High-risk exposure without personal protective equipment and infection with SARS-CoV-2 in healthcare workers: results of the CoV-CONTACT prospective cohort
Résumé
Objective:
We aimed to estimate the risk of infection in Healthcare workers (HCWs) following a high-risk exposure without personal protective equipment (PPE).
Methods:
We conducted a prospective cohort in HCW s who had a high-risk exposure to SARS-CoV-2-infected subject without PPE. Daily symptoms were self-reported for 30 days, nasopharyngeal swabs for SARS-CoV-2 RT-PCR were performed at inclusion and at days 3, 5, 7 and 12, SARS-CoV-2 serology was assessed at inclusion and at day 30. Confirmed infection was defined by positive RT-PCR or seroconversion, and possible infection by one general and one specific symptom for two consecutive days.
Results:
Between February 5th and May 30th, 2020, 154 HCWs were enrolled within 14 days following one high-risk exposure to either a hospital patient (70/154; 46.1%) and/or a colleague (95/154; 62.5%). At day 30, 2 5.0% had a confirmed infection (37/148; 95% CI, 18.4 %; 32.9%), and 43.9% (65/148; 95%CI, 35.9%; 52.3 %) had a confirmed or possible infection. Factors independently associated with confirmed or possible SARS-CoV-2 infection were being a pharmacist or administrative assistant rather than being from medical staff (adjusted OR (aOR)=3.8, CI95%=1 .3; 11.2, p=0.01) , and exposure to a SARS-CoV-2-inf ected patient rather than exposure to a SARS-CoV-2-infected colleague (a OR=2 .6, CI95%=1.2; 5.9, p=0.02). Among the 26 HCWs with a SARS-CoV-2-positive nasopharyngeal swab, 7 (26.9 %) had no symptom at the time of the RT-PCR positivity.
Conclusions:
The proportion of HCWs with confirmed or possible SARS-CoV-2 infection was high.
There were less occurrences of high-risk exposure with patients than with colleagues, but those were associated with an increased risk of infection.
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