Positive Healthcare Workers Research Articles

Effect of Covishieldtm (AZD1222) Vaccination on Incidences and Severity of Covid-19 among Health-Care Workers

Introduction: Limited information is available regarding effect of vaccination on protection against Covid-19 infections and their severity as well. Objectives: In the present study, we assessed the effect of Covid-19 vaccination on incidences and severity of break through Covid-19 infections. Method: This retrospective study was conducted at a tertiary care center in Northern India during one calendar year, 1st August 2021 to 31st July 2022. The study population included Health-care workers (HCWs) who were treated for Covid 19 infection and had already received at least 1 dose of Covishield TM (AZD1222) Covid-19 vaccine. Results: Out of 1868 health care workers enrolled for the study, 513 contracted Covid-19 infections. Amongst infected HCWs, number of single and double doses of CovishieldTM (AZD1222) recipients were 112 and 401 respectively. Out of the 513 covid positive HCWs, 459 (89.4%) had mild disease, whereas 54 (10.6%) had moderate disease. None of the HCWs developed severe disease and no mortality was noted in either group. Conclusion: In this study, we found that immunization with two doses of CovishieldTM (AZD1222) vaccine was associated with decline in number of cases with moderate or severe Covid-19. Moreover, immunization with even single dose of CovishieldTM (AZD1222) vaccine prevented development of severe disease. Henceforth, it is concluded that although, immunization with CovishieldTM (AZD1222) could not protect all recipients from SARS-Cov-2 infection, it did prevent the progress of disease to severe grades.

Comparison of SARS-COV-2 Infection Between Sero Positive and Sero Negative Healthcare Workers After Six Months in a Tertiary Care Hospital

Comparison of SARS-COV-2 Infection Between Sero Positive and Sero Negative Healthcare Workers After Six Months in a Tertiary Care Hospital

COVID-19 Pozitif Sağlık Çalışanlarının Semptom, Laboratuvar ve Toraks Bilgisayarlı Tomografi Bulgularının Değerlendirilmesi: Rektrospektif Çalışma

Objective: The study was carried out to examine the symptoms and laboratory and thoracic computed tomography findings of COVID-19-positive healthcare professionals in northeastern Turkey. 
 Material and Method: The sample of this descriptive, cross-sectional, and retrospective study consisted of 146 healthcare professionals who had positive COVID-19. Data were collected using electronic data from the hospital information management system and the personal health records of healthcare professionals. 
 Results: 50.6% of COVID-19-positive healthcare professionals were symptomatic, 49.4% were asymptomatic, 52.7% of nurses, midwives, and health officers, and those who were symptomatic experienced the most cough, muscle-joint pain, and fatigue. Healthcare workers had a high leukocyte, neutrophil, lymphocyte, platelet mean, C reactive protein, and D-dimer, and 24.1% had COVID-19-compatible thorax computed tomography. Symptomatic healthcare professionals had a lower median of leukocyte and a higher median of C reactive protein and procalcitonin compared to asymptomatic healthcare professionals. Healthcare professionals with COVID-19 compatible thorax computed tomography had a lower leukocyte, median, and platelet mean, lower high C reactive protein median, and higher D-dimer median. 
 Conclusion: The study found that half of the healthcare professionals are symptomatic, and leukocyte, neutrophil, lymphocyte, C reactive protein, and platelet values affect the development of COVID-19-compatible thoracic computed tomography. The results can be used as a knowledge base for research and by health workers and institutional authorities to implement methods to improve prevention levels.

COVID-19 geçiren veya geçirmemiş olan sağlık çalışanlarında anksiyete durumunun değerlendirilmesi

Aim: The coronavirus disease 2019 (COVID-19) pandemic has presented significant challenges to healthcare systems worldwide, impacting the mental health of healthcare workers. This study aimed to assess and compare anxiety levels among different categories of healthcare workers during the pandemic.
 
 Methods: A cross-sectional survey study was conducted with 180 healthcare workers categorized into four groups: COVID-19 negative healthcare workers (n=45), COVID-19 positive hospitalized and treated healthcare workers (n=45), COVID-19 positive healthcare workers treated at home (n=45), and COVID-19 negative healthcare workers who were off duty due to chronic illnesses (n=45). The Coronavirus Anxiety Scale (CAS) was used to measure anxiety levels.
 
