Perceived infection transmission routes, infection control practices, psychosocial changes, and management of COVID-19 infected healthcare workers in a tertiary acute care hospital in Wuhan: a cross-sectional survey

Abstract

Background: Many healthcare workers were infected by coronavirus disease 2019 (COVID-19) early in the epidemic posing a big challenge for epidemic control. Hence, this study aims to explore perceived infection routes, influencing factors, psychosocial changes, and management procedures for COVID-19 infected healthcare workers.

Methods: This is a cross-sectional, single hospital-based study. We recruited all 105 confirmed COVID-19 healthcare workers in the Zhongnan Hospital of Wuhan University from February 15 to 29, 2020. All participants completed a validated questionnaire. Electronic consent was obtained from all participants. Perceived causes of infection, infection prevention, control knowledge and behaviour, psychological changes, symptoms and treatment were measured.

Results: Finally, 103 professional staff with COVID-19 finished the questionnaire and was included (response rate: 98.1%). Of them, 87 cases (84.5%) thought they were infected in working environment in hospital, one (1.0%) thought their infection was due to the laboratory environment, and 5 (4.9%) thought they were infected in daily life or community environment. Swab of throat collection and physical examination were the procedures perceived as most likely causing their infection by nurses and doctors respectively. Forty-three (41.8%) thought their infection was related to protective equipment, utilization of common equipment (masks and gloves). The top three first symptoms displayed before diagnosis were fever (41.8%), lethargy (33.0%) and muscle aches (30.1%). After diagnosis, 88.3% staff experienced psychological stress or emotional changes during their isolation period, only 11.7% had almost no emotional changes. Arbidol (Umifenovir; an anti-influza drug; 69.2%) was the drug most commonly used to target infection in mild and moderate symptoms.

Conclusion: The main perceived mode of transmission was not maintaining protection when working at a close distance and having intimate contact with infected cases. Positive psychological intervention is necessary.

Keywords: 2019-nCoV; COVID-19; Healthcare professional; Healthcare worker; Infection transmission route; Psychosocial status; SARS-CoV-2.

Fig. 1

Perceived causes of COVID-19 infection in medical professionals a. Department distribution of infected healthcare professionals; b. Perceived routes of infection; c. Perceived routes of infection in working environment in hospital; d. Duration distribution in an environment with risk of infection; e. Perceived transmission routes; f. Perceived infection causing procedures among nurses; g. Perceived infection causing procedures among doctors

Fig. 2

Use of protective equipment before COVID-19 outbreak. a. Types, layers, and length of masks usage by all participants (frequency), LRDs and HRDs (percentage) in their routine work. b. Types, layers, and length of gloves usage by all participants (frequency), LRDs and HRDs (percentage) in their routine work

Fig. 3

Clinical symptoms and change of laboratory indexes a. Clinical symptoms of all included staff before diagnosis. b. Laboratory and CT examination of all included staff

Fig. 4

Psychological statuses before and after diagnosis of COVID-19 a. Attention level to the epidemic before their diagnosis; b. Mental status since the outbreak; c. Psychological stress or emotional changes during their isolation; d. Reasons of psychological stress and emotional change; e. Willingness to express psychological stress or emotional changes; f. Methods to regulate their stress or mood changes; a-b, psychological status before diagnosis; c-f, psychological status after diagnosis