COVID-19 symptoms, duration, and prevalence among healthcare workers in the New York metropolitan area.

Fran A Ganz-Lord,Michael L Rinke,Kathryn R Segal

doi:10.1017/ice.2020.1334

Abstract

To evaluate symptoms, workforce implications, and testing patterns related to the coronavirus disease 2019 (COVID-19) pandemic among healthcare workers (HCWs) in the New York metropolitan area during spring 2020. Retrospective cohort study of occupational health services (OHS) records. A large, urban, academic medical center with 5 inpatient campuses and multiple ambulatory centers throughout Bronx and Westchester counties. We included HCWs who called OHS to report COVID-19 symptoms and had either severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) or IgG antibody testing. We analyzed the impact of COVID-19-related symptoms on (1) time from symptom onset to return to work, (2) the results of SARS-CoV-2 nasopharyngeal PCR testing, and (3) the results of SARS-CoV-2 IgG antibody testing in HCWs with mild-to-moderate COVID-19. The median time from symptom onset until return to work for HCWs who did not require hospitalization was 15 days (interquartile range, 10-22). Shortness of breath, fever, sore throat, and diarrhea were significantly associated with longer durations from symptom onset to return to work. Among symptomatic HCWs who had PCR testing during the study period, 51.9% tested positive. Of the previously symptomatic HCWs who had IgG antibody testing, 55.4% had reactive tests. Ageusia was associated with having both positive PCR and reactive antibody tests. Sore throat was associated with both negative PCR and nonreactive antibody tests. HCWs with COVID-19 who did not require hospitalization still had prolonged illness. Shortness of breath, fever, sore throat, and diarrhea are associated with longer durations of time away from work.

Highlights

The study population consisted of all healthcare workers (HCWs) who called the Occupational Health Services (OHS) office between March 1 and June 12, 2020
1,698 HCWs were away from work due to COVID-19 symptoms, had a positive polymerase chain reaction (PCR) test within a month of symptom onset, and were cleared by OHS to return to work during our study period
In a multivariable model with backward variable selection including these symptoms, and controlling for age, 4 symptoms were significantly associated with longer illness durations: shortness of breath (5.64 days; standard error [SE], 0.73), fever (2.94 days; SE, 0.74), sore throat (2.25 days; SE, 0.73), and diarrhea (2.14 days; SE, 0.76) (Table 1)

Summary

Introduction

The study population consisted of all HCWs who called the Occupational Health Services (OHS) office between March 1 and June 12, 2020. This cohort included employees in both clinical and nonclinical roles. HCWs called OHS to report potential symptoms of COVID-19, to receive guidance regarding fitness to work and returning to work, and to obtain both PCR and IgG antibody testing. IgG antibody testing was offered to all HCWs 21 days after symptom onset as of late April. Results of tests performed by the MMC laboratory were obtained from electronic medical records. Results of tests performed by non-MMC laboratories were reported to OHS verbally by the HCWs and were entered into the database.

Methods

Results

Conclusion