 Results: COVID-19 negative healthcare workers reported relatively lower anxiety levels (mean CAS score = 1.29, SD = 1.829), with the majority experiencing minimal anxiety. COVID-19 positive hospitalized and treated healthcare workers had expressively higher anxiety levels (mean CAS score = 4.09, SD = 5.049), indicating substantial distress. COVID-19 positive healthcare workers treated at home demonstrated intermediate anxiety levels (mean CAS score = 3.09, SD = 3.014). COVID-19 negative healthcare workers with chronic illnesses showed higher anxiety levels compared to their non-chronically ill counterparts (mean CAS score = 2.02, SD = 2.19).
 
 Conclusion: This study highlights the diverse psychological impact of the COVID-19 pandemic on healthcare workers. COVID-19 positive hospitalized and treated healthcare workers experienced the highest levels of anxiety, followed by those treated at home. Even COVID-19 negative healthcare workers and those with chronic illnesses experienced notable anxiety. These findings emphasize the need for targeted interventions and support systems to address the mental health needs of healthcare workers effectively during and beyond the pandemic. Understanding and mitigating anxiety among healthcare workers are crucial for their well-being and the quality of patient care. Further research is warranted to explore additional factors influencing anxiety levels in this population.

SARS-COV-2 INFECTION AND ITS SYMPTOMS AMONG COVID-19 VACCINATED AND UNVACCINATED HEALTH-CARE WORKERS

Objective: India’s national coronavirus disease 2019 (COVID-19) vaccination programs started during January 2021 and prioritized health-care workers (HCWs). In this study, we are attempting to measure post-vaccination product-specific (ChAdOx1_nCoV-19/COVISHIELD) COVID-19 vaccine effectiveness among vaccinated hospital HCWs and also to assess symptoms in HCWs with reverse transcription-polymerase chain reaction (RT-PCR) confirmed severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection. Methods: This is an online web-based cross-sectional study conducted in June 2021 among vaccinated HCWs, comparing SARS-CoV-2 incidence and symptoms. In this study, demographic data such as age, gender, and profession were collected. Other data collected were vaccination status at the time of infection, the gap between COVID-19 positivity and vaccination, symptoms, hospitalization, time to recovery, and previous positive history before vaccination. Results: A total of 1685 HCWs were vaccinated with the COVISHIELD vaccine from January 16 to March 18, 2021. Out of 1685 HCWs, 82 (4.8%) were tested positive by RT-PCR after vaccination. Out of 82 positive HCWs, 84% experienced mild symptoms, 12.2% experienced moderate symptoms, and 3.7% had severe manifestations leading to hospitalization. Among these positive HCWs, 25.6% recovered within 7 days, 35.3% recovered in 7–10 days, 15.8% recovered in 11–14 days, and 23.1% recovered after 2 weeks from the 1st day of experiencing symptoms. Conclusion: Although COVID-19 vaccination by COVISHIELD may not fully prevent from infection by SARS-CoV-2 or its different variants, majority of positive cases present with asymptomatic/mild symptoms. Post-vaccination-positive cases may also present with severe symptoms and require hospitalization.

A screening strategy to prevent hospital acquired COVID -19 in peak pandemic period

Health care worker (HCW) are at increased risk for Severe acute respiratory syndrome corona virus 2 (SARSCoV-2) infection. The study evaluates seroprevalence of SARS CoV-2 IgG antibody among HCW during peak pandemic period and plans a screening strategy for early identification and isolation of HCW. This is the prospective cross sectional study of HCW where High risk and low risk HCW were tested for the presence of SARS-CoV-2 IgG antibodies using Architect automated analyser. Out of 264 HCW, 36 (13.6%) HCW were positive for SARS CoV-2 IgG antibodies. Seroprevalence was 14.7% in low risk group while 13.2 % among high risk group. Serosurvey could detect antibody in 47.3% HCW which were either negative by COVID-19 RTPCR or were never tested owing to absence of clinical symptoms.SARS-CoV-2 IgG antibody were absent in 39% previously COVID-19 positive HCW. Equal seroprevalence in both the groups of HCW during peak of pandemic is suggestive of community transmission in India and robust infection control policy of hospital. Also, we conclude that there is need of multiprong approach with serial diagnostic screening of COVID infection in health care worker which should include both RTPCR and serological test.

