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1.
Infect Control Hosp Epidemiol ; 43(1): 102-104, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1634839

ABSTRACT

We performed viral culture of respiratory specimens in 118 severe acute respiratory coronavirus virus 2 (SARS-CoV-2)-infected healthcare workers (HCWs), ∼2 weeks after symptom onset. Only 1 HCW (0.8%) had a positive culture. No factors for prolonged viral shedding were identified. Infectivity is resolved in nearly all HCWs ∼2 weeks after symptom onset.


Subject(s)
COVID-19 , Cross-Sectional Studies , Health Personnel , Humans , SARS-CoV-2 , Virus Shedding
2.
Clin Infect Dis ; 73(7): e1878-e1880, 2021 10 05.
Article in English | MEDLINE | ID: covidwho-1455258

ABSTRACT

Many patients are fearful of acquiring coronavirus disease 2019 (COVID-19) in hospitals and clinics. We characterized the risk of COVID-19 among 226 patients exposed to healthcare workers with confirmed COVID-19. One patient may have been infected, suggesting that the risk of COVID-19 transmission from healthcare workers to patients is generally low.


Subject(s)
COVID-19 , Health Personnel , Humans , SARS-CoV-2
4.
Clin Microbiol Infect ; 27(9): 1351.e5-1351.e7, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1379061

ABSTRACT

OBJECTIVES: Data on the immune response after two doses of BNT162b2 are so far limited. Previously infected individuals were excluded from pivotal clinical trials and the optimum dose regimen in this population has not been clearly studied. The CRO-VAX HCP study aims to investigate the early antibody response in a population of health-care professionals having received two doses of the BNT162b2 mRNA coronavirus disease 2019 (COVID-19) vaccine. METHODS: The CRO-VAX HCP study is a multicentre, prospective, interventional study conducted in several sites in Belgium. The study included 231 health-care professional volunteers who received the two-dose regimen of the BNT162b2 mRNA COVID-19 vaccine. Of these, 73 were previously infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and 158 were uninfected and seronegative. In the first group, blood samples were collected at baseline and after 2, 4, 7, 10, 14, 21 and 28 days. In the second group, samples were obtained at baseline and after 14 and 28 days. Antibodies against the SARS-CoV-2 nucleocapsid and the receptor binding domain of the S1 subunit of the spike protein were measured in all individuals at different time-points. RESULTS: In uninfected individuals, 95.5% (95% CI 91.0%-98.2%) developed anti-spike antibodies after 14 days and a 24.9-fold rise (95% CI 21.4%-28.9%) in antibody titre was observed after the second dose. In previously infected individuals, peak antibody response was reached after 7 days (i.e. 6347 U/mL) and the second dose did not lead to significantly higher antibody titres (i.e. 8856-11 911 U/mL). Antibody titres were higher in previously infected individuals. CONCLUSIONS: This study supports the concept that a single dose of BNT162b2 would be sufficient in previously infected individuals.


Subject(s)
Antibodies, Viral/blood , COVID-19 Vaccines/administration & dosage , COVID-19/epidemiology , SARS-CoV-2/immunology , Spike Glycoprotein, Coronavirus/immunology , Adult , Aged , Belgium , COVID-19/immunology , COVID-19/prevention & control , COVID-19 Vaccines/immunology , Case-Control Studies , Drug Administration Schedule , Female , Health Personnel , Humans , Immunity, Humoral , Male , Middle Aged , Prospective Studies , Time Factors , Young Adult
5.
Cochrane Database Syst Rev ; 4: CD013582, 2020 04 21.
Article in English | MEDLINE | ID: covidwho-1372688

