Case-control study evaluating risk factors for SARS-CoV-2 outbreak amongst healthcare personnel at a tertiary care center - 18/11/21
, Ralph Tayyar, MD a, 1, Richard Giardina, MPH, RN, CIC, FACHE b, Peter Kolonoski, RN, MSN, CIC b, Diane Kenski, MPH, RN, CIC b, Peidong Shen, PhD a, Lars M Steinmetz, PhD a, Li-Yuan Hung, MS c, Wenzhong Xiao, PhD c, Karen Bains, CEL, LVN b, Timothy Morrison, EdD b, Alexandra Madison, MPH b, Sang-ick Chang, MD, MPH b, Lucy Tompkins, MD, PhD a, b, Benjamin A Pinsky, MD, PhD a, Marisa Holubar, MD, MS a, b
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Highlights |
• | Repeat SARS-CoV-2 testing after admission is key in suspicious cases |
• | Whole genome sequencing can assist with outbreak investigations |
• | Increased patient contact time is a risk factor for nosocomial SARS-CoV-2 infection |
• | Performing aerosol-generating procedures increases nosocomial SARS-CoV-2 risk |
Abstract |
Background |
Despite several outbreaks of SARS-CoV-2 amongst healthcare personnel (HCP) exposed to COVID-19 patients globally, risk factors for transmission remain poorly understood.
Methods |
We conducted an outbreak investigation and case-control study to evaluate SARS-CoV-2 transmission risk in an outbreak among HCP at an academic medical center in California that was confirmed by whole genome sequencing.
Results |
A total of 7/9 cases and 93/182 controls completed a voluntary survey about risk factors. Compared to controls, cases reported significantly more patient contact time. Cases were also significantly more likely to have performed airway procedures on the index patient, particularly placing the patient on high flow nasal cannula, continuous positive airway pressure (CPAP), or bilevel positive airway pressure (BiPAP) (OR = 11.6; 95% CI = 1.7 –132.1).
Discussion |
This study highlights the risk of nosocomial infection of SARS-CoV-2 from patients who become infectious midway into their hospitalization. Our findings also reinforce the importance of patient contact time and aerosol-generating procedures as key risk factors for HCP infection with SARS-CoV-2.
Conclusions |
Re-testing patients for SARS-CoV-2 after admission in suspicious cases and using N95 masks for all aerosol-generating procedures regardless of initial patient SARS-CoV-2 test results can help reduce the risk of SARS-COV-2 transmission to HCP.
El texto completo de este artículo está disponible en PDF.Key Words : SARS-CoV-2, COVID-19, Healthcare personnel, Outbreak, Case-control study, Whole genome sequencing, contact tracing, Epidemiology, Aerosol generating procedure
Esquema
| Funding/support: J.I.R. is supported by NIH Training Grant 5T32AI052073-14 and by a Stanford University Maternal Child Health Research Institute grant. P.S., L.H., and W.X. are supported by funding from Open Medicine Foundation. None of the authors received financial or material support for the research and work in this manuscript. |
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| Conflicts of interest: None of the authors have any relevant conflict of interest or other financial disclosures relevant to the subject matter. |
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| Authors’ contributions: J.I.R. and R.T. equally contributed to this paper with study design, literature review and analysis, drafting and critical revision of the manuscript. R.G., P.K., D.K, S.C, K.B, T.M., A.M., and L.T. assisted with data acquisition, outbreak investigation, survey design, and critical review of the manuscript. B.A.P., P.S., L.S., L.H., and W.X. performed molecular sequencing and tracing, assisted with drafting and critical review of the manuscript. M.H. supervised the project, was involved in study and survey design, analysis, drafting and critical review of the manuscript. |
Vol 49 - N° 12
P. 1457-1463 - décembre 2021 Regresar al número
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