the health care workers (HCWs) at the frontline have been largely exposed to infected patients, running a high risk of being infected by the SARS-CoV-2 virus.Since limiting transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in health care setting is crucial to avoid the community spread of SARS-CoV-2, we want to share our experience as an early hit hospital where standard infection control practices have been conscientiously applied and effective. We believe that our example, as first and hardest hit country, might be a warning and aid not only for those who have been hit later, but also for a second fearful wave of contagion. In addition, we want to offer an insight on modifiable risk factors for HWs-related infection. METHODS Demographic, lifestyle, work-related and comorbidities data of 1447 HCWs, which underwent a nasopharyngeal swab for SARS-CoV-2, were retrospectively collected. For the 164 HCWs positive for SARS-CoV-2, data about safety in the workplace, symptoms and clinical course of COVID-19 were also collected. Cumulative incidence of SARS-CoV-2 infection was estimated. Risk factors for SARS-CoV-2 infection were assessed using a multivariable Poisson regression. RESULTS The cumulative incidence of SARS-CoV-2 infection among the screened HCWs was 11.33% (9.72-13.21). Working in a COVID-19 ward, being a former smoker (versus being a person who never smoked) and BMI was positively associated with SARS-CoV-2 infection, whereas being a current smoker was negatively associated with this variable. CONCLUSIONS Assuming an equal accessibility and proper use of personal protective equipment of all the HCWs of our Hospital, the great and more prolonged contact with COVID-19 patients remains the crucial risk factor for SARS-CoV-2. Therefore, increased and particular care needs to be focused specifically on the most exposed HCWs groups, which should be safeguarded. Furthermore, in order to limit the risk of asymptomatic spread of SARS-CoV-2 infection, the HCWs mild symptoms of COVID-19 should be considered when evaluating the potential benefits of universal staff testing.
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Affiliation(s)
- Marta Colaneri
- Division of Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Viola Novelli
- Medical Direction, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Sara Cutti
- Medical Direction, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Alba Muzzi
- Medical Direction, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Guido Resani
- Medical Direction, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- Department of Public Health, Experimental and Forensic Medicine, Section of Hygiene, University of Pavia, Pavia, Italy
| | - Maria Cristina Monti
- Department of Public Health, Experimental and Forensic Medicine, Unit of Biostatistics and Clinical Epidemiology, University of Pavia, Pavia, Italy
| | - Claudia Rona
- Medical Direction, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Anna Maria Grugnetti
- Department of Health Professions, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marco Rettani
- Information Tecnology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Francesca Rovida
- Department of Microbiology and Virology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Valentina Zuccaro
- Division of Infectious Diseases I, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Antonio Triarico
- Department of Hospital Leadership, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Carlo Marena
- Medical Direction, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Kundisova L, Sanguineti I, Resani G, Lentino C, Nante N. Factors associated to functional outcome after total hip and knee arthroplasty. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
An individual rehabilitation plan should guarantee a personalized approach to each patient. Identifying patients at risk of slower progression could help to implement a targeted approach. Aim of this study was to analyse patients characteristics associated to worse Functional Outcome (FO).
Methods
A cross sectional study of patients after Total Hip Arthoplasty (THA) or Total Knee Artroplasty (TKA) recovered in a Rehabilitation Clinic from January 2017 to December 2018 was performed. Patients characteristic: Age, Gender, Body Mass Index (BMI), Pain at admission (expressed in Numeric Pain Rating Scale: NRS), Cumulative Illness Rating Scale (CIRS) and Length of Stay in surgical facility (SLOS). Outcome tested: Active Flexion (AF), Barthel index (BI), Tinetti scale (TS), Pain at Discharge (PD). Patients were divided into two groups in relation to the achievement of target values in eight day of rehabilitation (AF = 84°, BI = 90, TS = 19 and PD ≥ 5). Statistical analysis was realized using Stata12.
Results
In total 1857 patients, 58% females, 56% after THA. Average age was 70.5±10.4, higher for females (72±9.7 vs. 68.3±11), average BMI 27.2±4.3, average SLOS 5.2±2.8. Regarding AF: 48% did not reach target value (38%THA; 55%TKA), for THA more likely older (OR 1.01) and females (OR 1.5) and for both THA and TKA higher NRS (OR 1.2). As for the BI target value was not reached by 24% patients (24.4%THA; 23.4%TKA); more likely older patients (OR 1.05), females (THA OR 2.1; TKA OR1.5), those with higher NRS (OR 1.13) and higher SLOS (THA OR 1.16; TKA OR 1.14). As for TS, 7% did not reached target (6.5%THA; 6.8%TKA), association with age (TKA OR 1.08; THA OR 1.04) and for THA also with SLOS (OR 1.13), pain (OR 1.16) and female sex (OR 2.16) was observed. As for the PD 17% not reached target (9.78%THA; 25.59%TKA), for TKA an association with BMI was observed (OR 1.08).
Conclusions
Worse FO was associated to not modifiable variables as age and gender but also with NRS, BMI and SLOS.
Key messages
Analysing patients characteristics associated to worse Functional Outcome allow to identify patients at risk of slower progression. The aim is to implement a targeted and personalized approach. The worse FO was associated to not modifiable variables as age and sex but also to higher NRS, prolonged SLOS and high BMI. Those conclusions help to manage an Individual Rehabilitation plan.
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Affiliation(s)
- L Kundisova
- Post Graduate School of Public Health, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - I Sanguineti
- Rehabilitation Unit, Hospital “San Michele”, Albenga (SV), Italy
| | - G Resani
- Post Graduate School of Public Health, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - C Lentino
- Functional Recovery and Rehabilitation Department, Hospital “Santa Corona”, Pietra Ligure (SV), Italy
| | - N Nante
- Post Graduate School of Public Health, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
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