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. 2020 Dec 8;8(1):ofaa592.
doi: 10.1093/ofid/ofaa592. eCollection 2021 Jan.

A Prospective Cohort of SARS-CoV-2-Infected Health Care Workers: Clinical Characteristics, Outcomes, and Follow-up Strategy

David Nicolás  1   2   3 , Anna Camós-Carreras  4 , Felipe Spencer  4 , Andrea Arenas  2 , Eugenia Butori  2 , Pol Maymó  2 , Gerard Anmella  5 , Orla Torrallardona-Murphy  1   2 , Eduarda Alves  1   2 , Laura García  2 , Irene Pereta  2 , Eva Castells  2 , Nuria Seijas  2 , Begoña Ibáñez  2 , Carme Grané  2 , Marta Bodro  2   6 , Celia Cardozo  2   6 , Sonia Barroso  7 , Victoria Olive  7 , Marta Tortajada  7 , Carme Hernández  2   3   8 , David Cucchiari  9 , Emmanuel Coloma  1   2   3 , Juan M Pericàs  1   2   10 ; Hospital Clinic Hospital at Home Team
Collaborators, Affiliations

A Prospective Cohort of SARS-CoV-2-Infected Health Care Workers: Clinical Characteristics, Outcomes, and Follow-up Strategy

David Nicolás et al. Open Forum Infect Dis. .

Abstract

Background: During the coronavirus disease 2019 (COVID-19) outbreaks, health care workers (HCWs) are at a high risk of infection. Strategies to reduce in-hospital transmission between HCWs and to safely manage infected HCWs are lacking. Our aim was to describe an active strategy for the management of COVID-19 in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected HCWs and investigate its outcomes.

Methods: A prospective cohort study of SARS-CoV-2-infected health care workers in a tertiary teaching hospital in Barcelona, Spain, was performed. An active strategy of weekly polymerase chain reaction screening of HCWs for SARS-CoV-2 was established by the Occupational Health department. Every positive HCW was admitted to the Hospital at Home Unit with daily assessment online and in-person discretionary visits. Clinical and epidemiological data were recorded.

Results: Of the 590 HCWs included in the cohort, 134 (22%) were asymptomatic at diagnosis, and 15% (89 patients) remained asymptomatic during follow-up. A third of positive cases were detected during routine screening. The most frequent symptoms were cough (68%), hyposmia/anosmia (49%), and fever (41%). Ten percent of the patients required specific treatment at home, while only 4% of the patients developed pneumonia. Seventeen patients required a visit to the outpatient clinic for further evaluation, and 6 of these (1%) required hospital admission. None of the HCWs included in this cohort required intensive care unit admission or died.

Conclusions: Active screening for SARS-CoV-2 among HCWs for early diagnosis and stopping in-hospital transmission chains proved efficacious in our institution, particularly due to the high percentage of asymptomatic HCWs. Follow-up of HCWs in Hospital at Home units is safe and effective, with low rates of severe infection and readmission.

Keywords: COVID-19; Hospital at Home; SARS-CoV-2; coronavirus; health care workers.

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Figures

Figure 1.
Figure 1.
Timeline of admissions (total numbers, right vertical axis) and prevalence (percentage over total number of admissions per day, left axis) of positive health care workers in the Hospital at Home unit.
Figure 2.
Figure 2.
Symptom onset diagram in patients who were asymptomatic at diagnosis who presented symptoms during follow-up (days from positive polymerase chain reaction to symptom manifestation; n = 46).
See this image and copyright information in PMC

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