Objective: Frontline healthcare workers (HCW) exposed to coronavirus disease-2019 (COVID-19) patients at their work environment are at a higher risk of acquiring the disease. The aim of this study was to research the COVID-19 risks due to the occupational exposure of HCW and the clinical characteristics of the affected. Material and Methods: In this retrospective study, HCW, employed by The Ümraniye Research and Training Hospital, who were diagnosed with COVID-19 between 20th March 2020 to 20th May 2020 were analysed. Results: A total of 128 (3.8%) HCW were diagnosed with COVID-19. Most of the infected HCW were medical staff (34%), nurses (24%), physicians (22%) and staff with no patient contact (20%). Fifty-six percent of the infected HCW were working in COVID-19 wards and outpatient clinics. Twenty-nine percent acquired the infection in hospital from an index patient and 32% of them from an infected HCW. The highest transmission was during the sharing of the same environment (53%) like offices. Thirteen per cent of the HCW took the virus during examination or treatment, 31% of the individuals were unaware of the transmission. The number of the infected HCW was higher during the beginning of the outbreak in Turkey. The symptomatic cases were more (88%) than the asymptomatic cases (12%). A total of 28 (22%) HCW were hospitalised and only 4% of the cases were severe. Conclusion: The asymptomatic COVID-19 carrying HCW are to be considered as the source of the spread of the disease among their colleagues. Stricter measures should be implemented to prevent in-hospital transmission.
Keywords: Healthcare workers; coronavirus; transmission
Amaç: Sağlık çalışanlarının koronavirüs hastalığı-2019'a [coronavirus disease-2019 (COVID-19)] yakalanma riskleri, hastalara ön safhada maruz kaldıklarından dolayı fazladır. Bu çalışmada, sağlık çalışanlarının mesleki maruziyetine bağlı COVID-19 risklerini ve etkilenenlerin klinik özelliklerini araştırmak amaçlanmıştır. Gereç ve Yöntemler: Bu retrospektif çalışmada, 20 Mart-20 Mayıs 2020 tarihleri arasında Ümraniye Eğitim ve Araştırma Hastanesi'nde çalışan COVID-19 teşhisi konulan sağlık sektörü çalışanları analiz edilmiştir. Bulgular: Toplam 128 (3,8%) sağlık çalışanı COVID-19 tanısı almıştır. Enfekte olan sağlık çalışanlarının %34'ü sağlık personeli, %24'ü hemşire, %22'si doktor ve %20'si hasta teması olmayan personeldi. Enfekte sağlık çalışanlarının %56'sı COVID-19 servis ve ayaktan tedavi kliniklerinde çalışıyordu. Sağlık çalışanlarının %29'u hastanede enfeksiyonu bir indeks hastadan ve %32'si enfekte bir sağlık çalışanından almıştır. En yüksek bulaşma, ofisler gibi aynı ortamın paylaşılması sırasında gerçekleşti (%53). Sağlık çalışanlarının %13'ü virüsü muayene veya tedavi sırasında alırken, %31'i bulaşmanın farkında değildi. Semptomatik vakalar (%88) asemptomatik vakalardan (%12) daha fazlaydı. Toplam 28 (%22) sağlık çalışanı hastaneye yatırılarak tedavi edildi, vakaların sadece %4'ü ağırdı. Sonuç: Asemptomatik COVID-19 taşıyıcısı olan sağlık çalışanlarının, hastalığın kaynağı olarak meslektaşları arasında yayılmasında sorumlu olduğu kanısına varılmıştır. COVID-19'un hastane içi bulaşını önlemek için daha sıkı önlemler alınmalıdır.
Anahtar Kelimeler: Sağlık çalışanı; koronavirüs; bulaş
- Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;15;395(10223):497-506. Erratum in: Lancet. 2020:30. [Crossref] [PubMed] [PMC]
- Wu JT, Leung K, Leung GM. Now casting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modeling study. Lancet. 2020;395(10255):689-97. [Crossref]
- Chang D, Xu H, Rebaza A, Sharma L, Dela Cruz CS. Protecting health-care workers from subclinical coronavirus infection. Lancet Respir Med. 2020;8(3):e13. [Crossref] [PubMed] [PMC]
- Barrett ES, Horton DB, Roy J, Gennaro ML, Brooks A, Tischfield J, et al. Prevalence of SARS-CoV-2 infection in previously undiagnosed health care workers at the onset of the U.S. COVID-19 epidemic. medRxiv. 2020;24:2020.04.20.20072470. Update in: BMC Infect Dis. 2020;16;20(1):853. [Crossref] [PubMed] [PMC]
- Gan WH, Lim JW, Koh D. Preventing intra-hospital infection and transmission of coronavirus disease 2019 in health-care workers. Saf Health Work. 2020;11(2):241-3. [Crossref] [PubMed] [PMC]
- Remuzzi A, Remuzzi G. COVID-19 and Italy: what next? Lancet. 2020;11;395(10231):1225-8. [Crossref] [PubMed] [PMC]
- Madran B, Keske Ş, Beşli Y, İsmail Bozkurt İ, Önder Ergönül Ö. The risk of SARS-CoV-2 infection among healthcare workers. Infect Dis Clin Microbiol. 2020;2(2):54-60. [Crossref]
- Lai X, Wang M, Qin C, Tan L, Ran L, Chen D, et al. Coronavirus disease 2019 (COVID-2019) Infection Among Health Care Workers and Implications for prevention measures in a tertiary hospital in Wuhan, China. JAMA Network Open. 2020;3(5):e209666. [Crossref] [PubMed] [PMC]
- Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382:1708-20. [Crossref] [PubMed] [PMC]
- Clark A, Jit M, Warren-Gash C, Guthrie B, Wang HHX, Mercer SW, et al; Centre for the Mathematical Modelling of Infectious Diseases COVID-19 working group. Global, regional, and national estimates of the population at increased risk of severe COVID-19 due to underlying health conditions in 2020: a modelling study. Lancet Glob Health. 2020;8(8):e1003-17. [PubMed] [PMC]
- Tzotzos SJ, Fischer B, Fischer H, Zeitlinger M. Incidence of ARDS and outcomes in hospitalized patients with COVID-19: a global literature survey. Crit Care. 2020;21;24(1):516. [Crossref] [PubMed] [PMC]
- Chu J, Yang N, Wei Y, Yue H, Zhang F, Zhao J, et al. Clinical characteristics of 54 medical staff with COVID-19: a retrospective study in a single center in Wuhan, China. J Med Virol. 2020;92(7):807-13. [Crossref] [PubMed] [PMC]
- Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. 2020;26;382(13):1199-1207. [PubMed] [PMC]
- Boulware DR, Pullen MF, Bangdiwala AS, Pastick KA, Lofgren SM, Okafor EC, et al. A randomized trial of hydroxychloroquine as postexposure prophylaxis for Covid-19. N Engl J Med. 2020;6;383(6):517-25. [Crossref] [PubMed] [PMC]
- Heinzerling A, Stuckey MJ, Scheuer T, Xu K, Perkins KM, Resseger H, et al. Transmission of COVID-19 to health care personnel during exposures to a hospitalized patient - Solano County, California, February 2020. MMWR Morb Mortal Wkly Rep. 2020;17;69(15):472-6. [Crossref] [PubMed] [PMC]
- Zou L, Ruan F, Huang M, Liang L, Huang H, Hong Z, et al. SARS-CoV-2 viral load in upper respiratory specimens of infected patients. N Engl J Med. 2020;19;382(12):1177-9. [Crossref] [PubMed] [PMC]
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