Diagnosed and Undiagnosed COVID-19 in US Emergency Department Health Care Personnel: A Cross-sectional Analysis

Autor: Nicholas M. Mohr, Karisa K. Harland, Anusha Krishnadasan, Patrick Ten Eyck, William R. Mower, James Willey, Makini Chisolm-Straker, Stephen C. Lim, L. Clifford McDonald, Preeta K. Kutty, Elisabeth Hesse, Scott Santibanez, David A. Talan, Monica Bahamon, Jestin N. Carlson, Brian Driver, Brett Faine, James Galbraith, Philip A. Giordano, John P. Haran, Amanda Higgins, Jeremiah Hinson, Stacey House, Ahamed H. Idris, Efrat Kean, Elizabeth Krebs, Michael C. Kurz, Lilly Lee, Stephen Y. Liang, Juan Carlos C. Montoy, Gregory Moran, Utsav Nandi, Kavitha Pathmarajah, James H. Paxton, Yesenia Perez, Lynne D. Richardson, Robert M. Rodriguez, Richard Rothman, Walter A. Schrading, Jessica Shuck, Patricia Slev, Howard A. Smithline, Kimberly Souffront, Mark Steele, Amy Stubbs, Morgan Swanson, Josh Tiao, Jesus R. Torres, Stacy Trent, Lisandra Uribe, Arvind Venkat, Gregory Volturo, Kelli Wallace, Kurt D. Weber
Rok vydání: 2020
Předmět:
Zdroj: Annals of Emergency Medicine
ISSN: 1097-6760
Popis: Study objective We determine the percentage of diagnosed and undiagnosed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among a sample of US emergency department (ED) health care personnel before July 2020. Methods This was a cross-sectional analysis of ED health care personnel in 20 geographically diverse university-affiliated EDs from May 13, to July 8, 2020, including case counts of prior laboratory-confirmed coronavirus disease 2019 (COVID-19) diagnoses among all ED health care personnel, and then point-in-time serology (with confirmatory testing) and reverse transcriptase–polymerase chain reaction testing in a sample of volunteers without a previous COVID-19 diagnosis. Health care staff were categorized as clinical (physicians, advanced practice providers, and nurses) and nonclinical (clerks, social workers, and case managers). Previously undiagnosed infection was based on positive SARS-CoV-2 serology or reverse transcriptase–polymerase chain reaction result among health care personnel without prior diagnosis. Results Diagnosed COVID-19 occurred in 2.8% of health care personnel (193/6,788), and the prevalence was similar for nonclinical and clinical staff (3.8% versus 2.7%; odds ratio 1.5; 95% confidence interval 0.7 to 3.2). Among 1,606 health care personnel without previously diagnosed COVID-19, 29 (1.8%) had evidence of current or past SARS-CoV-2 infection. Most (62%; 18/29) who were seropositive did not think they had been infected, 76% (19/25) recalled COVID-19–compatible symptoms, and 89% (17/19) continued to work while symptomatic. Accounting for both diagnosed and undiagnosed infections, 4.6% (95% confidence interval 2.8% to 7.5%) of ED health care personnel were estimated to have been infected with SARS-CoV-2, with 38% of those infections undiagnosed. Conclusion In late spring and early summer 2020, the estimated prevalence of severe acute respiratory syndrome coronavirus 2 infection was 4.6%, and greater than one third of infections were undiagnosed. Undiagnosed SARS-CoV-2 infection may pose substantial risk for transmission to other staff and patients.
Databáze: OpenAIRE
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