"For my safety and wellbeing, I always travel to seek health care in a distant facility"-the role of place and stigma in HIV testing decisions among GBMSM - BSGH 002.

Gays, bisexuals, and all other men who have sex with men (GBMSM) are heavily impacted by HIV in Ghana compared to the general population. In addition to HIV and same-sex intercourse stigma, barriers such as reduced privacy, lower-income status and limited health care facilities (HCF) affect HIV testing decisions among GBMSM. We employed a phenomenological research design to understand the role of place and stigma in HIV testing among GBMSM in slums. GBMSM (n=12) from slums in Accra and Kumasi, Ghana, were recruited and engaged in face-to-face interviews. We used a multiple reviewer summative content analysis to analyze and organize our key findings. The HIV testing options we identified include 1. Government HCF, 2. NGO and community outreach 3. Peer-educated services. Factors influencing GBMSM to test for HIV at HCF outside their areas included 1. The location of HCF 2. HIV and sexual stigma from slum areas 3. Positive HCW attitudes at distant HCF. 4. Negative Healthcare worker (HCW) attitudes towards GBMSM. These findings highlighted how stigma from slums and HCW influence HIV testing decisions and the need for place-based interventions to address stigma among HCW in slums to improve testing among GBMSM.

Nosocomial SARS-COVID-19 Outbreak During the Third Wave of COVID-19 in an Oncology Facility at a Tertiary Care Hospital in Kashmir, India.

Coronavirus disease 2019 (COVID-19) emerged as a life-threatening respiratory condition, especially in immunocompromised patients, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Initially detected in China in December 2019, the first case in India was diagnosed on January30, 2020. Here we report a nosocomial COVID-19 outbreak among cancer patients and healthcare workers(HCWs) in a medical oncology unit of a tertiary care hospital from our region. This was a descriptive study of the nosocomial COVID-19 outbreak and was conducted in the month of January 2022 at the medical oncology unit of a tertiary care hospital in Srinagar, Jammu and Kashmir (J&K), India.The study included 25 COVID-19 cases, including patients and HC/non-HCWs (NHCWs). The confirmation of diagnosis was done through real-time polymerase chain reaction (RT-PCR) using nasopharyngeal/oropharyngeal swabs as the test sample. Twenty-five COVID-19 cases, including 14 admitted patients, nine HCWs, and two NHCWs were confirmed by COVID-19 RT-PCR in a span of 11 days. The first case was a positive HCW. The patients were admitted for management of various hematological as well as solid organ malignancies. Of the 14 patients, eight were in the pediatric age group with a mean age of 6.9 years, and six were adults with a mean age of 55.2 years. Thirteen patients were on different chemotherapy protocols, and one was undergoing an autologous stem cell transplant. Of the 14 patients, four were asymptomatic for COVID-19 symptoms, eight had mild disease, and two had severe disease with respiratory failure. Two patients with severe diseases needed COVID-19-designated high-dependency unit (HDU) admission. There was one COVID-19-related death. Among the healthcare workers, the mean age was 33.8 years, of which six were males and three were females. All the HCWs and NHCWs had mild disease, and all of them recovered completely. Nosocomial COVID-19 illness is a new entity and is preventable. COVID-19 illness will remain in society after the pandemic is over, like the influenza B viral illness, and there can be seasonal flares in the future. Proper measures should be taken to prevent its clustering in hospital settings.

A Serological Analysis of the Humoral Immune Responses of Anti-RBD IgG, Anti-S1 IgG, and Anti-S2 IgG Levels Correlated to Anti-N IgG Positivity and Negativity in Sicilian Healthcare Workers (HCWs) with Third Doses of the mRNA-Based SARS-CoV-2 Vaccine: A Retrospective Cohort Study.

