Clinical and laboratory characteristics of symptomatic healthcare workers with suspected COVID-19: a prospective cohort study

Antonin Bal,Hélène Lozano,Frédéric Moll,François Gueyffier,Isabelle Schlienger,Pascal Fascia,Grégory Quéromès,Valérie Cheynet,Myriam Gillet,Juliette Fontaine,Laurence Josset,Eurydice Caire,François Durupt,Matthieu Godinot,Alain Bergeret,David Narbey,Virginie Pitiot,Marie-Paule Milon,Lucie Gaillot-Durand,Marielle Perry,Audrey Samperiz,Matthieu Lahousse,Mélanie Prudent,Constance D’Aubarede,Chantal Simon,Jerôme Adnot,Muriel Rabilloud,Fatima Oria,Amélie Massardier-Pilonchery,Julie-Anne Nazare,Florent Bonnet,Dulce Alfaiate,Martine Valette,Vanessa Escuret,Djamila Makhloufi,A Boibieux ,Césari Laurent ,Bruno Pozzetto,Mary‐Anne Trabaud ,Florence Bellanger ,Alexandre Gaymard,Jean‐Baptiste Fassier ,Cristina Bárbara ,Émilie Frobert ,Maude Bouscambert,Nicolas Guibert,Florence Morfin,Florence Allantaz-Frager,Karen Brengel‐Pesce ,Sophie Trouillet‐Assant ,Bruno Lina,Pascal Poignard,Marlyse Buisson,Julien Lupo,Pierre Coriat ,Guy Oriol

doi:10.1038/s41598-021-93828-y

Abstract

A comprehensive clinical and microbiological assessments of COVID-19 in front-line healthcare workers (HCWs) is needed. Between April 10th and May 28th, 2020, 319 HCWs with acute illness were reviewed. In addition to SARS-CoV-2 RT-PCR screening, a multiplex molecular panel was used for testing other respiratory pathogens. For SARS-CoV-2 positive HCWs, the normalized viral load, viral culture, and virus neutralization assays were performed weekly. For SARS-CoV-2 negative HCWs, SARS-CoV-2 serological testing was performed one month after inclusion. Among the 319 HCWs included, 67 (21.0%) were tested positive for SARS-CoV-2; 65/67 (97.0%) developed mild form of COVID-19. Other respiratory pathogens were found in 6/66 (9.1%) SARS-CoV-2 positive and 47/241 (19.5%) SARS-Cov-2 negative HCWs (p = 0.07). The proportion of HCWs with a viral load > 5.0 log10 cp/mL (Ct value < 25) was less than 15% at 8 days after symptom onset; 12% of HCWs were positive after 40 days (Ct > 37). More than 90% of cultivable virus had a viral load > 4.5 log10 cp/mL (Ct < 26) and were collected within 10 days after symptom onset. Among negative HCWs, 6/190 (3.2%) seroconverted. Our data suggest that the determination of viral load can be used for appreciating the infectiousness of infected HCWs. These data could be helpful for facilitating their return to work.

Highlights

Since the beginning of the SARS-CoV-2 pandemic in December 2019, healthcare workers (HCWs) from all over the world have been on the front line for the management of COVID-19 patients
We performed a comprehensive assessment of COVID-19 in a longitudinal cohort study of 319 front-line HCWs enrolled during the first wave of the pandemic
The proportion of active smokers was lower among positive SARS-CoV-2 HCWs (6/67, 8.9%) compared to negative SARS-CoV-2 HCWs (64/252, 25.4%; p-adjusted = 0.09)

Summary

Introduction

Since the beginning of the SARS-CoV-2 pandemic in December 2019, healthcare workers (HCWs) from all over the world have been on the front line for the management of COVID-19 patients. SARS-CoV-2 isolation could be performed up to 10 days after symptom onset in mild-symptomatic p atients[18,23,24,25] and up to 22 days after the first positive results in severe cases[20,25,26,27]. To improve the clinical management of SARS-CoV-2 infection in HCWs, a virological investigation including quantitative RT-PCR, viral culture, as well as the determination of neutralizing antibody titers over the course of the disease is needed. With this aim, we performed a comprehensive assessment of COVID-19 in a longitudinal cohort study of 319 front-line HCWs enrolled during the first wave of the pandemic

Methods

Results

Conclusion