Risk of SARS-CoV-2 infection among front-line healthcare workers in Northeast Brazil: a respondent-driven sampling approach
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Abstract
We assessed the prevalence of SARS-CoV-2 infection, personal protective equipment (PPE) shortages and occurrence of biological accidents among front-line healthcare workers (HCW).
Design, setting and participants
Using respondent-driven sampling, the study recruited distinct categories of HCW attending suspected or confirmed patients with COVID-19 from May 2020 to February 2021, in the Recife metropolitan area, Northeast Brazil.
Outcome measures
The criterion to assess SARS-CoV-2 infection among HCW was a positive self-reported PCR test.
Results
We analysed 1525 HCW: 527 physicians, 471 registered nurses, 263 nursing assistants and 264 physical therapists. Women predominated in all categories (81.1%; 95% CI: 77.8% to 84.1%). Nurses were older with more comorbidities (hypertension and overweight/obesity) than the other staff. The overall prevalence of SARS-CoV-2 infection was 61.8% (95% CI: 55.7% to 67.5%) after adjustment for the cluster random effect, weighted by network, and the reference population size. Risk factors for a positive RT-PCR test were being a nursing assistant (OR adjusted: 2.56; 95% CI: 1.42 to 4.61), not always using all recommended PPE while assisting patients with COVID-19 (OR adj: 2.15; 95% CI: 1.02 to 4.53) and reporting a splash of biological fluid/respiratory secretion in the eyes (OR adj: 3.37; 95% CI: 1.10 to 10.34).
Conclusions
This study shows the high frequency of SARS-CoV2 infection among HCW presumably due to workplace exposures. In our setting, nursing assistant comprised the most vulnerable category. Our findings highlight the need for improving healthcare facility environments, specific training and supervision to cope with public health emergencies.
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SciScore for 10.1101/2021.10.08.21264755: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics Consent: Providing electronic informed consent was mandatory to participate and access the questionnaire.
IRB: The project was approved by the National Ethics Committee (CONEP; CAAE: 30629220.8.0000.0008).Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
Software and Algorithms Sentences Resources All statistical analyses were performed using Stata, version 15.0 (StataCorp LLC, College Station, TX, USA). StataCorpsuggested: (Stata, RRID:SCR_012763)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results…SciScore for 10.1101/2021.10.08.21264755: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics Consent: Providing electronic informed consent was mandatory to participate and access the questionnaire.
IRB: The project was approved by the National Ethics Committee (CONEP; CAAE: 30629220.8.0000.0008).Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
Software and Algorithms Sentences Resources All statistical analyses were performed using Stata, version 15.0 (StataCorp LLC, College Station, TX, USA). StataCorpsuggested: (Stata, RRID:SCR_012763)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:This study had some limitations. First, there was an imbalance in recruitment among the HCW categories; physicians and nurses were more rapidly enrolled by RDS than nursing assistants. One possible explanation is that physicians and nurses seem to understand research methodology better and/or to have either better smartphones or data plans required to answer the approximately 15-minute online questionnaire. Physicians and nurses were also a more vocal category early in the pandemic, publicizing the constraints/pressure of the workplace. Conversely, nursing assistants, as routine healthcare assistants, spend more time providing direct patient care and have low wages. They could also be less confident/willing to participate due to work overload or unfavorable socio-economic conditions when compared to the other categories that require university degrees. Additionally, disclosure of the work environment concerning PPE and infection control prevention may be problematic for nursing assistants whose jobs are less stable and more prone to replacement in our setting. The current study did not discriminate the source of SARS-CoV-2 infection among HCWs. Accidents involving biological fluids should be further investigated in other studies to validate this finding. Finally, our findings provide a comprehensive picture of the factors associated with SARS-CoV-2 infection among HCWs. This study highlighted the high prevalence of SARS-CoV-2 infection among all HCW categories, with nursing a...
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.
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