With SARS-CoV-2 antibody tests on the market, healthcare providers must be confident that they can use the results to provide actionable information to understand the characteristics and dynamics of the humoral response and antibodies (abs) in SARS-CoV-2-vaccinated patients. In this way, the study of the antibody responses of healthcare workers (HCWs), a population that is immunocompetent, adherent to vaccination, and continuously exposed to different virus variants, can help us understand immune protection and determine vaccine design goals. We retrospectively evaluated antibody responses via multiplex assays in a sample of 538 asymptomatic HCWs with a documented complete vaccination cycle of 3 doses of mRNA vaccination and no previous history of infection. Our sample was composed of 49.44% males and 50.56% females, with an age ranging from 21 to 71 years, and a mean age of 46.73 years. All of the HCWs' sera were collected from April to July 2022 at the Sant'Elia Hospital of Caltanissetta to investigate the immunologic responses against anti-RBD, anti-S1, anti-S2, and anti-N IgG abs. A significant difference in age between HCWs who were positive and negative for anti-N IgG was observed. For anti-S2 IgG, a significant difference between HCWs who were negative and positive compared to anti-N IgG was observed only for positive HCWs, with values including 10 (U/mL)-100 (U/mL); meanwhile, for anti-RBD IgG and anti-S1 IgG levels, there was only a significant difference observed for positive HCWs with diluted titers. For the negative values of anti-N IgG, among the titer dilution levels of anti-RBD, anti-S1, and anti-S2 IgG, the anti-S2 IgG levels were significantly lower than the anti-RBD and anti-S1 levels; in addition, the anti-S1 IgG levels were significantly lower than the anti-RBD IgG levels. For the anti-N IgG positive levels, only the anti-S2 IgG levels were significantly lower than the anti-RBD IgG and anti-S1 IgG levels. Finally, a logistic regression analysis showed that age and anti-S2 IgG were negative and positive predictors of anti-N IgG levels, respectively. The analysis between the vaccine type and mixed mRNA combination showed higher levels of antibodies in mixed vaccinated HCWs. This finding disappeared in the anti-N positive group. Most anti-N positive HCWs showed antibodies against the S2 domain and were young subjects. Therefore, the authors suggest that including the anti-SARS-CoV-2-S2 in antibody profiles can serve as a complementary testing approach to qRT-PCR for the early identification of asymptomatic infections in order to reduce the impact of potential new SARS-CoV-2 variants. Our serological investigation on the type of mRNA vaccine and mixed mRNA vaccines shows that future investigations on the serological responses in vaccinated asymptomatic patients exposed to previous infection or reinfection are warranted for updated vaccine boosters.

Profile of COVID-19 breakthrough cases and its comparison with unvaccinated COVID-19 cases among healthcare workers in a tertiary care centre in North Kerala.

Healthcare workers (HCWs) were the most vulnerable group during COVID-19 pandemic and had faced many challenges including high rate of breakthrough infections. To study the incidence of reported breakthrough infections among HCWs in Government Medical College, Kozhikode and to compare profile of COVID-19 infection between fully vaccinated and unvaccinated COVID-19 positive HCWs. The research was conducted as a prospective study for a duration of 78 weeks from 1st of March 2020 through 31st of August 2021 in Government Medical College, Kozhikode. The study was conducted among HCWs in a COVID-19 tertiary care institute. Real-time data were collected from 401 breakthrough cases and 390 unvaccinated COVID-19 positive HCWs through telephonic interviews. Univariate analysis was done using frequency for categorical variables and mean and standard deviation for quantitative variables. Chi-square test was used to find out statistical significance. Incidence of breakthrough infection was found to be 5.62% with 43.3% being asymptomatic. Fever was the most predominant symptom (62.5%). None of the breakthrough cases developed complication requiring intensive care (ICU). There was a reduction in incidence of acute post-COVID-19 syndrome in vaccinated group (17.45%) compared to unvaccinated group (57.2%). COVID-19 vaccination plays a key role in preventing severity, complication, and ICU admissions in COVID-19 infection. Incidence of post-COVID-19 syndrome is also less among fully vaccinated compared to unvaccinated individuals.

