Highlights
- •HCWs face a high risk of SARS-CoV-2 transmission during serving health care.
- •Transmission may also occur in nonmedical areas while speaking or eating.
- •Proper use of PPE and basic infection control precautions are essential.
Aim
Methods
Results
Conclusion
Key Words
INTRODUCTION
WHO timeline - COVID-19. Available at:https://www.who.int/news-room/detail/27-04-2020-who-timeline—covid-19. Accessed August 19, 2020.
Coronavirus disease (COVID-2019) situation reports. Available at:https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports. Accessed August 19, 2020.
WHO timeline - COVID-19. Available at:https://www.who.int/news-room/detail/27-04-2020-who-timeline—covid-19. Accessed August 19, 2020.
Interim U.S. guidance for risk assessment and work restrictions for healthcare personnel with potential exposure to COVID-19. Available at:https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html. Accessed August 19, 2020.
Lynch JB, Davitkov P, Anderson DJ, et al. Infectious diseases society of America guidelines on infection prevention in patients with suspected or known COVID-19 published by IDSA, 4/27/2020. Available at: https://www.idsociety.org/COVID19guidelines/ip. Accessed August 19, 2020.
Infection prevention and control during health care when novel coronavirus (nCoV) infection is suspected. 2020. Available at:https://www.who.int/publications-detail/infection-prevention-and-control-during-health-care-when-novel-coronavirus-(ncov)-infection-is-suspected-20200125. Accessed August 19, 2020.
Material and methods
Hospital settings
Case-control study
RT-PCR detection
Statistical analyses
Results

Profession | RT-PCR positive n/N (%) | RT-PCR negative n/N (%) | P value |
---|---|---|---|
Medical doctor | 8/128 (6.3%) | 120/128 (93.8%) | .094 |
Nurse | 22/274 (8%) | 252/274 (92%) | |
Cleaning personnel | 17/186 (9.1%) | 169/186 (90.9%) | |
Other | 3/115 (2.6%) | 112/115 (97.4%) | |
Total | 50/703 (7.1%) | 653/703 (92.9%) |
Work location | RT-PCR positive n/N (%) | RT-PCR negative n/N (%) | Relative risk (RR) |
---|---|---|---|
HCWs worked in a COVID-19 unit | 44/527 (8.3%) | 483/527 (91.7%) | RR = 2.449 (CI = 1.062-5.649) P = .027 |
HCWs did not work in a COVID-19 unit | 6/176 (3.4%) | 170/176 (96.6%) | |
Medical doctor worked in a COVID-19 unit | 5/114 (4.4%) | 109/114 (95.6%) | RR = 0.205 (CI = 0.055-0.766) P = .042 |
Medical doctor did not work in a COVID-19 unit | 3/14 (21.4%) | 11/14 (78.6%) | |
Nurses worked in a COVID-19 unit | 19/187 (10.2%) | 168/187 (89.8%) | RR = 2.947 (CI = 0.896-9.693) P = .057 |
Nurses did not work in a COVID-19 unit | 3/87 (3.4%) | 84/87 (96.6%) | |
Cleaning personnel worked in a COVID-19 unit | 17/167 (10.2%) | 150/167 (89.8%) | RR = 2.237 (CI = 0.314-15.910) P = .700 |
Cleaning personnel did not work in a COVID-19 unit | 0/19 (0.0%) | 19/19 (100%) | |
Other worked in a COVID-19 unit | 3/59 (5.1%) | 56/59 (94.9%) | RR = 3.803 (CI = 0.438-33.032) P = .365 |
Other did not work in a COVID-19 unit | 0/56 (0.0%) | 56/56 (100.0%) |
Case-control study
Variables | Cases N = 47 | Controls N = 134 | P value |
---|---|---|---|
Date interval of RT-PCR detection | 26.03.2020-16.04.2020 | 26.03.2020-30.04.2020 | |
Age (the mean, min-max) | 35.7 (21-61) | 34.4 (21-50) | .253 |
n/(%) | n/(%) | ||
Sex | .507 | ||
Female | 32 (68.1) | 84 (62.7) | |
Male | 15 (31.9) | 50 (37.3) | |
Profession | .107 | ||
Medical doctor | 7 (14.9) | 41 (30.6) | |
Nurse | 28 (59.6) | 67 (50.0) | |
Cleaning personnel | 12 (25.5) | 26 (19.4) | |
Having an underlying disorder | 16 (34.0) | 41 (30.6) | .662 |
Presence of an HCW in the household | 10 (21.3) | 31 (23.1) | .793 |
