tetano
Editor, Senior Moderator
J Hosp Infect
. 2022 Mar 11;S0195-6701(22)00079-2.
doi: 10.1016/j.jhin.2022.02.024. Online ahead of print.
SARS-CoV-2 transmission risk upon return to work in RNA-positive healthcare workers
L M Kolodziej[SUP] 1 [/SUP], S Hordijk[SUP] 2 [/SUP], J Koopsen[SUP] 2 [/SUP], J J Maas[SUP] 3 [/SUP], H T Thung[SUP] 3 [/SUP], I J B Spijkerman[SUP] 2 [/SUP], M Jonges[SUP] 2 [/SUP], M K Bomers[SUP] 4 [/SUP], J J Sikkens[SUP] 4 [/SUP], de Jong[SUP] 2 [/SUP], R Zonneveld[SUP] 1 [/SUP], J Schinkel[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Healthcare workers (HCWs) are at risk for coronavirus disease 2019 (COVID-19) and for spreading Severe Acute Respiratory Syndrome Virus 2 (SARS-CoV-2) amongst colleagues and patients.
Aim: We aimed to study presence of SARS-CoV-2 RNA and possible onward transmission by HCWs upon return to work after COVID-19, and association with disease severity and development of antibodies over time.
Methods: Unvaccinated HCWs with positive SARS-CoV-2 RT-PCR were prospectively recruited. Data on symptoms was collected via telephone questionnaires on day 2, 7, 14 and 21 after positive test. Upon return to work, repeat SARS-CoV-2 RT-PCR was performed and serum was collected. Repeat sera were collected at week 4, 8, 12 and 16 to determine antibody dynamics over time. Phylogenetic analysis was conducted to investigate possible transmission events originating from HCW with a positive repeat RT-PCR.
Findings: Sixty-one (84.7%) participants with mild-moderate COVID-19 had a repeat SARS-CoV-2 PCR performed upon return to work (median 13 days post symptom onset), of which 30 (49.1%) were positive with a median cycle threshold (Ct) value of 29.2 (IQR 3.0). All HCWs developed antibodies against SARS-CoV-2. No significant differences in symptomatology and presence of antibodies were found between repeat RT-PCR-positive and -negative HCWs. Eleven direct colleagues of six participants with a repeat RT-PCR Ct-value <30 tested positive after the HCW returned to work. Phylogenetic and epidemiologic analysis did not indicate onward transmission through HCW who were SARS-CoV-2 RNA positive upon return to work.
Conclusions: HCWs regularly return to work with sub stantial SARS-CoV-2 RNA loads. However, we found no evidence for subsequent in-hospital transmission.
Keywords: COVID-19; Healthcare worker; Infectious disease transmission; SARS-CoV-2.
. 2022 Mar 11;S0195-6701(22)00079-2.
doi: 10.1016/j.jhin.2022.02.024. Online ahead of print.
SARS-CoV-2 transmission risk upon return to work in RNA-positive healthcare workers
L M Kolodziej[SUP] 1 [/SUP], S Hordijk[SUP] 2 [/SUP], J Koopsen[SUP] 2 [/SUP], J J Maas[SUP] 3 [/SUP], H T Thung[SUP] 3 [/SUP], I J B Spijkerman[SUP] 2 [/SUP], M Jonges[SUP] 2 [/SUP], M K Bomers[SUP] 4 [/SUP], J J Sikkens[SUP] 4 [/SUP], de Jong[SUP] 2 [/SUP], R Zonneveld[SUP] 1 [/SUP], J Schinkel[SUP] 1 [/SUP]
Affiliations
- PMID: 35288252
- DOI: 10.1016/j.jhin.2022.02.024
Abstract
Background: Healthcare workers (HCWs) are at risk for coronavirus disease 2019 (COVID-19) and for spreading Severe Acute Respiratory Syndrome Virus 2 (SARS-CoV-2) amongst colleagues and patients.
Aim: We aimed to study presence of SARS-CoV-2 RNA and possible onward transmission by HCWs upon return to work after COVID-19, and association with disease severity and development of antibodies over time.
Methods: Unvaccinated HCWs with positive SARS-CoV-2 RT-PCR were prospectively recruited. Data on symptoms was collected via telephone questionnaires on day 2, 7, 14 and 21 after positive test. Upon return to work, repeat SARS-CoV-2 RT-PCR was performed and serum was collected. Repeat sera were collected at week 4, 8, 12 and 16 to determine antibody dynamics over time. Phylogenetic analysis was conducted to investigate possible transmission events originating from HCW with a positive repeat RT-PCR.
Findings: Sixty-one (84.7%) participants with mild-moderate COVID-19 had a repeat SARS-CoV-2 PCR performed upon return to work (median 13 days post symptom onset), of which 30 (49.1%) were positive with a median cycle threshold (Ct) value of 29.2 (IQR 3.0). All HCWs developed antibodies against SARS-CoV-2. No significant differences in symptomatology and presence of antibodies were found between repeat RT-PCR-positive and -negative HCWs. Eleven direct colleagues of six participants with a repeat RT-PCR Ct-value <30 tested positive after the HCW returned to work. Phylogenetic and epidemiologic analysis did not indicate onward transmission through HCW who were SARS-CoV-2 RNA positive upon return to work.
Conclusions: HCWs regularly return to work with sub stantial SARS-CoV-2 RNA loads. However, we found no evidence for subsequent in-hospital transmission.
Keywords: COVID-19; Healthcare worker; Infectious disease transmission; SARS-CoV-2.