Sero-Prevalence and Determinants of Hepatitis C Virus Infection Among Healthcare Workers of a Private Tertiary Care Hospital in Karachi

Health care workers (HCWs) are at high risk of exposure to hepatitis B virus (HBV), hepatitis C virus (HCV) and HIV transmission due to occupational exposure to injuries, from sharp needles, and scalpels during the execution of their health care duties. We aimed to assess HCV sero-prevalence, and possible risk factors of HCV among HCWs of Kharadar General Hospital, Karachi. Total 300 HCWs were included in the study. Hepatitis C virus antibody was detected through rapid diagnostic test (RDT) then HCV-Ribo-nucleic Acid (RNA) was detected among RDT positive HCWs by using GeneXpert. Structure questionnaire was used for data collection. Data was analyzed by using SPSS 19. Correlation was seen between HCV determinants and positivity by using Pearson chi-square test. A p value of < 0.05 were considered statistically significant. Total 300 HCWs were screened for HCV. Mean age of participants was 30.19 ± 10.55 years and 179 (60%) were female. Both Sero-prevalence and Viraemic prevalence was reported 3 (1%) among study HCWs. Occupational exposure through needle stick injury (NSI) was reported among 172 (57%) HCWs and commonly seen in nursing staff 88 (68.7%), especially at ER 13 (72%). Other significant non-occupational risk factors were ear/nose piercing 175 (58%), dental and surgical procedures 166 (55%). Frequency of HCV among HCWs of study hospital was low, despite high occupational exposure of NSI. Study findings can be used for future prevention of occupational exposure of HCV among HCWs by developing and implementing standard operational procedures and policies.

Combining epidemiological data and whole genome sequencing to understand SARS-CoV-2 transmission dynamics in a large tertiary care hospital during the first COVID-19 wave in The Netherlands focusing on healthcare workers

BackgroundHealthcare facilities have been challenged by the risk of SARS-CoV-2 transmission between healthcare workers (HCW) and patients. During the first wave of the COVID-19 pandemic, infections among HCW were observed, questioning infection prevention and control (IPC) measures implemented at that time.AimThis study aimed to identify nosocomial transmission routes of SARS-CoV-2 between HCW and patients in a tertiary care hospital.MethodsAll SARS-CoV-2 PCR positive HCW and patients identified between 1 March and 19 May 2020, were included in the analysis. Epidemiological data were collected from patient files and HCW contact tracing interviews. Whole genome sequences of SARS-CoV-2 were generated using Nanopore sequencing (WGS). Epidemiological clusters were identified, whereafter WGS and epidemiological data were combined for re-evaluation of epidemiological clusters and identification of potential transmission clusters. HCW infections were further classified into categories based on the likelihood that the infection was acquired via nosocomial transmission. Secondary cases were defined as COVID-19 cases in our hospital, part of a transmission cluster, of which the index case was either a patient or HCW from our hospital.FindingsThe study population consisted of 293 HCW and 245 patients. Epidemiological data revealed 36 potential epidemiological clusters, with an estimated 222 (75.7%) HCW as secondary cases. WGS results were available for 195 HCW (88.2%) and 20 patients (12.8%) who belonged to an epidemiological cluster. Re-evaluation of the epidemiological clusters, with the available WGS data identified 31 transmission clusters with 65 (29.4%) HCW as secondary cases. Transmission clusters were all part of 18 (50.0%) previously determined epidemiological clusters, demonstrating that several larger outbreaks actually consisted, of several smaller transmission clusters. A total of 21 (7.2%) HCW infections were classified as from confirmed nosocomial, of which 18 were acquired from another HCW and 3 from a patient.ConclusionThe majority of SARS-CoV-2 infections among HCW could be attributed to community-acquired infection. Infections among HCW that could be classified as due to nosocomial transmission, were mainly caused by HCW-to-HCW transmission rather than patient-to-HCW transmission. It is important to recognize the uncertainties of cluster analyses based solely on epidemiological data.

