Impact of SARS-CoV-2 pandemic among health care workers in a secondary teaching hospital in Spain

  1. Javier Garralda Fernandez
  2. Ignacio Molero Vilches
  3. Alfredo Bermejo Rodríguez
  4. Isabel Cano Torres
  5. Elda Isabel Colino Romay
  6. Isabel García Arata
  7. Jerónimo Jaqueti Aroca
  8. Rosa Lillo Rodríguez
  9. Daniel López Lacomba
  10. Luis Mazón Cuadrado
  11. Laura Molina Esteban
  12. Luis Javier Morales García
  13. Laura Moratilla Monzo
  14. Elva Nieto-Borrajo
  15. María Pacheco Delgado
  16. Santiago Prieto Menchero
  17. Cristina Sánchez Hernández
  18. Eva Sánchez Testillano
  19. Jesús García-Martínez

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Abstract

The COVID-19 pandemic has posed a huge challenge to healthcare systems and their personnel worldwide. The study of the impact of SARS-CoV-2 infection among healthcare workers (HCW), through prevalence studies, will let us know viral expansion, individuals at most risk and the most exposed areas in healthcare organizations. The aim of this study is to gauge the impact of SARS-CoV-2 pandemic in our hospital workforce and identify groups and areas at increased risk.

Methods and findings

This is a cross-sectional and incidence study carried out on healthcare workers based on molecular and serological diagnosis of SARS-CoV-2 infection. Of the 3013 HCW invited to participate, 2439 (80.9%) were recruited, including 674 (22.4%) who had previously consulted at the Occupational Health Service (OHS) for confirmed exposure and/or presenting symptoms suggestive of COVID-19. A total of 411 (16.9%) and 264 (10.8%) healthcare workers were SARS-CoV-2 IgG and rRT-PCR positive, respectively. The cumulative prevalence considering all studies (IgG positive HCW and/or rRT-PCR positive detection) was 485 (19.9%). SARS-CoV-2 IgG-positive patients in whom the virus was not detected were 221 (9.1%); up to 151 of them (68.3%) did not report any compatible symptoms nor consult at the OHS for this reason. Men became more infected than women (25% vs 18.5%, p = 0.0009), including when data were also classified by age. COVID-19 cumulative prevalence among the HCW assigned to medical departments was higher (25.2%) than others, as well as among medical staff (25.4%) compared with other professional categories (p<0.01).

Conclusions

The global impact of the COVID-19 pandemic on HCW of our centre has been 19.9%. Doctors and medical services personnel have had the highest prevalence of SARS-CoV-2 infection, but many of them have not presented compatible symptoms. This emphasizes the performance of continuous surveillance methods of the most exposed health personnel and not only based on the appearance of symptoms.

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  1. Version published to 10.1371/journal.pone.0245001
  2. ScreenIT

    SciScore for 10.1101/2020.07.26.20162529: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementIRB: Ethical considerations: The study has been independently evaluated and approved by the Research Ethics Committee of the Hospital Universitario de Fuenlabrada (Internal Code 20/37)
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    Serum IgG and IgM antibody directed against SARS-CoV-S (spike) and SARS-CoV-N (nucleocapside) recombinant antigens were measured in the Maglumi 2000 platform (Snibe diagnostic, Shenzhen, China) with the Maglumi 2019-nCoV (SARS-CoV-2) IgM and IgG kits in a fully automated chemiluminescence immunoassay (CLIA).
    IgM
    suggested: None
    SARS-CoV-S
    suggested: None
    SARS-CoV-2) IgM
    suggested: None

    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: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    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.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. ScreenIT

    SciScore for 10.1101/2020.07.26.20162529: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementEthical considerations The study has been independently evaluated and approved by the Research Ethics Committee of the Hospital Universitario de FuenlabradaRandomizationnot detected.Blindingnot detected.Power Analysisnot detected.Sex as a biological variableMen became more infected than women (25% vs 18.5%, p=0.0009), including when data were also classified by age.

    Table 2: Resources

    Antibodies
    SentencesResources
    Serum IgG and IgM antibody directed against SARS-CoV-S (spike) and SARS-CoV-N (nucleocapside) recombinant antigens were measured in the Maglumi 2000 platform (Snibe diagnostic, Shenzhen, China) with the Maglumi 2019-nCoV (SARS-CoV-2) IgM and IgG kits in a fully automated chemiluminescence immunoassay (CLIA).
    SARS-CoV-S
    suggested: None
          <div style="margin-bottom:8px">
        <div><b>SARS-CoV-2 ) IgM</b></div>
        <div>suggested: None</div>
      </div>
    </td></tr><tr><td style="min-width:100px;vertical-align:top;border-bottom:1px solid lightgray">, IgG was not detected and the repetitions of the tests did not confirm the infection, so they were considered IgM false positive results; in 19 cases with detectable IgG, a past infection with residual persistence of IgM antibodies was considered.</td><td style="min-width:100px;border-bottom:1px solid lightgray">
      <div style="margin-bottom:8px">
        <div><b>IgM</b></div>
        <div>suggested: None</div>
      </div>
    </td></tr><tr><td style="min-width:100px;text-align:center; padding-top:4px;" colspan="2"><b>Software and Algorithms</b></td></tr><tr><td style="min-width:100px;text=align:center"><i>Sentences</i></td><td style="min-width:100px;text-align:center"><i>Resources</i></td></tr><tr><td style="min-width:100px;vertical-align:top;border-bottom:1px solid lightgray">Blue columns are the number of HCW from HUF that declared COVID-19 compatible symptoms by date of symptom onset; red line is rRT-PCR-based diagnosed cases by date of diagnosis in región of Madrid*; green line is rRT-PCR-based diagnosed cases by date in HUF **. *Source: based on RENAVE data[12] **Source: based on own Laboratory Medicine data In summary, a total of 264 workers out of 2439 (10.8%) with active SARSCoV-2 infection were detected by rRT-PCR.</td><td style="min-width:100px;border-bottom:1px solid lightgray">
      <div style="margin-bottom:8px">
        <div><b>RENAVE</b></div>
        <div>suggested: None</div>
      </div>
    </td></tr></table>

    Data from additional tools added to each annotation on a weekly basis.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore is not a substitute for expert review. SciScore checks for the presence and correctness of RRIDs (research resource identifiers) in the manuscript, and detects sentences that appear to be missing RRIDs. SciScore also checks to make sure that rigor criteria are addressed by authors. It does this by detecting sentences that discuss criteria such as blinding or power analysis. SciScore does not guarantee that the rigor criteria that it detects are appropriate for the particular study. Instead it assists authors, editors, and reviewers by drawing attention to sections of the manuscript that contain or should contain various rigor criteria and key resources. For details on the results shown here, including references cited, please follow this link.

  4. Version published to 10.1101/2020.07.26.20162529v1 on medRxiv