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Observational Study
. 2022 Mar 18;11(1):51.
doi: 10.1186/s13756-022-01092-0.

Occupational and community risk of SARS-CoV-2 infection among employees of a long-term care facility: an observational study

Lauriane Lenggenhager  1   2 , Romain Martischang  3 , Julien Sauser  3 , Monica Perez  3 , Laure Vieux  4 , Christophe Graf  5 , Samuel Cordey  6   7 , Florian Laubscher  7 , Tomás Robalo Nunes  8 , Walter Zingg  3 , Anne Cori  9 , Stephan Harbarth  3   6 , Mohamed Abbas  3   6   9
Affiliations
Observational Study

Occupational and community risk of SARS-CoV-2 infection among employees of a long-term care facility: an observational study

Lauriane Lenggenhager et al. Antimicrob Resist Infect Control. .

Abstract

Background: We investigated the contribution of both occupational and community exposure for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among employees of a university-affiliated long-term care facility (LTCF), during the 1st pandemic wave in Switzerland (March-June 2020).

Methods: We performed a nested analysis of a seroprevalence study among all volunteering LTCF staff to determine community and nosocomial risk factors for SARS-CoV-2 seropositivity using modified Poison regression. We also combined epidemiological and genetic sequencing data from a coronavirus disease 2019 (COVID-19) outbreak investigation in a LTCF ward to infer transmission dynamics and acquisition routes of SARS-CoV-2, and evaluated strain relatedness using a maximum likelihood phylogenetic tree.

Results: Among 285 LTCF employees, 176 participated in the seroprevalence study, of whom 30 (17%) were seropositive for SARS-CoV-2. Most (141/176, 80%) were healthcare workers (HCWs). Risk factors for seropositivity included exposure to a COVID-19 inpatient (adjusted prevalence ratio [aPR] 2.6; 95% CI 0.9-8.1) and community contact with a COVID-19 case (aPR 1.7; 95% CI 0.8-3.5). Among 18 employees included in the outbreak investigation, the outbreak reconstruction suggests 4 likely importation events by HCWs with secondary transmissions to other HCWs and patients.

Conclusions: These two complementary epidemiologic and molecular approaches suggest a substantial contribution of both occupational and community exposures to COVID-19 risk among HCWs in LTCFs. These data may help to better assess the importance of occupational health hazards and related legal implications during the COVID-19 pandemic.

Keywords: COVID-19; Nosocomial outbreaks; Occupational exposure; SARS-CoV-2.

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Conflict of interest statement

All authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Epidemic curve of the nosocomial COVID-19 outbreak involving LTCF HCWs (red) and patients (blue)
Fig. 2
Fig. 2
Maximum likelihood phylogenetic tree of SARS-CoV-2 genomes from 10 patients (blue) and 18 HCWs (red) sequenced during the outbreak investigation
See this image and copyright information in PMC

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