Evaluation of the Route of Transmission and Clinical Course of SARS-CoV-2 Infection in Healthcare Workers at Istanbul Medipol University Hospital

Abstract

Objective: Healthcare workers (HCW) have been the occupational group at highest risk of coronavirus disease-2019 infection despite early availability of guidelines for infection control, administrative management, and application of required conditions on field since the beginning of the pandemic. In this survey study our aim is to investigate environmental and individual factors which facilitate transmission of the virus among HCW in order to target preventative measures to be taken in the future. Material and Methods: This current study is a single center based retrospective study conducted by analysing 446 telephone surveys conducted on HCW in Medipol Mega University Hospital who tested positive for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) between 15.03.2020-14.01.2021. Demographic details, comorbidities, department of work, occupation, symptoms, clinical course, choice of pulmonary imaging, use and availability of personel protective equipment (PPE) as well as adherance to social distancing rules was determined. Results: Among the 3,013 HCW’s at our hospital, 877 (29%) were tested positive for SARS-CoV-2, of which 446 were included in the survey. It was shown that 337 (85%) of those included in the study were adherent to the infection prevention protocols. Despite the high application of preventative measures at our hospital in-hospital transmission rates were still found to be high. In-hospital transmission was observed to be in groups of workers simultaneously among different departments of the hospital. The source of transmission was unknown in 33.78% of our HCW. Advanced age and those with comorbidities were found to have higher rates of severe infection. Infection rate was low in pregnant HCW due to the granted administrative leave. Conclusion: Overall transmission of the infection among HCW is seen to be substantially in-hospital. More extensive training and education should be given to hospital staff who do not comply with infection control guidelines as well as to those who are unable to identify the source of transmission. Supervision of the implementation of hospital infection control policies, screening of asymptomatic cases as well as evaluation of PPE quality is valuable in the protection of HCW. In the event of a pandemic, elderly healthcare workers and those who have comorbidities may benefit from working in secluded environments within the hospital due to the severe course of disease seen in this group of patients.