ABSTRACT

BACKGROUND: This review is one of a series of rapid reviews that Cochrane contributors have prepared to inform the 2020 COVID-19 pandemic. When new respiratory infectious diseases become widespread, such as during the COVID-19 pandemic, healthcare workers' adherence to infection prevention and control (IPC) guidelines becomes even more important. Strategies in these guidelines include the use of personal protective equipment (PPE) such as masks, face shields, gloves and gowns; the separation of patients with respiratory infections from others; and stricter cleaning routines. These strategies can be difficult and time-consuming to adhere to in practice. Authorities and healthcare facilities therefore need to consider how best to support healthcare workers to implement them. OBJECTIVES: To identify barriers and facilitators to healthcare workers' adherence to IPC guidelines for respiratory infectious diseases. SEARCH METHODS: We searched OVID MEDLINE on 26 March 2020. As we searched only one database due to time constraints, we also undertook a rigorous and comprehensive scoping exercise and search of the reference lists of key papers. We did not apply any date limit or language limits. SELECTION CRITERIA: We included qualitative and mixed-methods studies (with a distinct qualitative component) that focused on the experiences and perceptions of healthcare workers towards factors that impact on their ability to adhere to IPC guidelines for respiratory infectious diseases. We included studies of any type of healthcare worker with responsibility for patient care. We included studies that focused on IPC guidelines (local, national or international) for respiratory infectious diseases in any healthcare setting. These selection criteria were framed by an understanding of the needs of health workers during the COVID-19 pandemic. DATA COLLECTION AND ANALYSIS: Four review authors independently assessed the titles, abstracts and full texts identified by our search. We used a prespecified sampling frame to sample from the eligible studies, aiming to capture a range of respiratory infectious disease types, geographical spread and data-rich studies. We extracted data using a data extraction form designed for this synthesis. We assessed methodological limitations using an adapted version of the Critical Skills Appraisal Programme (CASP) tool. We used a 'best fit framework approach' to analyse and synthesise the evidence. This provided upfront analytical categories, with scope for further thematic analysis. We used the GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) approach to assess our confidence in each finding. We examined each review finding to identify factors that may influence intervention implementation and developed implications for practice. MAIN RESULTS: We found 36 relevant studies and sampled 20 of these studies for our analysis. Ten of these studies were from Asia, four from Africa, four from Central and North America and two from Australia. The studies explored the views and experiences of nurses, doctors and other healthcare workers when dealing with severe acute respiratory syndrome (SARS), H1N1, MERS (Middle East respiratory syndrome), tuberculosis (TB), or seasonal influenza. Most of these healthcare workers worked in hospitals; others worked in primary and community care settings. Our review points to several barriers and facilitators that influenced healthcare workers' ability to adhere to IPC guidelines. The following factors are based on findings assessed as of moderate to high confidence. Healthcare workers felt unsure as to how to adhere to local guidelines when they were long and ambiguous or did not reflect national or international guidelines. They could feel overwhelmed because local guidelines were constantly changing. They also described how IPC strategies led to increased workloads and fatigue, for instance because they had to use PPE and take on additional cleaning. Healthcare workers described how their responses to IPC guidelines were influenced by the level of support they felt that they received from their management team. Clear communication about IPC guidelines was seen as vital. But healthcare workers pointed to a lack of training about the infection itself and about how to use PPE. They also thought it was a problem when training was not mandatory. Sufficient space to isolate patients was also seen as vital. A lack of isolation rooms, anterooms and shower facilities was a problem. Other important practical measures described by healthcare workers included minimising overcrowding, fast-tracking infected patients, restricting visitors, and providing easy access to handwashing facilities. A lack of PPE, and equipment that was of poor quality, was a serious concern for healthcare workers and managers. They also pointed to the need to adjust the volume of supplies as infection outbreaks continued. Healthcare workers believed that they followed IPC guidance more closely when they saw the value of it. Some healthcare workers felt motivated to follow the guidance because of fear of infecting themselves or their families, or because they felt responsible for their patients. Some healthcare workers found it difficult to use masks and other equipment when it made patients feel isolated, frightened or stigmatised. Healthcare workers also found masks and other equipment uncomfortable to use. The workplace culture could also influence whether healthcare workers followed IPC guidelines or not. Across many of the findings, healthcare workers pointed to the importance of including all staff, including cleaning staff, porters, kitchen staff and other support staff when implementing IPC guidelines. AUTHORS' CONCLUSIONS: Healthcare workers point to several factors that influence their ability and willingness to follow IPC guidelines when managing respiratory infectious diseases. These include factors tied to the guideline itself and how it is communicated, support from managers, workplace culture, training, physical space, access to and trust in personal protective equipment, and a desire to deliver good patient care. The review also highlights the importance of including all facility staff, including support staff, when implementing IPC guidelines.


Subject(s)
Coronavirus Infections , Cross Infection/prevention & control , Guideline Adherence , Health Personnel , Infection Control , Pandemics , Pneumonia, Viral , COVID-19 , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Guideline Adherence/standards , Health Knowledge, Attitudes, Practice , Humans , Pandemics/prevention & control , Patient Isolation , Personal Protective Equipment , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Practice Guidelines as Topic , Universal Precautions
6.
Infect Control Hosp Epidemiol ; 42(9): 1046-1052, 2021 09.
Article in English | MEDLINE | ID: covidwho-1368877

