Factors associated with an increased risk of SARS-CoV-2 infection in healthcare workers in aerosol-generating disciplines

  1. Christoph Römmele
  2. Maria Kahn
  3. Stephan Zellmer
  4. Anna Muzalyova
  5. Gertrud Hammel
  6. Christina Bartenschlager
  7. Albert Beyer
  8. Jonas Rosendahl
  9. Tilo Schlittenbauer
  10. Johannes Zenk
  11. Bilal Al-Nawas
  12. Roland Frankenberger
  13. Juergen Hoffmann
  14. Christoph Arens
  15. Frank Lammert
  16. Claudia Traidl-Hoffmann
  17. Helmut Messmann
  18. Alanna Ebigbo

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Abstract

Background Healthcare workers (HCWs) are at a high risk of SARS-CoV-2 infection due to exposure to potentially infectious material, especially during aerosol-generating procedures (AGP). We aimed to investigate risk factors for SARS-CoV-2 infection among HCWs in medical disciplines with AGP.

Methods A nationwide questionnaire-based study in private practices and hospital settings was conducted between 12/16/2020 and 01/24/2021. Data on SARS-CoV-2 infections among HCWs and potential risk factors of infection were investigated.

Results 2070 healthcare facilities with 25113 employees were included in the study. The overall infection rate among HCWs was 4.7%. Multivariate analysis showed that regions with higher incidence rates had a significantly increased risk of infection. Furthermore, hospital setting and HCWs in gastrointestinal endoscopy (GIE) had more than double the risk of infection (OR 2.63; 95% CI 2.50–2.82, p<0.01 and OR 2.35; 95% CI 2.25–2.50, p<0.01). For medical facilities who treated confirmed SARS-CoV-2 cases, there was a tendency towards higher risk of infection (OR 1.39; 95% CI 1.11–1.63, p=0.068).

Conclusion Both factors within and outside medical facilities appear to be associated with an increased risk of infection among HCWs. Therefore, GIE and healthcare delivery setting were related to increased infection rates. Regions with higher SARS-CoV-2 incidence rates were also significantly associated with increased risk of infection.

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  1. Version published to 10.1055/a-1845-2979
  2. ScreenIT

    SciScore for 10.1101/2021.09.20.21263566: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical analysis: The statistical analysis was performed using SPSS version 27.0.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)
    The comparison of GIE and Non-GIE facilities regarding the presumed source of infection was adjusted with Cochran-Mantel-Haenszel-Test to control the confounding effect of the facility healthcare delivery setting.
    Cochran-Mantel-Haenszel-Test
    suggested: None

    Results from OddPub: Thank you for sharing your data.

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Like other cross-sectional studies, our study has some limitations. Due to the recruitment strategy via the professional associations, a selection bias cannot be ruled out. In particular, facilities that established elaborate protection and hygiene measures might have been higher motivated to participate. On the other hand, facilities with infected HCWs may also be more motivated to participate. Moreover, there is an uneven distribution of the medical facility types between examined specialties. For instance, in dental medicine, hardly any clinic was represented in comparison to the more than 1000 participating private practices.Nonetheless, Non-GIE specialties had significantly more private practices due to the regional specificity of the respective fields of activity. Another shortcoming of the study worth mentioning is that this study is cross-sectional inquiring information over a considerable period comprising three quarters of the year 2020. Moreover, all calculations presented in the manuscript are based on the assessments and judgments made for a private practice or a hospital ward and its workforce by one person. Despite the limitation mentioned above, the present study is the first to provide data on prevalence and revealing risk factors of SARS-CoV-2 infection among HCW in medical disciplines associated with AGP, such as GIE, ORL, OMS, and dentistry. Due to the results provided in this scientific manuscript, GIE seems to be at a higher risk of infection compared to...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  3. Version published to 10.1101/2021.09.20.21263566v1 on medRxiv