A hospital-based prospective cohort study to assess the factors associated with transmission dynamics of SARS CoV-2 among healthcare workers in Delhi

Abstract

Background: Healthcare personnel providing COVID-19 care are at increased risk of acquiring infection. Understanding the factors associated with the transmission of infection among healthcare workers provides input for the development of prevention strategies. The objectives of this study were to study the adherence to Infection Prevention and Control (IPC) measures followed between different categories of healthcare workers, to estimate seroconversion rate based on the type of exposure with COVID-19 patients, and to study the association between seroconversion and IPC practices. Methods: A prospective cohort study was conducted from December 2020 to June 2021 among the healthcare workers in two tertiary healthcare institutes selected by purposive sampling. All Healthcare workers (HCWs) participating in the clinical management or having any exposure to a laboratory-confirmed COVID-19 case were included. A total of 817 subjects were enrolled in the study. At baseline, details on IPC training and adherence along with details of the type of exposure with the COVID-19 patient were collected. The end-line visit was scheduled at 22-31 (preferably 28 days) days from the first visit for the collection of the symptom diary and end-line form. Results: Hand hygiene practices were found to be best among paramedics (98.0%), followed by doctors (84.5%) and nurses (90.1%). Maximum HCWs (99.5%; 99.8%; 97.1%) reported using Personal Protective Equipment (PPE) appropriately and regular availability of PPE in the hospital setting. Among the various categories of HCWs, nurses had the highest proportion (28.7%) of untrained personnel. Conclusion: The HCWs who had contact with the surroundings of an infected patient showed higher odds of seroconversion although not statistically significant. Further, analyzing the types of PPE used, we found that the use of masks and gloves was protective in preventing infection. Strengthening IPC training through refresher training and demonstrating the correct use of PPE can enhance adherence to IPC measures.