ABSTRACT

OBJECTIVE: To describe the pattern of transmission of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) during 2 nosocomial outbreaks of coronavirus disease 2019 (COVID-19) with regard to the possibility of airborne transmission. DESIGN: Contact investigations with active case finding were used to assess the pattern of spread from 2 COVID-19 index patients. SETTING: A community hospital and university medical center in the United States, in February and March, 2020, early in the COVID-19 pandemic. PATIENTS: Two index patients and 421 exposed healthcare workers. METHODS: Exposed healthcare workers (HCWs) were identified by analyzing the electronic medical record (EMR) and conducting active case finding in combination with structured interviews. Healthcare coworkers (HCWs) were tested for COVID-19 by obtaining oropharyngeal/nasopharyngeal specimens, and RT-PCR testing was used to detect SARS-CoV-2. RESULTS: Two separate index patients were admitted in February and March 2020, without initial suspicion for COVID-19 and without contact or droplet precautions in place; both patients underwent several aerosol-generating procedures in this context. In total, 421 HCWs were exposed in total, and the results of the case contact investigations identified 8 secondary infections in HCWs. In all 8 cases, the HCWs had close contact with the index patients without sufficient personal protective equipment. Importantly, despite multiple aerosol-generating procedures, there was no evidence of airborne transmission. CONCLUSION: These observations suggest that, at least in a healthcare setting, most SARS-CoV-2 transmission is likely to take place during close contact with infected patients through respiratory droplets, rather than by long-distance airborne transmission.


Subject(s)
COVID-19 , Cross Infection , Cross Infection/epidemiology , Health Personnel , Humans , Infectious Disease Transmission, Patient-to-Professional , Pandemics , SARS-CoV-2
7.
Psychol Med ; 51(10): 1773-1774, 2021 07.
Article in English | MEDLINE | ID: covidwho-1337073

ABSTRACT

Since the first cases, the coronavirus disease (COVID-19) rapidly spread around the world, with hundred-thousand cases and thousands of deaths. Post-traumatic stress disorder (PTSD) is a common consequence of major disasters. Exceptional epidemic situations also promoted PTSD in the past. Considering that humanity is undergoing the most severe pandemic since Spanish Influenza, the actual pandemic of COVID-19 is very likely to promote PTSD. Moreover, COVID-19 was renamed severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2). With a poor understanding of viruses and spreading mechanisms, the evocation of SARS is generating a great anxiety contributing to promote PTSD. Quarantine of infected patients evolved to quarantine of 'infected' towns or popular districts, and then of entire countries. In the families of cases, the brutal death of family members involved a spread of fear and a loss of certainty, promoting PTSD. In the context of disaster medicine with a lack of human and technical resources, healthcare workers could also develop acute stress disorders, potentially degenerating into chronic PTSD. Globally, WHO estimates 30-50% of the population affected by a disaster suffered from diverse psychological distress. PTSD individuals are more at-risk of suicidal ideation, suicide attempt, and deaths by suicide - considering that healthcare workers are already at-risk occupations. We draw attention towards PTSD as a secondary effect of the SARS-Cov-2 pandemic, both for general population, patients, and healthcare workers. Healthcare policies need to take into account preventive strategy of PTSD, and the related risk of suicide, in forthcoming months.


Subject(s)
COVID-19 , Influenza, Human , Stress Disorders, Post-Traumatic , Humans , Pandemics , SARS-CoV-2 , Stress Disorders, Post-Traumatic/epidemiology
8.
Int J Health Plann Manage ; 36(S1): 174-181, 2021 May.
Article in English | MEDLINE | ID: covidwho-1318709

ABSTRACT

Healthcare workers, who are in low-resource settings, are critically vulnerable during the COVID-19 pandemic. The increasing rate of coronavirus infection in a developing country such as Bangladesh caused the highest death rate of doctors among frontline service providers and resulted in fear and anxiety among healthcare workers. Even with the preliminary measures of hospitals and clinics to protect healthcare workers, the growing casualties are alarming. This research uses case study approach to explore the issues doctors and nurses face in 'priority intervention areas' (PIA) in order to improve the health system quality. Qualitative in-depth semi-structured interviews were conducted from 12 May to 4 June 2020 among doctors and nurses from two different private hospitals in Dhaka city. Data were analysed using thematic content analysis. The two significant areas that required immediate attention were identified from the PIA framework as 'patient and staff safety, infection control' and 'cultural aspects and community engagement'. Each area of the PIA framework showed previously ignored issues in the current health system. The adaptation of the PIA framework helped identify critical health system issues. Possible corrective actions including proper planning and management of isolating the infected patients and provision of adequate personal protective equipment are recommended to management and policymakers to save the lives of healthcare workers and to minimise the spread of infection.