A systematic outbreak investigation of SARS-CoV-2 transmission clusters in a tertiary academic care center

BackgroundWe sought to decipher transmission pathways in healthcare-associated infections with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) within our hospital by epidemiological work-up and complementary whole genome sequencing (WGS). We report the findings of the four largest epidemiologic clusters of SARS-CoV-2 transmission occurring during the second wave of the pandemic from 11/2020 to 12/2020.MethodsAt the University Hospital Basel, Switzerland, systematic outbreak investigation is initiated at detection of any nosocomial case of SARS-CoV-2 infection, as confirmed by polymerase chain reaction, occurring more than five days after admission. Clusters of nosocomial infections, defined as the detection of at least two positive patients and/or healthcare workers (HCWs) within one week with an epidemiological link, were further investigated by WGS on respective strains.ResultsThe four epidemiologic clusters included 40 patients and 60 HCWs. Sequencing data was available for 70% of all involved cases (28 patients and 42 HCWs), confirmed epidemiologically suspected in house transmission in 33 cases (47.1% of sequenced cases) and excluded transmission in the remaining 37 cases (52.9%). Among cases with identical strains, epidemiologic work-up suggested transmission mainly through a ward-based exposure (24/33, 72.7%), more commonly affecting HCWs (16/24, 66.7%) than patients (8/24, 33.3%), followed by transmission between patients (6/33, 18.2%), and among HCWs and patients (3/33, 9.1%, respectively two HCWs and one patient).ConclusionsPhylogenetic analyses revealed important insights into transmission pathways supporting less than 50% of epidemiologically suspected SARS-CoV-2 transmissions. The remainder of cases most likely reflect community-acquired infection randomly detected by outbreak investigation. Notably, most transmissions occurred between HCWs, possibly indicating lower perception of the risk of infection during contacts among HCWs.

POST VIRAL FATIGUE SYNDROME IN COVID-19 AND ITS ASSOCIATION WITH INFLAMMATORY MARKERS AMONGST HEALTH CARE WORKERS.

Background: Coronavirus contribute to respiratory illness, including severe disease. COVID-19 infection is associated with multiple acute complications including post viral fatigue syndrome. Healthcare workers have a higher rate of exposure to this virus which crippled the healthcare system. Patients acutely infected with SARS-CoV-2, demonstrate elevated inammatory markers. Hence in this study we sought to establish whether patients of SARS-CoV-2 infection remained fatigued post recovery and whether there was a relationship between severe fatigue and inammatory markers. 390 COVID-19 Materials And Methods: positive healthcare workers were studied at Assam Medical College and Hospital from July 2021 to June 2022. Assessment of fatigue was done using the Prole of Fatigue Related Symptoms (PFRS) score. In our study, maximum belong to age group 18-30 ye Results: ars of age (45.64%). Out of 390 cases, 211 (54.10%) were female. 180 (46.2%) had elevated LDH, 209 (53.6%) had elevated CRP. 18 (4.6%) had an SPO2 of &lt; 90% in room air, post viral fatigue syndrome was present in 201 (51.54%) out of which 38(9.75%) had extreme fatigue symptoms, 163(41.79%) had moderate fatigue symptoms. The association between the association between post viral fatigue syndrome and inammatory markers (LDH and CRP) was signicant (p &lt; 0.001). There was a signicant association between inamma Conclusion: tory markers (LDH and CRP) with Post Viral Fatigue Syndrome in COVID-19. . Hence, proper assessment after ruling out other co-existent diseases and using the Prole of Fatigue Related Symptoms (PFRS) score, may help in identifying cases of Post Viral Fatigue Syndrome

Evaluation of the Abbott Panbio™ COVID-19 antigen detection rapid diagnostic test among healthcare workers in elderly care.

Coronavirus disease 2019 (COVID-19) has been especially dangerous for elderly people. To reduce the risk of transmission from healthcare workers to elderly people, it is of utmost importance to detect possible severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive healthcare workers as early as possible. We aimed to determine whether the Abbott Panbio™ COVID-19 antigen detection rapid diagnostic test (Ag-RDT) could be used as an alternative to reverse transcription-quantitative polymerase chain reaction (RT-qPCR). The second aim was to compare the cycle threshold (Ct) in RT-qPCR with the results of the Ag-RDT. A prospective diagnostic evaluation of the Abbott Panbio™ COVID-19 Ag-RDT among healthcare workers across three elderly care facilities as well as home-based elderly care workers who met clinical criteria for COVID-19 during the second wave of the COVID-19 pandemic. Per healthcare worker, the first nasopharyngeal swab was obtained to perform the Ag-RDT and the second swab for RT-qPCR. A Ct-value of < 40 was interpreted as positive, ≥ 40 as negative. A total of 683 healthcare workers with COVID-19 symptoms were sampled for detection of SARS-CoV-2 by both Ag-RDT and RT-qPCR. Sixty-three healthcare workers (9.2%) tested positive for SARS-CoV-2 by RT-qPCR. The overall sensitivity of Ag-RDT was 81.0% sensitivity (95%CI: 69.6-88.8%) and 100% specificity (95%CI: 99.4-100%). Using a cut-off Ct-value of 32, the sensitivity increased to 92.7% (95% CI: 82.7-97.1%). Negative Ag-RDT results were moderately associated with higher Ct-values (r = 0.62) compared to positive Ag-RDT results. The Panbio™ COVID-19 Ag-RDT can be used to quickly detect positive SARS-CoV-2 healthcare workers. Negative Ag-RDT should be confirmed by RT-qPCR. In case of severe understaffing and with careful consideration, fully vaccinated healthcare workers with Ag-RDT negative results could work with a mask pending PCR results.

