Prevalence, Clinical Characteristics, Virus Clearance and Treatment Outcomes of SARS-CoV-2 Infection in Healthcare Workers in India (preprint)

ABSTRACT

Introduction: This aim of the study was to determine prevalence, associated factors, clinical characteristics, virus clearance and treatment outcomes of healthcare workers ( HCWs) with coronavirus disease 2019 (COVID-19) in a dedicated tertiary care COVID-19 hospital in India. Methods: The study included healthcare workers with laboratory confirmed COVID-19 from BYL Nair Hospital (NH), Mumbai, India. The data was captured from medical case records from 6th April to 31st August 2020. Epidemiological data was captured through interview of HCW. Duration of viral clearance amongst symptomatic and symptomatic HWCs was carried out using chi-square test.Results: The prevalence of SARS-CoV2 infection amongst HCWs was observed 11% during the first 5 months of COVID-19 pandemic. Majority of the HCWs with COVID-19 (85%) were symptomatic and 15% were asymptomatic. The frequency of SARS-CoV-2 infection was higher in Male HCWs (57%) as compared to female HCWs (43%). Hypertension and Diabetes Mellitus were the most common co-morbidities reported. More than 4% percent (18/413) of HCWs with COVID-19 were also positive for plasmodium vivax Malaria. 26% (107/413) of HCWs with COVID-19 were having symptoms suggestive of Severe Acute Respiratory Infection (SARI). Median duration for virus clearance was 11 (IQR, 7-15) days with maximum 40 days. Most of the asymptomatic cases cleared the virus within 15 days (93%) whilst most of the symptomatic cases cleared the virus between days 8 to 40 days (73%). Mean time to viral clearance was significantly higher in symptomatic compared to asymptomatic cases (8 days and 12 days, respectively, p<0.0005). Additionally, higher mean time to viral clearance was observed in HCWs with comorbidities as compared to HCWs with co-infection (12 days and 8 days respectively, p<0.0005). There was a significant difference in duration of virus clearance (<7 days) between asymptomatic and symptomatic HCWs (p<0.0005).Around 9% (35/413) of HCWs developed severe disease requiring ICU admission with 1 % mortality. Reinfection of SARS-CoV-2 was reported in 2% of HCWs. Conclusion: There is increased frequency of SARS-CoV-2 infection amongst frontline HCWs. We recommend universal testing of HCWs and double negative testing to label HCWs as fit to discharge to optimize staffing levels during this current pandemic. Testing should also be extended to family members and other close contacts. The HCWs are the most precious resource for every country.