A Prospective Cohort of SARS-CoV-2 Infected Health Care Professionals: Clinical Characteristics, Outcomes and Follow Up Strategy

Abstract

Background: During COVID-19 outbreak healthcare professionals were at high risk of infection, due to increased assistance pressure, shortage of personal protection equipment and screening tests. Strategies to reduce in-hospital transmission between HCPs and to safely manage infected HCPs are lacking. Methods: Prospective cohort of SARS-CoV-2 infected healthcare professionals of a tertiary teaching hospital in Barcelona, Spain. An active strategy of weekly PCR screening for SARS-CoV-2 on HCPs was established by the Occupational Health department. Every positive HCP was admitted in the Hospital at Home Unit with daily virtual assessment and in-person discretionary visits. Clinical and epidemiological data was recorded. Findings: Of the 590 HCP included in the cohort, 134 (22%) were asymptomatic at diagnosis, and 15% (89 patients) remained asymptomatic during the follow up. One third of the positives were detected during routine screening. The most frequent symptoms were cough (68%), hyposmia/anosmia (49%) and fever (41%). 10% of the patients required specific treatment at home, while only 4% of the patients developed pneumonia. Seventeen patients required an extra visit to the hospital, while six patients (1%) required hospital readmission. None of them required ICU admission or died. Interpretation: The high percentage of asymptomatic HCPs detected in our study point out the necessity of an active screening for SARS-CoV-2 among HCPs for early diagnosis, and stopping in-hospital transmission chains. Follow up of HCPs in Hospital at Home units is safe and effective, with low rates of severe infection and readmission. Funding Statement: The authors received no specific funding for this work. Declaration of Interests: None of the authors declare competing interests with regards to the current work. Ethics Approval Statement: The study protocol was evaluated and approved by the Ethical Board of the Hospital Clinic (HCB/2020/0444). A waiver for informed consent was provided due to the state of infectious disease emergency.