Subject(s)
COVID-19 , Nurses/psychology , Physicians/psychology , Bangladesh , Hospitals, Private , Humans , Infection Control , Interviews as Topic , Pandemics , SARS-CoV-2 , Surveys and Questionnaires
9.
Sci Prog ; 104(2): 368504211026121, 2021.
Article in English | MEDLINE | ID: covidwho-1277844

ABSTRACT

The COVID-19 pandemic has affected the psychological well-being of healthcare professionals, among them, on medical and nursing occupational specialists. This study describes the psychological distress that this group has suffered, analyzing the effect that the sense of coherence related with the history of contact with infected people has generated in their mental health. Cross-sectional descriptive study using online questionnaires. Data were collected on a sample of 499 subjects, representing 42.0% and 38.8% of the associations of specialists in Occupational Medicine and Nursing, respectively. A univariate data analysis, independence test, and the CHAID multivariate method were carried out. The percentage of workers with high psychological distress was higher among women than among men; this was also higher in public sector workers than in the private sector. No differences have been observed regarding psychological distress and educational level, coexistence, having children, working away from home, having a pet, or between being a physician or nurse. The most efficient measure to prevent psychological distress was acting regarding the comprehensibility dimension of the sense of coherence. Sex, contact with any infected person, age, living as a couple, working in public or private centers, the availability of diagnostic tests, and the correlation with the manageability dimension were modulating factors. Sense of coherence is an effective measure to prevent psychological distress due to contact with people affected by COVID-19 in Occupational Health professionals.


Subject(s)
Anxiety/epidemiology , COVID-19/epidemiology , Health Personnel/psychology , Pandemics , Psychological Distress , Sense of Coherence , Stress, Psychological/epidemiology , Adult , Anxiety/physiopathology , Anxiety/psychology , COVID-19/psychology , Cross-Sectional Studies , Female , Humans , Male , Mental Health/statistics & numerical data , Middle Aged , Occupational Health/statistics & numerical data , SARS-CoV-2/pathogenicity , Spain/epidemiology , Stress, Psychological/physiopathology , Surveys and Questionnaires
10.
Chest ; 160(3): 944-955, 2021 09.
Article in English | MEDLINE | ID: covidwho-1275208

ABSTRACT

BACKGROUND: Working in the ICU during the first COVID-19 wave was associated with high levels of mental health disorders. RESEARCH QUESTION: What are the mental health symptoms in health care providers (HCPs) facing the second wave? STUDY DESIGN AND METHODS: A cross-sectional study (October 30-December 1, 2020) was conducted in 16 ICUs during the second wave in France. HCPs completed the Hospital Anxiety and Depression Scale, the Impact of Event Scale-Revised (for post-traumatic stress disorder), and the Maslach Burnout Inventory. RESULTS: Of 1,203 HCPs, 845 responded (70%) (66% nursing staff, 32% medical staff, 2% other professionals); 487 (57.6%) had treated more than 10 new patients with COVID-19 in the previous week. Insomnia affected 320 (37.9%), and 7.7% were taking a psychotropic drug daily. Symptoms of anxiety, depression, post-traumatic stress disorder, and burnout were reported in 60.0% (95% CI, 56.6%-63.3%), 36.1% (95% CI, 32.9%-39.5%), 28.4% (95% CI, 25.4%-31.6%), and 45.1% (95% CI, 41.7%-48.5%) of respondents, respectively. Independent predictors of such symptoms included respondent characteristics (sex, profession, experience, personality traits), work organization (ability to rest and to care for family), and self-perceptions (fear of becoming infected or of infecting family and friends, feeling pressure related to the surge, intention to leave the ICU, lassitude, working conditions, feeling they had a high-risk profession, and "missing the clapping"). The number of patients with COVID-19 treated in the first wave or over the last week was not associated with symptoms of mental health disorders. INTERPRETATION: The prevalence of symptoms of mental health disorders is high in ICU HCPs managing the second COVID-19 surge. The highest tiers of hospital management urgently need to provide psychological support, peer-support groups, and a communication structure that ensure the well-being of HCPs.


Subject(s)
Anxiety/epidemiology , COVID-19/complications , Critical Care , Depression/epidemiology , Health Personnel/psychology , Mental Health , Physicians/psychology , Adult , Anxiety/etiology , Burnout, Professional/psychology , COVID-19/epidemiology , Cross-Sectional Studies , Depression/etiology , Female , France/epidemiology , Humans , Male , Pandemics , Prevalence
11.
J Med Life ; 14(2): 257-261, 2021.
Article in English | MEDLINE | ID: covidwho-1262738

