tetano
Editor, Senior Moderator
Antimicrob Resist Infect Control
. 2022 Mar 18;11(1):51.
doi: 10.1186/s13756-022-01092-0.
Occupational and community risk of SARS-CoV-2 infection among employees of a long-term care facility: an observational study
Lauriane Lenggenhager[SUP] 1 2 [/SUP], Romain Martischang[SUP] 3 [/SUP], Julien Sauser[SUP] 3 [/SUP], Monica Perez[SUP] 3 [/SUP], Laure Vieux[SUP] 4 [/SUP], Christophe Graf[SUP] 5 [/SUP], Samuel Cordey[SUP] 6 7 [/SUP], Florian Laubscher[SUP] 7 [/SUP], Tomás Robalo Nunes[SUP] 8 [/SUP], Walter Zingg[SUP] 3 [/SUP], Anne Cori[SUP] 9 [/SUP], Stephan Harbarth[SUP] 3 6 [/SUP], Mohamed Abbas[SUP] 3 6 9 [/SUP]
Affiliations
Abstract
Background: We investigated the contribution of both occupational and community exposure for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among employees of a university-affiliated long-term care facility (LTCF), during the 1[SUP]st[/SUP] pandemic wave in Switzerland (March-June 2020).
Methods: We performed a nested analysis of a seroprevalence study among all volunteering LTCF staff to determine community and nosocomial risk factors for SARS-CoV-2 seropositivity using modified Poison regression. We also combined epidemiological and genetic sequencing data from a coronavirus disease 2019 (COVID-19) outbreak investigation in a LTCF ward to infer transmission dynamics and acquisition routes of SARS-CoV-2, and evaluated strain relatedness using a maximum likelihood phylogenetic tree.
Results: Among 285 LTCF employees, 176 participated in the seroprevalence study, of whom 30 (17%) were seropositive for SARS-CoV-2. Most (141/176, 80%) were healthcare workers (HCWs). Risk factors for seropositivity included exposure to a COVID-19 inpatient (adjusted prevalence ratio [aPR] 2.6; 95% CI 0.9-8.1) and community contact with a COVID-19 case (aPR 1.7; 95% CI 0.8-3.5). Among 18 employees included in the outbreak investigation, the outbreak reconstruction suggests 4 likely importation events by HCWs with secondary transmissions to other HCWs and patients.
Conclusions: These two complementary epidemiologic and molecular approaches suggest a substantial contribution of both occupational and community exposures to COVID-19 risk among HCWs in LTCFs. These data may help to better assess the importance of occupational health hazards and related legal implications during the COVID-19 pandemic.
Keywords: COVID-19; Nosocomial outbreaks; Occupational exposure; SARS-CoV-2.
. 2022 Mar 18;11(1):51.
doi: 10.1186/s13756-022-01092-0.
Occupational and community risk of SARS-CoV-2 infection among employees of a long-term care facility: an observational study
Lauriane Lenggenhager[SUP] 1 2 [/SUP], Romain Martischang[SUP] 3 [/SUP], Julien Sauser[SUP] 3 [/SUP], Monica Perez[SUP] 3 [/SUP], Laure Vieux[SUP] 4 [/SUP], Christophe Graf[SUP] 5 [/SUP], Samuel Cordey[SUP] 6 7 [/SUP], Florian Laubscher[SUP] 7 [/SUP], Tomás Robalo Nunes[SUP] 8 [/SUP], Walter Zingg[SUP] 3 [/SUP], Anne Cori[SUP] 9 [/SUP], Stephan Harbarth[SUP] 3 6 [/SUP], Mohamed Abbas[SUP] 3 6 9 [/SUP]
Affiliations
- PMID: 35303939
- DOI: 10.1186/s13756-022-01092-0
Abstract
Background: We investigated the contribution of both occupational and community exposure for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among employees of a university-affiliated long-term care facility (LTCF), during the 1[SUP]st[/SUP] pandemic wave in Switzerland (March-June 2020).
Methods: We performed a nested analysis of a seroprevalence study among all volunteering LTCF staff to determine community and nosocomial risk factors for SARS-CoV-2 seropositivity using modified Poison regression. We also combined epidemiological and genetic sequencing data from a coronavirus disease 2019 (COVID-19) outbreak investigation in a LTCF ward to infer transmission dynamics and acquisition routes of SARS-CoV-2, and evaluated strain relatedness using a maximum likelihood phylogenetic tree.
Results: Among 285 LTCF employees, 176 participated in the seroprevalence study, of whom 30 (17%) were seropositive for SARS-CoV-2. Most (141/176, 80%) were healthcare workers (HCWs). Risk factors for seropositivity included exposure to a COVID-19 inpatient (adjusted prevalence ratio [aPR] 2.6; 95% CI 0.9-8.1) and community contact with a COVID-19 case (aPR 1.7; 95% CI 0.8-3.5). Among 18 employees included in the outbreak investigation, the outbreak reconstruction suggests 4 likely importation events by HCWs with secondary transmissions to other HCWs and patients.
Conclusions: These two complementary epidemiologic and molecular approaches suggest a substantial contribution of both occupational and community exposures to COVID-19 risk among HCWs in LTCFs. These data may help to better assess the importance of occupational health hazards and related legal implications during the COVID-19 pandemic.
Keywords: COVID-19; Nosocomial outbreaks; Occupational exposure; SARS-CoV-2.