Healthcare workers vulnerable to SARS-CoV-2 infections

Cohort data shows a substantial risk of being infected with SARS-CoV-2 not only for nurses, people working in the emergency department, or in operating rooms, but also for employees such as those in housekeeping and nutrition. Even in COVID-19 patients with non-severe disease, post-acute sequelae play an important role.

The current presentation covered the risk situation of healthcare workers during the pandemic concerning infection prevalence and risks according to specific occupations [1]. “New Jersey ranked second of the 50 US states with regard to infection,” Prof. Reynold A. Panettieri Jr (Rutgers Institute for Translational Medicine and Science, NJ, USA) described the setting of the research. A screening of nearly 4,000 employees of the Robert Wood Johnson teaching hospital (RWJ) included 74% women, 68.8% had direct patient contact, 44.1% were 20–39 years old, and 12.2% ≥60 years of age [2]. Markers of ongoing or previous SARS-CoV-2 infection were detected in about 10%. However, when looking further at the different occupations within the hospital, the rate varied. Being a phlebotomist carried the highest risk of a positive COVID-19 test with a proportion of 23.9%. Corresponding percentages in other occupations included maintenance/housekeeping 17.3% and food services 16.9%. Interestingly, rates of positive testing were 9.1% in nurses and 7.2% in doctors.

The Rutgers Corona Cohort consists of 548 healthcare workers (HCW) and 283 non-HCW. HCW from this cohort had regular patient exposure and worked at least 20 hours per week in the hospital [3]. Non-HCW included faculty, staff, and students. All participants had no prior history of a COVID-19 diagnosis. The proportion of positive tests for COVID-19 showed differences between hospital sites but, overall, HCW had higher rates of infection (7.3%) than non-HCW (0.4%). “So, the takeaway is, if you work in a hospital, you are more likely to get infected,” commented Prof. Panettieri.

When evaluating factors that might be associated with SARS-CoV-2 infection in HCW, working in an intensive care unit appeared protective, as was having diabetes, whereas working as a nurse, being obese, or being Hispanic increased the likelihood of infection [1]. “For nurses, working in an emergency room or on a medical floor rendered greater susceptibility to SARS-CoV-2 infection,” Prof Panettieri specified. Also, being staff of an operating room was a significant factor. Another interesting result was that among the HCW who were infected, those with the most severe disease had the highest IgG antibody titres.

Duration of symptom prevalence was additionally followed, and it was observed that even though most patients were not hospitalised, some of their symptoms were longer lasting. “Fatigue and body aches were symptoms that persisted in almost 20% of positive cases of HCW,” Prof Panettieri said, “fatigue lasted for 30 days in the 75-percentile, chest tightness nearly 30 days for the 75-percentile, and cognitive changes almost half a year. Hence, long haulers or long-haul symptoms persisted in HCW in those individuals who had mild disease without hospitalisation or ER visits” (see Figure).

Figure: Duration of symptoms in infected participants of the Rutgers Corona Cohort [1]

1. Panettieri RA. Lessons Learned from a Large, Prospective COVID-19 Occupational Exposure Cohort. Session C026: Occupational COVID-19 exposure: risks and mitigation. ATS 2021 International conference, 14-19 May 2021.
2. Barrett ES, et al. Open Forum Infect Dis. 2020;7(12):ofaa534.
3. Barrett ES, et al. BMC Infect Dis. 2020;20(1):853.

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Posted on 5 July 202115 February 2024