Prevalence of SARS-CoV-2 infection in previously undiagnosed health care workers in New Jersey, at the onset of the U.S. COVID-19 pandemic
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Abstract
Background
Healthcare workers (HCW) are presumed to be at increased risk of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection due to occupational exposure to infected patients. However, there has been little epidemiological research to assess these risks.
Methods
We conducted a prospective cohort study of HCW ( n = 546) and non-healthcare workers (NHCW; n = 283) with no known prior SARS-CoV-2 infection who were recruited from a large U.S. university and two affiliated university hospitals. In this cross-sectional analysis of data collected at baseline, we examined SARS-CoV-2 infection status (as determined by presence of SARS-CoV-2 RNA in oropharyngeal swabs) by healthcare worker status and role.
Results
At baseline, 41 (5.0%) of the participants tested positive for SARS-CoV-2 infection, of whom 14 (34.2%) reported symptoms. The prevalence of SARS-CoV-2 infection was higher among HCW (7.3%) than in NHCW (0.4%), representing a 7.0% greater absolute risk (95% confidence interval for risk difference 4.7, 9.3%). The majority of infected HCW (62.5%) were nurses. Positive tests increased across the two weeks of cohort recruitment in line with rising confirmed cases in the hospitals and surrounding counties.
Conclusions
Overall, our results demonstrate that HCW had a higher prevalence of SARS-CoV-2 infection than NHCW. Continued follow-up of this cohort will enable us to monitor infection rates and examine risk factors for transmission.
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SciScore for 10.1101/2020.04.20.20072470: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement Consent: After informed consent, participants completed an online baseline questionnaire with items on demographics, general health, recent symptoms, lifestyle, occupation, and potential COVID-19 exposure followed by a face-to-face baseline visit.
IRB: All study activities were approved by the Rutgers Institutional Review Board prior to study implementation (Pro2020000679).Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
Software and Algorithms Sentences Resources Study data were collected and managed using REDCap electronic data capture tools hosted at Rutgers Robert Wood Johnson … SciScore for 10.1101/2020.04.20.20072470: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement Consent: After informed consent, participants completed an online baseline questionnaire with items on demographics, general health, recent symptoms, lifestyle, occupation, and potential COVID-19 exposure followed by a face-to-face baseline visit.
IRB: All study activities were approved by the Rutgers Institutional Review Board prior to study implementation (Pro2020000679).Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
Software and Algorithms Sentences Resources Study data were collected and managed using REDCap electronic data capture tools hosted at Rutgers Robert Wood Johnson Medical School15. REDCapsuggested: (REDCap, RRID:SCR_003445)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:Limitations of this study include opportunistic recruitment that may have led to over-enrollment of subjects highly concerned about potential infection. In our cohort, slightly higher proportions of HCW versus NHCW reported recent COVID-19 symptoms or sick contacts with COVID-19 diagnoses or symptoms, raising the possibility of ascertainment bias. However, simultaneous enrollment and testing of NHCW in the same locations and timeline, and the low overall prevalence of recent symptoms or exposures among both HCW and NHCW minimized this source of bias. Despite biases that could have raised the rates of detected infections, in fact 95% of the cohort were uninfected. We cannot definitively identify the exposures leading to infection or rule out HCW infections transmitted from sources other than hospitalized patients, including asymptomatic colleagues or contacts outside the hospital 13. The hospital with higher rates of infected HCW had both higher rates of infected patients within the facility as well as higher rates of infections in the surrounding area. However, infected HCW appeared to spend more time in patients’ rooms and care for more patients with COVID-19, and HCW were considerably more likely than NHCW to be infected, suggesting possible infectious transmission within the hospital. Planned longitudinal follow-up in this cohort will provide novel incidence and exposure data. Finally, the small numbers of SARS-CoV-2 diagnoses limited statistical comparisons. In summary, i...
Results from TrialIdentifier: We found the following clinical trial numbers in your paper:
Identifier Status Title NCT04336215 Recruiting Rutgers COVID-19 Cohort Study 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.
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