Healthcare workers exposed to COVID-19 patients present an inflammatory status and Th2/Th17/Th22 immune profile: findings from before vaccine application in Brazil

Healthcare workers present an increased risk of contagion for the SARS-CoV-2 virus due to their labor exposure. Here, we describe the clinical, laboratory, and immunological characteristics of healthcare workers, before vaccine application, exposed to SARS-CoV-2-infected patients. We collected sociodemographic, clinical, and laboratory information from 50 professionals who worked during the COVID-19 pandemic at the Clinical Hospital of the Northwest in Brazil. The results showed that most workers are women, over 50 years old, and worked as nursing technicians. Approximately 56% of workers were positive for a previous infection by RT-PCR and/or anti-SARS-CoV-2-immunoglobulin tests. Increased levels of hematocrit, neutrophils, NK lymphocytes, and fibrinogen, were found in positive healthcare workers, suggesting a light inflammatory status. The immunological findings showed an increase in IL-17 production and a Th2/Th17/Th22 profile followed by high serology for anti-SARS-CoV-2 IgM and IgG. Those data reveal the importance of studies with healthcare workers to investigate if the continuous exposition to the virus may result in chronic activation of the immune system and/or pulmonary inflammation in this target group.

Psychological impact of COVID 19 on confirmed positive health care workers of a selected government hospital

Psychological impact of COVID 19 on confirmed positive health care workers of a selected government hospital

Control of an outbreak of COVID-19 at a tertiary hospital in Taiwan.

BackgroundCoronavirus disease 2019 (COVID-19) has circulated in Taiwan since late 2019. Healthcare facilities are vulnerable to COVID-19 outbreaks due to clusters of symptomatic patients and susceptible hosts. Prompt control of outbreaks is crucial. In May 2021, an index case of COVID-19 was detected at Far Eastern Memorial Hospital (FEMH) in New Taipei City, Taiwan, 3 days after hospital admission, spreading to 26 patients and staff. Herein we evaluate control of this COVID-1 outbreak.MethodsTo control the outbreak, the index case ward was closed, and large-scale COVID-19 testing (RT PCR) was performed for all inpatients, caregivers and healthcare workers (HCWs). All exposed persons were quarantined. Thorough investigation was conducted to analyze the transmission route.ResultsThe outbreak comprised 12 patients, 12 caregivers, and 3 HCWs. Seven patients expired and the remaining cases recovered. Overall, 456 patients/caregivers and 169 HCWs were quarantined. Analysis showed that longer exposure time was the main cause of HCW infection; all three infected HCWs were primary-care nurses related to the index case. To diminish hidden cases, all hospitalized patients/caregivers received PCR examinations and all results were negative. Thereafter, all patients/caregivers routinely received PCR examination on admission. Hospital-wide PCR screening for HCW detected 4 positive HCWs unrelated to this outbreak, and a second-round of screening detected 2 more cases, with no additional cases during the following 6 months.ConclusionPrompt infection control measures and large-scale PCR screening can control a COVID-19 outbreak within 2 weeks. Exposure time is the major risk factor for HCW infection.

