Risk factors and frequency of COVID-19 among healthcare workers at a tertiary care centre in India: a case–control study

{ 'indexed': {'date-parts': [[2024, 1, 30]], 'date-time': '2024-01-30T07:58:23Z', 'timestamp': 1706601503345}, 'reference-count': 21, 'publisher': 'Oxford University Press (OUP)', 'issue': '5', 'license': [ { 'start': { 'date-parts': [[2021, 3, 24]], 'date-time': '2021-03-24T00:00:00Z', 'timestamp': 1616544000000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model'}], 'content-domain': {'domain': [], 'crossmark-restriction': False}, 'published-print': {'date-parts': [[2021, 5, 8]]}, 'abstract': '<jats:title>Abstract</jats:title>\n' ' <jats:sec>\n' ' <jats:title>Background</jats:title>\n' ' <jats:p>There is a paucity of data on risk factors for infection among ' 'healthcare workers (HCWs) from India. Our objective was to evaluate the risk factors and ' 'frequency of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among ' 'HCWs.</jats:p>\n' ' </jats:sec>\n' ' <jats:sec>\n' ' <jats:title>Methods</jats:title>\n' ' <jats:p>We conducted this retrospective case–control study of 3100 HCWs ' 'between May and July 2020. HCWs positive for SARS-CoV-2 infection were the cases (n=506) and ' 'those negative for SARS-CoV-2 were the controls (n=253). Univariate analysis was followed by ' 'multivariate analysis of key demographic, clinical and infection control variables.</jats:p>\n' ' </jats:sec>\n' ' <jats:sec>\n' ' <jats:title>Results</jats:title>\n' ' <jats:p>SARS-CoV-2 infection was found in 16.32% of HCWs. Nearly 45% of ' 'infected HCWs were asymptomatic. The proportions of sanitation workers (24% vs 8%; ' 'p&amp;lt;0.0001) and technicians (10% vs 4%; p=0.0002) were higher and that of doctors was ' 'lower among cases as compared with controls (23% vs 43%; p&amp;lt;0.0001). On univariate ' 'analysis, the type of HCW, smoking, lack of training, inadequate personal protective ' 'equipment (PPE) use and taking no or fewer doses of hydroxychloroquine (HCQ) were found to be ' 'significant. On multivariate analysis, the type of HCW (risk ratio [RR] 1.67 [95% confidence ' 'interval {CI} 1.34 to 2.08], p&amp;lt;0.0001), inappropriate PPE use (RR 0.63 [95% CI 0.44 to ' '0.89], p=0.01) and taking fewer doses of HCQ (RR 0.92 [95% CI 0.86 to 0.99], p=0.03) were ' 'significant.</jats:p>\n' ' </jats:sec>\n' ' <jats:sec>\n' ' <jats:title>Conclusions</jats:title>\n' ' <jats:p>The frequency of SARS-CoV-2 infection was 16% among HCWs. Being a ' 'sanitation worker, inappropriate PPE use and lack of HCQ prophylaxis predisposed HCWs to ' 'SARS-CoV-2 infection.</jats:p>\n' ' </jats:sec>', 'DOI': '10.1093/trstmh/trab047', 'type': 'journal-article', 'created': {'date-parts': [[2021, 3, 3]], 'date-time': '2021-03-03T20:34:04Z', 'timestamp': 1614803644000}, 'page': '551-556', 'source': 'Crossref', 'is-referenced-by-count': 19, 'title': 'Risk factors and frequency of COVID-19 among healthcare workers at a tertiary care centre in ' 'India: a case–control study', 'prefix': '10.1093', 'volume': '115', 'author': [ { 'ORCID': 'http://orcid.org/0000-0003-2486-6725', 'authenticated-orcid': False, 'given': 'Nishanth', 'family': 'Dev', 'sequence': 'first', 'affiliation': [ { 'name': 'Department of Medicine, Vardhman Mahavir Medical College & ' 'Safdarjung Hospital, Delhi, India 110029'}]}, { 'given': 'Ramesh Chand', 'family': 'Meena', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Medicine, Vardhman Mahavir Medical College & ' 'Safdarjung Hospital, Delhi, India 110029'}]}, { 'given': 'D K', 'family': 'Gupta', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Medicine, Vardhman Mahavir Medical College & ' 'Safdarjung Hospital, Delhi, India 110029'}]}, { 'given': 'Nitesh', 'family': 'Gupta', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Pulmonology and Critical Care, Vardhman Mahavir ' 'Medical College & Safdarjung Hospital, Delhi, India 110029'}]}, { 'given': 'Jhuma', 'family': 'Sankar', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Pediatrics, All India Institute of Medical ' 'Sciences, Delhi, India 110029'}]}], 'member': '286', 'published-online': {'date-parts': [[2021, 3, 24]]}, 'reference': [ { 'key': '2021090110141259500_bib1', 'article-title': 'Novel coronavirus (2019-nCoV). Situation report – 1. 