tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2020 Dec 8;8(1)
faa592.
doi: 10.1093/ofid/ofaa592. eCollection 2021 Jan.
A Prospective Cohort of SARS-CoV-2-Infected Health Care Workers: Clinical Characteristics, Outcomes, and Follow-up Strategy
David Nicol?s[SUP] 1 2 3 [/SUP], Anna Cam?s-Carreras[SUP] 4 [/SUP], Felipe Spencer[SUP] 4 [/SUP], Andrea Arenas[SUP] 2 [/SUP], Eugenia Butori[SUP] 2 [/SUP], Pol Maym?[SUP] 2 [/SUP], Gerard Anmella[SUP] 5 [/SUP], Orla Torrallardona-Murphy[SUP] 1 2 [/SUP], Eduarda Alves[SUP] 1 2 [/SUP], Laura Garc?a[SUP] 2 [/SUP], Irene Pereta[SUP] 2 [/SUP], Eva Castells[SUP] 2 [/SUP], Nuria Seijas[SUP] 2 [/SUP], Bego?a Ib??ez[SUP] 2 [/SUP], Carme Gran?[SUP] 2 [/SUP], Marta Bodro[SUP] 2 6 [/SUP], Celia Cardozo[SUP] 2 6 [/SUP], Sonia Barroso[SUP] 7 [/SUP], Victoria Olive[SUP] 7 [/SUP], Marta Tortajada[SUP] 7 [/SUP], Carme Hern?ndez[SUP] 2 3 8 [/SUP], David Cucchiari[SUP] 9 [/SUP], Emmanuel Coloma[SUP] 1 2 3 [/SUP], Juan M Peric?s[SUP] 1 2 10 [/SUP], Hospital Clinic Hospital at Home Team
Collaborators, Affiliations
Abstract
Background: During the coronavirus disease 2019 (COVID-19) outbreaks, health care workers (HCWs) are at a high risk of infection. Strategies to reduce in-hospital transmission between HCWs and to safely manage infected HCWs are lacking. Our aim was to describe an active strategy for the management of COVID-19 in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected HCWs and investigate its outcomes.
Methods: A prospective cohort study of SARS-CoV-2-infected health care workers in a tertiary teaching hospital in Barcelona, Spain, was performed. An active strategy of weekly polymerase chain reaction screening of HCWs for SARS-CoV-2 was established by the Occupational Health department. Every positive HCW was admitted to the Hospital at Home Unit with daily assessment online and in-person discretionary visits. Clinical and epidemiological data were recorded.
Results: Of the 590 HCWs included in the cohort, 134 (22%) were asymptomatic at diagnosis, and 15% (89 patients) remained asymptomatic during follow-up. A third of positive cases were detected during routine screening. The most frequent symptoms were cough (68%), hyposmia/anosmia (49%), and fever (41%). Ten percent of the patients required specific treatment at home, while only 4% of the patients developed pneumonia. Seventeen patients required a visit to the outpatient clinic for further evaluation, and 6 of these (1%) required hospital admission. None of the HCWs included in this cohort required intensive care unit admission or died.
Conclusions: Active screening for SARS-CoV-2 among HCWs for early diagnosis and stopping in-hospital transmission chains proved efficacious in our institution, particularly due to the high percentage of asymptomatic HCWs. Follow-up of HCWs in Hospital at Home units is safe and effective, with low rates of severe infection and readmission.
Keywords: COVID-19; Hospital at Home; SARS-CoV-2; coronavirus; health care workers.
. 2020 Dec 8;8(1)
faa592.doi: 10.1093/ofid/ofaa592. eCollection 2021 Jan.
A Prospective Cohort of SARS-CoV-2-Infected Health Care Workers: Clinical Characteristics, Outcomes, and Follow-up Strategy
David Nicol?s[SUP] 1 2 3 [/SUP], Anna Cam?s-Carreras[SUP] 4 [/SUP], Felipe Spencer[SUP] 4 [/SUP], Andrea Arenas[SUP] 2 [/SUP], Eugenia Butori[SUP] 2 [/SUP], Pol Maym?[SUP] 2 [/SUP], Gerard Anmella[SUP] 5 [/SUP], Orla Torrallardona-Murphy[SUP] 1 2 [/SUP], Eduarda Alves[SUP] 1 2 [/SUP], Laura Garc?a[SUP] 2 [/SUP], Irene Pereta[SUP] 2 [/SUP], Eva Castells[SUP] 2 [/SUP], Nuria Seijas[SUP] 2 [/SUP], Bego?a Ib??ez[SUP] 2 [/SUP], Carme Gran?[SUP] 2 [/SUP], Marta Bodro[SUP] 2 6 [/SUP], Celia Cardozo[SUP] 2 6 [/SUP], Sonia Barroso[SUP] 7 [/SUP], Victoria Olive[SUP] 7 [/SUP], Marta Tortajada[SUP] 7 [/SUP], Carme Hern?ndez[SUP] 2 3 8 [/SUP], David Cucchiari[SUP] 9 [/SUP], Emmanuel Coloma[SUP] 1 2 3 [/SUP], Juan M Peric?s[SUP] 1 2 10 [/SUP], Hospital Clinic Hospital at Home Team
Collaborators, Affiliations
- PMID: 33537362
- PMCID: PMC7798565
- DOI: 10.1093/ofid/ofaa592
Abstract
Background: During the coronavirus disease 2019 (COVID-19) outbreaks, health care workers (HCWs) are at a high risk of infection. Strategies to reduce in-hospital transmission between HCWs and to safely manage infected HCWs are lacking. Our aim was to describe an active strategy for the management of COVID-19 in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected HCWs and investigate its outcomes.
Methods: A prospective cohort study of SARS-CoV-2-infected health care workers in a tertiary teaching hospital in Barcelona, Spain, was performed. An active strategy of weekly polymerase chain reaction screening of HCWs for SARS-CoV-2 was established by the Occupational Health department. Every positive HCW was admitted to the Hospital at Home Unit with daily assessment online and in-person discretionary visits. Clinical and epidemiological data were recorded.
Results: Of the 590 HCWs included in the cohort, 134 (22%) were asymptomatic at diagnosis, and 15% (89 patients) remained asymptomatic during follow-up. A third of positive cases were detected during routine screening. The most frequent symptoms were cough (68%), hyposmia/anosmia (49%), and fever (41%). Ten percent of the patients required specific treatment at home, while only 4% of the patients developed pneumonia. Seventeen patients required a visit to the outpatient clinic for further evaluation, and 6 of these (1%) required hospital admission. None of the HCWs included in this cohort required intensive care unit admission or died.
Conclusions: Active screening for SARS-CoV-2 among HCWs for early diagnosis and stopping in-hospital transmission chains proved efficacious in our institution, particularly due to the high percentage of asymptomatic HCWs. Follow-up of HCWs in Hospital at Home units is safe and effective, with low rates of severe infection and readmission.
Keywords: COVID-19; Hospital at Home; SARS-CoV-2; coronavirus; health care workers.