Characteristics and transmission dynamics of COVID-19 in healthcare workers in a tertiary teaching hospital

Coronavirus disease-19 (COVID-19) transmission significantly affected Healthcare workers (HCWs) worldwide. As a result, they have paid a heavy toll to the COVID-19 outbreak. However, the literature on its transmission routes and risk factors in HCWs is limited. The aim. The authors seek to characterize and know the transmission dynamics of COVID-19 infection in the HCWs of our hospital. Methods: A cross-sectional descriptive study was conducted by the authors. Staff records and virology testing results were used to identify SARS-CoV-2 positive HCWs and study the demographic characteristics and transmission dynamics over one and a half years. Data were analyzed using SPSS software version 23. Results: A total of 169 healthcare workers were positive for SARS-CoV-2. 6 doctors were positive from non-clinical branches, and 17 were positive from clinical branches. One health worker also died of cardio-pulmonary compromise. 88.2 % of healthcare workers got infected while managing patient’s positive for COVID-19. The most frequent clinical manifestation was myalgias in 90.53 % of health workers, followed by arthralgia in 86.98 %. The least common symptoms were loss of taste/smell followed by radiographic changes, and only 19 (11.24 %) presented with shortness of breath. 79.88 % have taken self-medication to relieve COVID symptoms. Maximum number of health workers got infected from July to September. Conclusions: Universal masking, reinforcement of hand hygiene, PPE kits with medical masks, appropriate infection control measures and testing of both clinical and non-clinical staff were essential measures for reducing transmission amongst HCWs

Reconstruction of transmission chains of SARS-CoV-2 amidst multiple outbreaks in a geriatric acute-care hospital: a combined retrospective epidemiological and genomic study.

There is ongoing uncertainty regarding transmission chains and the respective roles of healthcare workers (HCWs) and elderly patients in nosocomial outbreaks of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in geriatric settings. We performed a retrospective cohort study including patients with nosocomial coronavirus disease 2019 (COVID-19) in four outbreak-affected wards, and all SARS-CoV-2 RT-PCR positive HCWs from a Swiss university-affiliated geriatric acute-care hospital that admitted both Covid-19 and non-Covid-19 patients during the first pandemic wave in Spring 2020. We combined epidemiological and genetic sequencing data using a Bayesian modelling framework, and reconstructed transmission dynamics of SARS-CoV-2 involving patients and HCWs, to determine who infected whom. We evaluated general transmission patterns according to case type (HCWs working in dedicated Covid-19 cohorting wards: HCWcovid; HCWs working in non-Covid-19 wards where outbreaks occurred: HCWoutbreak; patients with nosocomial Covid-19: patientnoso) by deriving the proportion of infections attributed to each case type across all posterior trees and comparing them to random expectations. During the study period (1 March to 7 May 2020), we included 180 SARS-CoV-2 positive cases: 127 HCWs (91 HCWcovid, 36 HCWoutbreak) and 53 patients. The attack rates ranged from 10% to 19% for patients, and 21% for HCWs. We estimated that 16 importation events occurred with high confidence (4 patients, 12 HCWs) that jointly led to up to 41 secondary cases; in six additional cases (5 HCWs, 1 patient), importation was possible with a posterior probability between 10% and 50%. Most patient-to-patient transmission events involved patients having shared a ward (95.2%, 95% credible interval [CrI] 84.2%-100%), in contrast to those having shared a room (19.7%, 95% CrI 6.7%-33.3%). Transmission events tended to cluster by case type: patientnoso were almost twice as likely to be infected by other patientnoso than expected (observed:expected ratio 2.16, 95% CrI 1.17-4.20, p=0.006); similarly, HCWoutbreak were more than twice as likely to be infected by other HCWoutbreak than expected (2.72, 95% CrI 0.87-9.00, p=0.06). The proportion of infectors being HCWcovid was as expected as random. We found a trend towards a greater proportion of high transmitters (≥2 secondary cases) among HCWoutbreak than patientnoso in the late phases (28.6% vs. 11.8%) of the outbreak, although this was not statistically significant. Most importation events were linked to HCW. Unexpectedly, transmission between HCWcovid was more limited than transmission between patients and HCWoutbreak. This finding highlights gaps in infection control and suggests the possible areas of improvements to limit the extent of nosocomial transmission. This study was supported by a grant from the Swiss National Science Foundation under the NRP78 funding scheme (Grant no. 4078P0_198363).