ABSTRACT

The coronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organization (WHO) on the 11th of March 2020. In Romania, there have been 983,217 confirmed cases and 24,386 deaths. We aim to show our experience at the Fundeni Clinical Institute in the diagnosis of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection in both patients and health care personnel. Swab samples were collected for extraction of the SARS-CoV-2 RNA from 29380 patients and health care personnel. We have combined three real-time reverse transcription-polymerase chain reaction (RT-PCR) assays for the qualitative detection of SARS-CoV-2. Also, the presence of IgG against SARS-CoV-2 nucleoprotein was analyzed in 1068 patients and clinical staff using the chemiluminescence method. Other 50 people were screened post-vaccination for the presence of SARS-CoV-2 antibodies against the spike (S) protein, using the chemiluminescence method as well. The majority of confirmed cases were in adults, 71.3% of cases being registered in people aged 30-69 years. Most patients diagnosed with SARS-CoV-2 infection (83%) were admitted to the gastroenterology, hematology, and surgery wards. Our study showed that one-third of people developed antibodies against the nucleocapsid of SARS-CoV-2. SARS-CoV-2 IgG seroprevalence does not vary by gender or age. Also, we noticed the presence of antibodies against the SARS-CoV-2 spike protein in all 50 people post-vaccination that were tested two weeks after the second dose. Due to the increasing number of infected patients with SARS-CoV-2, the new coronavirus pandemic involves a sustained testing effort for an accurate virological diagnosis in both direct and indirect diagnosis.


Subject(s)
COVID-19/diagnosis , COVID-19/virology , SARS-CoV-2/physiology , Adult , Aged , Antibodies, Viral/immunology , COVID-19/genetics , COVID-19/immunology , COVID-19 Serological Testing , Female , Health Personnel , Humans , Immunoglobulin G/immunology , Male , Middle Aged , Pandemics , RNA, Viral , Real-Time Polymerase Chain Reaction , Romania
12.
BMC Infect Dis ; 21(1): 544, 2021 Jun 09.
Article in English | MEDLINE | ID: covidwho-1262498

ABSTRACT

BACKGROUND: SARS-CoV-2 is a recently emerged pandemic coronavirus (CoV) capable of causing severe respiratory illness. However, a significant number of infected people present as asymptomatic or pauci-symptomatic. In this prospective assessment of at-risk healthcare workers (HCWs) we seek to determine whether pre-existing antibody or T cell responses to previous seasonal human coronavirus (HCoV) infections affect immunological or clinical responses to SARS-CoV-2 infection or vaccination. METHODS: A cohort of 300 healthcare workers, confirmed negative for SARS-CoV-2 exposure upon study entry, will be followed for up to 1 year with monthly serology analysis of IgM and IgG antibodies against the spike proteins of SARS-CoV-2 and the four major seasonal human coronavirus - HCoV-OC43, HCoV-HKU1, HCoV-229E, and HCoV-NL63. Participants will complete monthly questionnaires that ask about Coronavirus Disease 2019 (COVID-19) exposure risks, and a standardized, validated symptom questionnaire (scoring viral respiratory disease symptoms, intensity and severity) at least twice monthly and any day when any symptoms manifest. SARS-CoV-2 PCR testing will be performed any time participants develop symptoms consistent with COVID-19. For those individuals that seroconvert and/or test positive by SARS-CoV-2 PCR, or receive the SARS-CoV-2 vaccine, additional studies of T cell activation and cytokine production in response to SARS-CoV-2 peptide pools and analysis of Natural Killer cell numbers and function will be conducted on that participant's cryopreserved baseline peripheral blood mononuclear cells (PBMCs). Following the first year of this study we will further analyze those participants having tested positive for COVID-19, and/or having received an authorized/licensed SARS-CoV-2 vaccine, quarterly (year 2) and semi-annually (years 3 and 4) to investigate immune response longevity. DISCUSSION: This study will determine the frequency of asymptomatic and pauci-symptomatic SARS-CoV-2 infection in a cohort of at-risk healthcare workers. Baseline and longitudinal assays will determine the frequency and magnitude of anti-spike glycoprotein antibodies to the seasonal HCoV-OC43, HCoV-HKU1, HCoV-229E, and HCoV-NL63, and may inform whether pre-existing antibodies to these human coronaviruses are associated with altered COVID-19 disease course. Finally, this study will evaluate whether pre-existing immune responses to seasonal HCoVs affect the magnitude and duration of antibody and T cell responses to SARS-CoV-2 vaccination, adjusting for demographic covariates.


Subject(s)
COVID-19/immunology , Health Personnel/statistics & numerical data , SARS-CoV-2/immunology , Seroconversion , Vaccination/statistics & numerical data , Antibodies, Viral/blood , Antibodies, Viral/immunology , Asymptomatic Infections , COVID-19 Vaccines/immunology , Coronavirus/immunology , Cross Reactions , Humans , Prospective Studies , Spike Glycoprotein, Coronavirus/immunology , T-Lymphocytes/immunology
13.
ERJ Open Res ; 7(2)2021 Apr.
Article in English | MEDLINE | ID: covidwho-1262495

