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. 2020 Dec 4;78(7):479-485.
doi: 10.1136/oemed-2020-106866. Online ahead of print.

Household transmission and incidence of positive SARS-CoV-2 RT-PCR in symptomatic healthcare workers, clinical course and outcome: a French hospital experience

Evguenia Krastinova  1   2   3 , Valérie Garrait  4   2 , Marie-Thérèse Lecam  5 , André Coste  6   7 , Emmanuelle Varon  8 , Isabelle Delacroix  4 , Amine Si Ali  9 , Camille Jung  10 , Mounira Smati  8 , Muriel Cherbit  11 , Bernard Maître  7   12 , Jean-Claude Pairon  5   7 , Pascal Andujar  5   7
Affiliations

Household transmission and incidence of positive SARS-CoV-2 RT-PCR in symptomatic healthcare workers, clinical course and outcome: a French hospital experience

Evguenia Krastinova et al. Occup Environ Med. .

Abstract

Objectives: Although healthcare workers (HCWs) have been particularly affected by SARS-CoV-2, detailed data remain scarce. In this study, we investigated infection rates, clinical characteristics, occupational exposure and household transmission among all symptomatic HCWs screened by SARS-CoV-2 RT-PCR between 17 March (French lockdown) and 20 April.

Methods: SARS-CoV-2 RT-PCR was proposed to symptomatic (new cough or dyspnoea) HCWs at Creteil Hospital in one of the Parisian suburbs most severely affected by COVID-19. Data on occupational profile, living situation and household, together with self-isolation and mask use at home were collected, as well as the number of cases in the household.

Results: The incidence rate of symptomatic SARS-CoV-2 was estimated to be 5% (110/2188). A total of 110 (35%) of the 314 HCWs tested positive and 9 (8%) were hospitalised. On multivariate analysis, factors independently associated with positive RT-PCR were occupational profile with direct patient facing (OR 3.1, 95% CI 1.1 to 8.8), p<0.03), and presence of anosmia (OR 5.7, 95% CI 3.1 to 10.6), p<0.0001). Being a current smoker was associated with negative RT-PCR (OR 0.3, 95% CI 0.1 to 0.7), p=0.005). Transmission from HCWs to household members was reported in 9 (14%) cases, and 2 deaths occurred. Overall, self-isolation was possible in 52% of cases, but only 31% of HCWs were able to wear a mask at home.

Conclusion: This is the first study to report infection rates among HCWs during the peak of the SARS-CoV-2 epidemic in France and the lockdown period, highlighting the risk related to occupational profile and household transmission.

Keywords: health care workers; hygiene / occupational hygiene; virology; viruses.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Number of positive SARS-CoV-2 RT-PCR tests per day in the general population in France (divided by 100) and among screened healthcare workers at Creteil Hospital between 17 March and 20 April.
Figure 2
Figure 2
Receiver operating characteristic (ROC) curve of anosmia, fever and a composite predictor (anosmia and/or fever) at illness onset.
See this image and copyright information in PMC

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