21 January 2020', 'author': 'World Health Organization'}, { 'key': '2021090110141259500_bib2', 'article-title': 'WHO coronavirus (COVID-19) dashboard', 'author': 'World Health Organization'}, { 'key': '2021090110141259500_bib3', 'article-title': 'COVID-19 statewise status', 'author': 'Ministry of Health and Family Welfare, Government of India'}, { 'issue': '15', 'key': '2021090110141259500_bib4', 'doi-asserted-by': 'crossref', 'first-page': '477', 'DOI': '10.15585/mmwr.mm6915e6', 'article-title': 'Characteristics of health care personnel with COVID-19 – United States, ' 'February 12–April 9, 2020', 'volume': '69', 'author': 'CDC COVID-19 Response Team', 'year': '2020', 'journal-title': 'MMWR Morb Mortal Wkly Rep'}, { 'issue': '5', 'key': '2021090110141259500_bib5', 'doi-asserted-by': 'crossref', 'first-page': 'e209666', 'DOI': '10.1001/jamanetworkopen.2020.9666', 'article-title': 'Coronavirus disease 2019 (COVID-2019) infection among health care ' 'workers and implications for prevention measures in a tertiary hospital ' 'in Wuhan, China', 'volume': '3', 'author': 'Lai', 'year': '2020', 'journal-title': 'JAMA Netw Open'}, { 'issue': '12', 'key': '2021090110141259500_bib6', 'doi-asserted-by': 'crossref', 'first-page': '1273', 'DOI': '10.1016/S1473-3099(20)30527-2', 'article-title': 'COVID-19 in health-care workers in three hospitals in the south of the ' 'Netherlands: a cross-sectional study', 'volume': '20', 'author': 'Sikkema', 'year': '2020', 'journal-title': 'Lancet Infect Dis'}, { 'issue': '5', 'key': '2021090110141259500_bib7', 'doi-asserted-by': 'crossref', 'first-page': 'e209673', 'DOI': '10.1001/jamanetworkopen.2020.9673', 'article-title': 'Prevalence and clinical presentation of health care workers with ' 'symptoms of coronavirus disease 2019 in 2 Dutch hospitals during an ' 'early phase of the pandemic', 'volume': '3', 'author': 'Kluytmans-van den Bergh', 'year': '2020', 'journal-title': 'JAMA Netw Open'}, { 'key': '2021090110141259500_bib8', 'doi-asserted-by': 'crossref', 'DOI': '10.4081/monaldi.2020.1474', 'article-title': 'COVID-19 infection outbreak among health care workers: perspective from ' 'a low-middle income country', 'author': 'Dev', 'year': '2020', 'journal-title': 'Monaldi Arch Chest Dis'}, { 'key': '2021090110141259500_bib9', 'article-title': 'Novel coronavirus disease 2019 (COVID-19): guidelines on rational use ' 'of personal protective equipment', 'author': 'Ministry of Health and Family Welfare, Government of India'}, { 'issue': '5', 'key': '2021090110141259500_bib10', 'doi-asserted-by': 'crossref', 'first-page': '459', 'DOI': '10.4103/ijmr.IJMR_2234_20', 'article-title': 'Healthcare workers & SARS-CoV-2 infection in India: a case-control ' 'investigation in the time of COVID-19', 'volume': '151', 'author': 'Chatterjee', 'year': '2020', 'journal-title': 'Indian J Med Res'}, { 'key': '2021090110141259500_bib11', 'volume-title': 'Ministry of Health and Family Welfare, Government of India', 'author': 'Clinical management protocol: COVID-19'}, { 'issue': '4', 'key': '2021090110141259500_bib12', 'doi-asserted-by': 'crossref', 'first-page': '530', 'DOI': '10.1007/s00134-003-1662-x', 'article-title': '2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions ' 'Conference', 'volume': '29', 'author': 'Levy', 'year': '2003', 'journal-title': 'Intensive Care Med'}, { 'key': '2021090110141259500_bib13', 'article-title': 'Advisory for managing health care workers working in COVID and ' 'non-COVID areas of the hospital', 'author': 'Ministry of Health and Family Welfare, Government of India'}, { 'issue': '1', 'key': '2021090110141259500_bib14', 'doi-asserted-by': 'crossref', 'first-page': '161', 'DOI': '10.1093/aje/kwaa191', 'article-title': 'COVID-19 in healthcare workers: a living systematic review and ' 'meta-analysis of prevalence, risk factors, clinical characteristics, ' 'and outcomes', 'volume': '190', 'author': 'Gómez-Ochoa', 'year': '2021', 'journal-title': 'Am J Epidemiol'}, { 'issue': '10', 'key': '2021090110141259500_bib15', 'doi-asserted-by': 'crossref', 'first-page': '1413.e9', 'DOI': '10.1016/j.cmi.2020.06.013', 'article-title': 'Characteristics of 1573 healthcare workers who underwent nasopharyngeal ' 'swab testing for SARS-CoV-2 in Milan, Lombardy, Italy', 'volume': '26', 'author': 'Lombardi', 'year': '2020', 'journal-title': 'Clin Microbiol Infect'}, { 'issue': '16', 'key': '2021090110141259500_bib16', 'doi-asserted-by': 'crossref', 'first-page': '2218', 'DOI': '10.1093/cid/ciaa287', 'article-title': 'Risk factors of healthcare workers with corona virus disease 2019: a ' 'retrospective cohort study in a designated hospital of Wuhan in China', 'volume': '71', 'author': 'Ran', 'year': '2020', 'journal-title': 'Clin Infect Dis'}, { 'issue': '3', 'key': '2021090110141259500_bib17', 'doi-asserted-by': 'crossref', 'first-page': '420', 'DOI': '10.1016/j.jinf.2020.05.067', 'article-title': 'High SARS-CoV-2 antibody prevalence among healthcare workers exposed to ' 'COVID-19 patients', 'volume': '81', 'author': 'Chen', 'year': '2020', 'journal-title': 'J Infect'}, { 'issue': '10242', 'key': '2021090110141259500_bib18', 'doi-asserted-by': 'crossref', 'first-page': '1973', 'DOI': '10.1016/S0140-6736(20)31142-9', 'article-title': 'Physical distancing, face masks, and eye protection to prevent ' 'person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic ' 'review and meta-analysis', 'volume': '395', 'author': 'Chu', 'year': '2020', 'journal-title': 'Lancet'}, { 'key': '2021090110141259500_bib19', 'doi-asserted-by': 'crossref', 'first-page': 'm2195', 'DOI': '10.1136/bmj.m2195', 'article-title': 'Use of personal protective equipment against coronavirus disease 2019 ' 'by healthcare professionals in Wuhan, China: cross sectional study', 'volume': '369', 'author': 'Liu', 'year': '2020', 'journal-title': 'BMJ'}, { 'issue': '2', 'key': '2021090110141259500_bib20', 'doi-asserted-by': 'crossref', 'first-page': '257', 'DOI': '10.1093/cid/ciaa977', 'article-title': 'Comparing dynamics and determinants of SARS-CoV-2 transmissions among ' 'health care workers of adult and pediatric settings in central Paris', 'volume': '72', 'author': 'Contejean', 'year': '2020', 'journal-title': 'Clin Infect Dis'}, { 'issue': '2', 'key': '2021090110141259500_bib21', 'doi-asserted-by': 'crossref', 'first-page': '195', 'DOI': '10.1001/jamainternmed.2020.6319', 'article-title': 'Efficacy and safety of hydroxychloroquine vs placebo for pre-exposure ' 'SARS-CoV-2 prophylaxis among health care workers: a randomized clinical ' 'trial', 'volume': '181', 'author': 'Abella', 'year': '2021', 'journal-title': 'JAMA Intern Med'}], 'container-title': 'Transactions of The Royal Society of Tropical Medicine and Hygiene', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'http://academic.oup.com/trstmh/article-pdf/115/5/551/40180644/trab047.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 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