ABSTRACT

BACKGROUND: Healthcare workers (HCWs) are believed to be at increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. It is not known to what extent the natural production of antibodies to SARS-CoV-2 is protective against re-infection. METHODS: A prospective observational study of HCWs in Scotland (UK) from May to September 2020 was performed. The Siemens SARS-CoV-2 total antibody assay was used to establish seroprevalence in this cohort. Controls, matched for age and sex to the general local population, were studied for comparison. New infections (up to 2 December 2020) post antibody testing were recorded to determine whether the presence of SARS-CoV-2 antibodies protects against re-infection. RESULTS: A total of 2063 health and social care workers were recruited for this study. At enrolment, 300 HCWs had a positive antibody test (14.5%). 11 out of 231 control sera tested positive (4.8%). HCWs therefore had an increased likelihood of a positive test (OR 3.4, 95% CI 1.85-6.16; p<0.0001). Dentists were most likely to test positive. 97.3% of patients who had previously tested positive for SARS-CoV-2 by reverse transcriptase (RT)-PCR had positive antibodies. 18.7% had an asymptomatic infection. There were 38 new infections with SARS-CoV-2 in HCWs who were previously antibody negative, and one symptomatic RT-PCR-positive re-infection. The presence of antibodies was therefore associated with an 85% reduced risk of re-infection with SARS-CoV-2 (hazard ratio 0.15, 95% CI 0.06-0.35; p=0.026). CONCLUSION: HCWs were three times more likely to test positive for SARS-CoV-2 than the general population. Almost all infected individuals developed an antibody response, which was 85% effective in protecting against re-infection with SARS-CoV-2.

14.
Prof Inferm ; 74(1): 41-47, 2021.
Article in Italian | MEDLINE | ID: covidwho-1259732

ABSTRACT

INTRODUCTION: The Coronavirus (Covid-19) pandemic caused a severe health crisis that has affected millions of people and quarantined half of the world's population. The health emergency from Covid-19 has seen health workers on the front line face all the difficulties related to the burden of care and the reorganization of procedures, roles, and tools at the hospital level. One of the most significant and probably underestimated aspects is the psychological stress of frontline nurses. The article aims to analyze the literature relating to the impact on the mental health of nurses engaged in the management and care of Covid-19 patients. METHODS: A systematic review of the published articles on the subject was conducted from January 2020 to November 2020. The search for papers was conducted on scientific databases like PubMed, Scopus and Embase. RESULTS: The results show the onset of anxiety, depression and stress and insomnia in healthcare workers. These aspects are closely related to numerous factors, including the fear of contracting the disease and infecting family members, stressful shifts and little rest, leading to a state of psychological and physical tension capable of activating pathological behaviours. The literature highlights the importance of support interventions for frontline personnel to avoid the onset of psycho-pathophysical severe problems. CONCLUSION: The review suggests that frontline nurses during the emergency phase of Covid- 19 may be prone to psychological disorders that can compromise mental health. Therefore, the surveillance and monitoring of symptoms, together with targeted support interventions, should be guaranteed daily to all professionals involved to prevent the onset of psychological disorders.


Subject(s)
COVID-19 , Nurses/organization & administration , Occupational Stress/epidemiology , Anxiety/epidemiology , Depression/epidemiology , Humans , Mental Health , Sleep Initiation and Maintenance Disorders/epidemiology
15.
Front Public Health ; 9: 679254, 2021.
Article in English | MEDLINE | ID: covidwho-1259412

ABSTRACT

Background: COVID-19 transmission was significant among Healthcare workers worldwide. In March 2020, Qatar started reporting numbers of COVID-19 positive cases among workers in Primary Health Care Corporation (PHCC). The study estimates the burden of the aforementioned infections and examines the demographic characteristics associated with the recorded positivity rates. Method: A cross-sectional descriptive study was conducted among Primary healthcare workers between March 1st and October 31st, 2020. The study examined the positivity rate of the different types of Primary healthcare workers and, analyzed the demographic characteristics of the infected persons. Results: 1,048 (87.4%) of the infected Health Care Workers (HCWs) belonged to the age group below 45 years, and 488 (40.7%) HCWs were females. 450 (37.5%) were HCWs clinical staff working in one of the 27 PHCC Health Centers (HCs) Despite the increased patient footfall and risk environment, the COVID dedicated HCs had an attack rate of 10.1%, which is not significantly different from the average attack rate of 8.9% among staff located in other HCs (p = 0.26). Storekeepers, engineering & maintenance staff, housekeeping staff, support staff, and security staff (outsourced non-clinical positions) had the highest positivity rates, 100, 67.2, 47.1, 32.4, and 29.5% respectively. Conclusion: The elevated risk of infection among outsourced non-clinical healthcare workers can be explained by environmental factors such as living conditions. Furthermore, better containment within clinical healthcare workers can be attributed to strict safety training and compliance with preventative measures which is recommended to be implemented across all settings.


