Infection, Screening, and Psychological Stress of Health-Care Workers With COVID-19 in a Nonfrontline Clinical Department

Abstract

Objectives: The aim of this study was to investigate risk factors and psychological stress of health-care workers (HCWs) with coronavirus disease 2019 (COVID-19) in a nonfrontline clinical department.

Methods: Data of 2 source patients and all HCWs with infection risk were obtained in a department in Wuhan from January to February 2020. A questionnaire was designed to evaluate psychological stress of COVID-19 on HCWs.

Results: The overall infection rate was 4.8% in HCWs. Ten of 25 HCWs who contacted with 2 source patients were diagnosed with confirmed COVID-19 (8/10) and suspected COVID-19 (2/10). Other 2 HCWs were transmitted by other patients or colleagues. Close care behaviors included physical examination (6/12), life nursing (4/12), ward rounds (4/12), endoscopic examination (2/12). Contacts fluctuated from 1 to 24 times and each contact was short (8.1 min ± 5.6 min). HCWs wore surgical masks (11/12), gloves (7/12), and isolation clothing (3/12) when providing medical care. Most HCWs experienced a mild course with 2 asymptomatic infections, taking 9.8 d and 20.9 d to obtain viral shedding and clinical cure, respectively. Psychological stress included worry (58.3%), anxiety (83.3%), depression (58.3%), and insomnia (58.3%).

Conclusions: Close contact with COVID-19 patients and insufficient protection were key risk factors. Precaution measures and psychological support on COVID-19 is urgently required for HCWs.

Keywords: COVID-19; health-care worker; nonfrontline; psychological stress; risk factors.

Figure 1.

Chronology of symptom onset of 12 infected HCWs and their contacts with suspected COVID-19 patients. Source patient 1, clinically identified with COVID-19, and source patient 2, laboratory-confirmed COVID-19, were admitted to the hospital on January 18, 2020, and January 6, 2020 (white box), respectively. Close contacts were marked with boxes of different colors. Days of exposure were presented with consecutive numbers of boxes with different colors. HCW 6 had close contacts with patient 2 and colleagues. HCW 12 had close contacts with patient 1, patient 2, and colleagues, with unknown exposure time. Their first chest CT scan were performed quickly. HCWs 1-10 were confirmed COVID-19 cases, and HCWs 11-12 were suspected COVID-19 cases. Most of HCWs were isolated at home from symptoms onset (arrow). Some were quarantined in designated hotels or Fangcang Shelter hospitals. Three HCWs and 2 source patients were hospitalized. HCW 5 and HCW 8 were of asymptomatic infection. In March, some HCWs recovered and returned to work. HCW, health-care worker; CT, computed tomography.

Figure 2.

Psychological effects of the outbreak on Ill HCWs in a department.