SARS-CoV-2 Infection Among Nursing Home Healthcare Workers: A Longitudinal Study in North-Eastern Italy

IF 4.3 4区医学 Q1 INFECTIOUS DISEASES

Influenza and Other Respiratory Viruses Pub Date : 2024-12-19 DOI:10.1111/irv.70056

Valentina Rosolen, Diana Menis, Luigi Castriotta, Fabio Barbone, Francesca Larese Filon

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Abstract

Background

During the pandemic, a surveillance program to monitor COVID-19 infection among healthcare workers was established in Friuli Venezia Giulia Region (FVG), Italy. The aim of our study was to measure the risk of acquiring SARS-CoV-2 infection among nursing home employees by job title.

Methods

From March 1, 2020, to March 31, 2023, a retrospective population-based longitudinal study was conducted in 8880 nursing home employees. For each employee, all swabs up to the first positive result (n = 211.534) were considered. The study period was divided in six phases based on epidemic waves. Generalized estimated equations method for longitudinal binary data was applied with a time lag of a month, in each phase, obtaining an odds ratio (OR) and 95% confidence limit (95% CI) for each job category.

Results

In Phase 1 (1.3.2020–30.6.2020), compared with administrative assistants, jobs with high patient contact were at increased risk of infection: The OR and 95% CI were 3.52 (1.44–8.56) and 2.96 (1.15–7.66) in healthcare elementary occupation and physicians/nurses, respectively. Corresponding associations in Phase 2 (1.7.2020–31.1.2021) were 1.54 (1.18–2.02) and 1.41 (1.04–1.91). On the contrary, in Phase 6 (20.12.2021–31.3.2023) physicians/nurses were at a decreased risk (0.73 [0.58–0.91]).

Conclusions

In nursing homes, the risk of COVID-19 infection varied by job title and pandemic phase. Virus higher infectivity, probability of closer contact, and better adherence to infection prevention control may explain part of these differences. Stronger nursing home–specific surveillance in patients and employees should be extended worldwide to control this high global burden of disease communities.

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背景大流行期间，意大利弗留利-威尼斯-朱利亚大区（FVG）制定了一项监控计划，以监测医护人员中 COVID-19 的感染情况。我们研究的目的是根据职称来衡量疗养院员工感染 SARS-CoV-2 的风险。方法从 2020 年 3 月 1 日至 2023 年 3 月 31 日，我们对 8880 名养老院员工进行了一项基于人群的回顾性纵向研究。每位员工的所有拭子结果均为阳性（n = 211.534）。研究期间根据流行病浪潮分为六个阶段。在每个阶段中，对纵向二元数据采用时滞为一个月的广义估计方程法，得出每个工作类别的几率比（OR）和 95% 置信限（95% CI）。结果在第一阶段（2020 年 3 月 1 日至 2020 年 6 月 30 日），与行政助理相比，与患者接触较多的岗位感染风险较高：医疗保健初级职业和医生/护士的 OR 值和 95% CI 值分别为 3.52（1.44-8.56）和 2.96（1.15-7.66）。第 2 阶段（2020 年 7 月 1 日至 2021 年 1 月 31 日）的相应相关性分别为 1.54（1.18-2.02）和 1.41（1.04-1.91）。相反，在第 6 阶段（20.12.2021-31.3.2023），医生/护士的风险降低（0.73 [0.58-0.91]）。结论在养老院中，COVID-19 的感染风险因职称和大流行阶段而异。病毒较高的感染性、更密切接触的可能性以及更好地遵守感染预防控制措施可能是造成这些差异的部分原因。应在全球范围内加强对疗养院患者和员工的监测，以控制这一全球负担沉重的疾病群体。

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来源期刊

Influenza and Other Respiratory Viruses 医学-病毒学

CiteScore

7.20

自引率

4.50%

发文量

120

审稿时长

6-12 weeks

期刊介绍： Influenza and Other Respiratory Viruses is the official journal of the International Society of Influenza and Other Respiratory Virus Diseases - an independent scientific professional society - dedicated to promoting the prevention, detection, treatment, and control of influenza and other respiratory virus diseases. Influenza and Other Respiratory Viruses is an Open Access journal. Copyright on any research article published by Influenza and Other Respiratory Viruses is retained by the author(s). Authors grant Wiley a license to publish the article and identify itself as the original publisher. Authors also grant any third party the right to use the article freely as long as its integrity is maintained and its original authors, citation details and publisher are identified.