Subject(s)
COVID-19 , Cross-Sectional Studies , Female , Health Personnel , Humans , Male , Middle Aged , Primary Health Care , Qatar/epidemiology , SARS-CoV-2
16.
J Hosp Infect ; 115: 59-63, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1258421

ABSTRACT

The increasing number of coronavirus disease 2019 (COVID-19) cases in the community has posed a significant epidemic pressure on healthcare settings. When healthcare workers (HCWs) acquire COVID-19, contact tracing and epidemiological investigation might not be adequate for determining the source of transmission. Here, we report a phylogenetic investigation involving two infected HCWs and nine patients to determine whether patient-to-HCW transmission had occurred in a hospital without a previous COVID-19 outbreak. This is the first study to apply phylogenomics to investigate suspected nosocomial transmission in a region with low prevalence of COVID-19. Our results do not support the occurrence of direct patient-to-HCW transmission.


Subject(s)
COVID-19 , Disease Outbreaks , Health Personnel , Humans , Phylogeny , SARS-CoV-2
17.
EClinicalMedicine ; 36: 100914, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1252783

ABSTRACT

BACKGROUND: Health care workers (HCWs) are at high risk of contracting an infection by SARS CoV-2 and thus they are a priority for vaccination. We hereby aim to investigate whether the risk of severe and moderate systemic symptoms (MSS) after vaccination is higher in HCWs with a history of previous COVID-19. METHODS: An online questionnaire was offered to the cohort all HCWs undergoing anti-SARS CoV-2 mRNA BNT162b2 vaccination between January 4th and February 9th 2021 in two large tertiary hospitals (ASST Santi Paolo and Carlo) in Milan, Italy. Previous SARS-CoV-2 infection/COVID-19 was recorded. Local and systemic symptoms after each of the two doses were reported. MSS were those either interfering with daily activities or resulting in time off-work. Factors associated to MSS were identified by logistic regression. FINDINGS: 3,078 HCW were included. Previous SARS-CoV-2 infection/COVID-19 occurred in 396 subjects (12·9%). 59·6% suffered from ≥1 local or systemic symptom after the first and 73·4% after the second dose. MSS occurred in 6·3% of cases (14·4% with previous vs 5·1% with no COVID-19 p<0·001) and in 28·3% (24·5% in COVID-19 vs 28·3% no COVID, p = 0·074) after the first and second dose, respectively. Subjects already experiencing COVID-19 had an independent 3-fold higher risk of MSS after the first and a 30% lower risk after the second dose. No severe adverse events were reported. INTERPRETATION: Our data confirm in a real-world setting, the lack of severe adverse events and the short duration of reactogenicity in already infected HCWs. Possible differences in immune reactivity are drivers of MSS among this group of HCWs, as well as among females and younger individuals. FUNDING: None.

18.
BMC Infect Dis ; 21(1): 490, 2021 May 27.
Article in English | MEDLINE | ID: covidwho-1244913

ABSTRACT

BACKGROUND: Novel-coronavirus 2019 (COVID-19) disease is currently a worldwide health risk and public health emergency concern. The virus is transmitted from an infected person to another person through close contact and droplets. Frontline health care workers are the most at risk of infection, and so a WHO interim guidance document was issued by the World Health Organization (WHO) which underscores the importance of proper sanitation and waste management practices for COVID- 19 in health-care settings. This study aimed at assessing knowledge and preventive practices towards Covid-19 among health care providers in selected health facilities of Illu Aba Bor and Buno Bedele zones, Southwest Ethiopia. METHODS: An institution-based cross-sectional study was conducted from April to May 2020 among 330 health workers in selected health facilities of Illu Aba Bor and Buno-Bedelle Zones, Southwest Ethiopia. Data were collected using a self-administered structured questionnaire. The collected data were entered into Epidata version 3.1 and exported to SPSS version 23 for analysis. Bivariate and multivariable logistic regression analysis was used to identify independent predictors of preventive practices towards Covid-19. Statistical significance was declared at a p-value of < 0.05. RESULT: The majority of respondents (93.3%) demonstrated good knowledge of COVID-19, and the mean (SD) knowledge score was 9.04 ± 1.06. Nearly two-thirds (64.2%) of the study participants had good infection prevention practices. Being male (AOR = 3.65, 95% CI: (1.96, 6.80)), education level (AOR = 1.82, 95% CI (1.02, 3.22)), profession (AOR = 3.17, 95% CI (1.08, 9.33)), service year (5-10 years) (AOR = 2.00 (1.02, 3.92)) and more than 10 years (AOR = 3.14 (1.51, 6.52)), availability of personal protective equipment (AOR = 1.96 (1.06, 3.61)) and Knowledge level (AOR = 2.61 (1.48, 4.62)) were independent predictors of COVID-19 preventive practices. CONCLUSION: The overall level of knowledge of HCWs was good. However, the practice was relatively low. Gender, educational status, profession, year of service, knowledge towards COVID-19, and availability of personal protective equipment were independent predictors of good infection prevention practices. Optimizing the infection prevention and control loop of the health facilities is recommended.


