Back to the First Days of the Pandemic: How Well Have We Done to Diagnose COVID-19 in Healthcare Workers?

ABSTRACT

Introduction: Healthcare workers (HCWs) are one of the most vulnerable groups for COVID-19. SARS-CoV-2 PCR was offered to HCWs who had symptoms compatible with COVID-19 or who had a close contact with COVID-19 patient. A rapid antibody test was used to identify the risk of exposure of the HCWs who worked at high-risk units in our hospital during the first month of the pandemic. Herein, we aimed to evaluate the usefulness of this approach. Materials and Methods: The records of the HCWs from a university hospital who were tested by SARS-CoV-2 PCR or rapid antibody test between March 12, 2020 and April 04, 2020 were reviewed retrospectively. Demographic and clinical characteristics of HCWs were extracted from the electronic database. Wards or outpatient clinics that served COVID-19 patients were defined as high-risk units. Results: A total of 599 HCWs were tested for SARS-CoV-2 by PCR and 409 by rapid antibody test. Thirty-seven (6.2%) were found to be PCR positive. Eleven (29.7%) out of 37 HCWs were asymptomatic when they were tested. There was no statistically significant relationship between PCR positivity and occupation or working unit. A positive PCR result was detected in 24 HCWs during the first admission. Eleven out of 114 HCWs who were tested by a second PCR were found to be positive and two out of 17 HCWs who were tested by a third test were reported as PCR positive. Median interval between the first and second PCR was seven days (IQR= 8.5 days) and median interval between second and third PCR test was 4.5 days for the HCWs who were reported as positive at repeated PCR tests. Rapid antibody test was positive in one HCW who did not have a history of COVID-19. Conclusion: Approximately, one third of the SARS-CoV-2 PCR positive HCWs were asymptomatic. In case of increasing incidence of COVID-19 in the community, a regular screening policy for the HCWs regardless of their occupation and contact tracing might help to have a safe environment in hospitals. Screening policy should be based on well validated tests.