Presence of a SARS-CoV-2 positive person in the household | 3 (6.5) | 0 (0.0) | .016 |
Presence of a SARS-CoV-2 positive person within the occupational or social surroundings | 25 (53.2) | 109 (81.3) | .000 |
Working in a COVID-19 unit (yes) | 31 (66.0) | 99 (73.9) | .299 |
Entering a room in which a suspected or confirmed COVID-19 patient was hospitalized (yes) | 31 (66.0) | 103 (76.9) | .142 |
Examining (touching) a suspected or confirmed Covid-19 patient (yes) | 27 (57.4) | 102 (76.1) | .015 |
Obtaining a respiratory sample from a suspected or confirmed COVID-19 patient (yes) | 9 (19.1) | 43 (32.1) | .092 |
Intubating a suspected or confirmed COVID-19 patient or being present in the room during intubation (yes) | 6 (13.3) | 21 (15.7) | .705 |
Resuscitating a suspected or confirmed COVID-19 patient or being present in the room during resuscitation (yes) | 6 (13.0) | 14 (10.4) | .629 |
Entering the ICU room of a suspected or confirmed patient with mechanical ventilation (yes) | 9 (19.6) | 33 (24.6) | .484 |
Being present in the operation room during a surgical procedure on a suspected or confirmed COVID-19 patient (yes) | 0 (0.0) | 2 (1.5) | 1.000 |
Improper use of PPE while caring for a suspected or confirmed COVID-19 patient | 8 (17.0 ) | 5 (3.8 ) | .003 |
Making a mistake while implementing infection control precautions (yes) | 3 (6.4) | 3 (2.3) | .191 |
Staying in the same personnel break room as an HCW without wearing medical mask for more than 15 minutes (yes) | 33 (70.2) | 37 (27.8) | .000 |
Consuming food within one meter of an HCW (yes) | 33 (70.2) | 60 (44.8) | .003 |
Failing to keep a safe social distance from an HCW | 29 (63.0) | 52 (39.1) | .005 |
Discussion
ICN calls for data on healthcare worker infections and deaths. Available at:https://www.2020yearofthenurse.org/story/icn-calls-for-data-on-healthcare-worker-infection-rates-deaths/. Accessed August 19, 2020
Assessment Report for COVID-19. Turkish medical association. Available at:https://www.ttb.org.tr/userfiles/files/covid19-rapor.pdf. Accessed August 19, 2020
Ran L, Chen X, Wang Y, Wu W, Zhang L, Tan X. Risk factors of healthcare workers with corona virus disease 2019: a retrospective cohort study in a designated hospital of Wuhan in China [e-pub ahead of print]. Clin Infect Dis. https://doi.org/10.1093/cid/ciaa287. Accessed August 19, 2020
- 1.Mandatory and continuous use of medical masks by HCWs in all areas (including administrative offices, technical services, cafeterias, and break rooms) of the hospital.
- 2.Forbidden consumption of food in all personnel break rooms.
- 3.Forbidden sitting face-to-face while dining at the central cafeteria of the hospital.
- 4.Informing and re-training all HCWs of the additional recommendations.
Xiang F, Wang X, He X, et al. Antibody detection and dynamic characteristics in patients with COVID-19 [e-pub ahead of print]. Clin Infect Dis.https://doi.org/10.1093/cid/ciaa461. Accessed August 19, 2020
CONCLUSION
Acknowledgments
Appendix. SUPPLEMENTARY MATERIALS
References
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Infection prevention and control during health care when novel coronavirus (nCoV) infection is suspected. 2020. Available at:https://www.who.int/publications-detail/infection-prevention-and-control-during-health-care-when-novel-coronavirus-(ncov)-infection-is-suspected-20200125. Accessed August 19, 2020.
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Article Info
Publication History
Footnotes
Conflicts of interest: None to report.
Contribution of the authors: All listed authors have made significant contributions to this article.