Subject(s)
COVID-19/prevention & control , Health Facilities , Health Knowledge, Attitudes, Practice , Health Personnel/psychology , Infection Control/methods , Adult , COVID-19/epidemiology , Cross-Sectional Studies , Disease Outbreaks , Educational Status , Ethiopia/epidemiology , Female , Humans , Logistic Models , Male , Personal Protective Equipment/statistics & numerical data , SARS-CoV-2 , Surveys and Questionnaires
19.
Int J Environ Res Public Health ; 18(11)2021 May 25.
Article in English | MEDLINE | ID: covidwho-1244007

ABSTRACT

The aim of this study was to explore the knowledge, emotions and perceived stressors by healthcare workers who were in contact with infected patients during the COVID-19 outbreak. An online cross-sectional survey was applied. Data were collected from N = 263 healthcare workers in Tabasco State, Mexico. We developed and administered a questionnaire, which consisted of sociodemographic characteristics, plus four sections. The sections evaluated were (1) knowledge of COVID-19; (2) feelings/emotions during the COVID-19 outbreak; (3) factors that caused stress and (4) factors that helped to reduce stress. Surveyed individuals were divided into three groups: physicians, nurses and other healthcare workers. When we evaluated their knowledge of COVID-19 we observed that the majority of healthcare workers in the three groups reported that they knew about COVID-19. Physicians indicated that they felt insecure about practicing their profession (62.5%) due to the high risk of being in contact with SARS-CoV-2. With regards to stressor factors, the risk of transmitting COVID-19 to their families was the main factor causing moderate to high stress (95.4%). Finally, we found that "your profession puts your life at risk" was the only factor associated with feeling nervous and scared (PR: 3.15; 95% CI: 1.54-6.43). We recommended health education campaigns, introductory courses on COVID-19 and other infectious diseases, management protocols and the provision of protection equipment to health workers in order to reduce personal and professional fears of contagion and to improve the health system in Mexico when facing epidemics.


Subject(s)
COVID-19 , Cross-Sectional Studies , Disease Outbreaks , Emotions , Health Personnel , Humans , Mexico/epidemiology , SARS-CoV-2 , Surveys and Questionnaires
20.
Int J Environ Res Public Health ; 18(11)2021 May 24.
Article in English | MEDLINE | ID: covidwho-1244003

ABSTRACT

Efforts to limit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections among hospital healthcare staff are crucial for controlling the Coronavirus Disease 19 (COVID-19) pandemics. The study aimed to explore the prevalence and clinical presentations of COVID-19 in healthcare workers (HCWs) at the University Clinical Hospital (UCH) in Wroclaw with 1677 beds. The retrospective study was performed in 2020 using a self-derived structured questionnaire in a sample of HCWs who were diagnosed with SARS-CoV-2 infection confirmed using a PCR double gene test and consented to be enrolled into the study. The significance level for all statistical tests was set to 0.05. The study showed that of the 4998 hospital workers, among 356 cases reported as COVID-19 infected, 70 consented to take part in the survey: nurses (48.5%), doctors (17.1%), HCWs with patient contact (10.0%), other HCWs without patient contact (7.1%), and cleaning personnel (5.7%). HCWs reported concurrent diseases such as hypertension (17.1%), bronchial asthma (5.7%), and diabetes (5.7%). Failure to keep 2 m distancing during contact (65.5%) and close contact with the infected person 14 days before the onset of symptoms or collection of biological material (58.6%) were identified as the increased risks of infection. A large part of infections in hospital healthcare staff were symptomatic (42.9%). The first symptoms of COVID-19 were general weakness (42.9%), poor mental condition (41.4%), and muscle pain (32.9%); whereas in the later stages of the illness, general weakness (38.6%), coughing (34.3%), lack of appetite (31.4%), and loss of taste (31.4%) were observed. In about 30% of the infected HCWs, there was no COVID-19 symptoms whatsoever. The vast majority of the patients were treated at home (85.7%). In conclusion, the majority of the SARS-CoV-2 infections in the hospital HCWs were asymptomatic or mildly symptomatic. Therefore, successful limitation of COVID-19 infection spread at hospitals requires a close attention to future cross-infections.


Subject(s)
COVID-19 , Health Personnel , Humans , Poland/epidemiology , Retrospective Studies , SARS-CoV-2 , Universities
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