Prospective Longitudinal Serosurvey of Healthcare Workers in the First Wave of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Pandemic in a Quaternary Care Hospital in Munich, Germany.


Journal

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
ISSN: 1537-6591
Titre abrégé: Clin Infect Dis
Pays: United States
ID NLM: 9203213

Informations de publication

Date de publication:
02 11 2021
Historique:
received: 25 11 2020
pubmed: 4 1 2021
medline: 9 11 2021
entrez: 3 1 2021
Statut: ppublish

Résumé

High infection rates among healthcare personnel in an uncontained pandemic can paralyze health systems due to staff shortages. Risk constellations and rates of seroconversion for healthcare workers (HCWs) during the first wave of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic are still largely unclear. Healthcare personnel (n = 300) on different organizational units in the LMU Munich University Hospital were included and followed in this prospective longitudinal study from 24 March until 7 July 2020. Participants were monitored in intervals of 2 to 6 weeks using different antibody assays for serological testing and questionnaires to evaluate risk contacts. In a subgroup of infected participants, we obtained nasopharyngeal swabs to perform whole-genome sequencing for outbreak characterization. HCWs involved in patient care on dedicated coronavirus disease 2019 (COVID-19) wards or on regular non-COVID-19 wards showed a higher rate of SARS-CoV-2 seroconversion than staff in the emergency department and non-frontline personnel. The landscape of risk contacts in these units was dynamic, with a decrease in unprotected risk contacts in the emergency department and an increase on non-COVID-19 wards. Both intensity and number of risk contacts were associated with higher rates of seroconversion. On regular wards, staff infections tended to occur in clusters, while infections on COVID-19 wards were less frequent and apparently independent of each other. Risk of SARS-CoV-2 infection for frontline HCWs was increased during the first pandemic wave in southern Germany. Stringent measures for infection control are essential to protect all patient-facing staff during the ongoing pandemic.

Sections du résumé

BACKGROUND
High infection rates among healthcare personnel in an uncontained pandemic can paralyze health systems due to staff shortages. Risk constellations and rates of seroconversion for healthcare workers (HCWs) during the first wave of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic are still largely unclear.
METHODS
Healthcare personnel (n = 300) on different organizational units in the LMU Munich University Hospital were included and followed in this prospective longitudinal study from 24 March until 7 July 2020. Participants were monitored in intervals of 2 to 6 weeks using different antibody assays for serological testing and questionnaires to evaluate risk contacts. In a subgroup of infected participants, we obtained nasopharyngeal swabs to perform whole-genome sequencing for outbreak characterization.
RESULTS
HCWs involved in patient care on dedicated coronavirus disease 2019 (COVID-19) wards or on regular non-COVID-19 wards showed a higher rate of SARS-CoV-2 seroconversion than staff in the emergency department and non-frontline personnel. The landscape of risk contacts in these units was dynamic, with a decrease in unprotected risk contacts in the emergency department and an increase on non-COVID-19 wards. Both intensity and number of risk contacts were associated with higher rates of seroconversion. On regular wards, staff infections tended to occur in clusters, while infections on COVID-19 wards were less frequent and apparently independent of each other.
CONCLUSIONS
Risk of SARS-CoV-2 infection for frontline HCWs was increased during the first pandemic wave in southern Germany. Stringent measures for infection control are essential to protect all patient-facing staff during the ongoing pandemic.

Identifiants

pubmed: 33388756
pii: 6060065
doi: 10.1093/cid/ciaa1935
pmc: PMC7799305
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e3055-e3065

Subventions

Organisme : NaFoUniMedCovid19
ID : 01KX2021

Informations de copyright

© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Auteurs

Tobias Weinberger (T)

Department of Medicine I, LMU Klinikum, Ludwig-Maximilians-Universität München, Munich, Germany.
DZHK (German Centre for Cardiovascular Research), Berlin, Germany, partner site Munich Heart Alliance, Munich, Germany.

Julius Steffen (J)

Department of Medicine I, LMU Klinikum, Ludwig-Maximilians-Universität München, Munich, Germany.
DZHK (German Centre for Cardiovascular Research), Berlin, Germany, partner site Munich Heart Alliance, Munich, Germany.

Andreas Osterman (A)

Max von Pettenkofer Institute, Virology, National Reference Center for Retroviruses, Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany.
German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany.

Tonina T Mueller (TT)

Department of Medicine I, LMU Klinikum, Ludwig-Maximilians-Universität München, Munich, Germany.

Maximilian Muenchhoff (M)

Max von Pettenkofer Institute, Virology, National Reference Center for Retroviruses, Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany.
German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany.
COVID-19 Registry of LMU Klinikum (CORKUM), Ludwig-Maximilians-Universität München, Munich, Germany.

Paul R Wratil (PR)

Max von Pettenkofer Institute, Virology, National Reference Center for Retroviruses, Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany.
German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany.

Alexander Graf (A)

Laboratory for Functional Genome Analysis, Gene Center, Ludwig-Maximilians-Universität München, Munich, Germany.

Stefan Krebs (S)

Laboratory for Functional Genome Analysis, Gene Center, Ludwig-Maximilians-Universität München, Munich, Germany.

Caroline Quartucci (C)

Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, LMU Klinikum, Ludwig-Maximilians Universität München, Munich, Germany.

Patricia M Spaeth (PM)

Max von Pettenkofer Institute, Virology, National Reference Center for Retroviruses, Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany.
German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany.

Beatrice Grabein (B)

Department of Clinical Microbiology and Hospital Hygiene, LMU Klinikum, Ludwig-Maximilians Universität München, Munich, Germany.

Kristina Adorjan (K)

Department of Psychiatry and Psychotherapy, LMU Klinikum, Ludwig-Maximilians Universität München, Munich, Germany.

Helmut Blum (H)

Laboratory for Functional Genome Analysis, Gene Center, Ludwig-Maximilians-Universität München, Munich, Germany.

Oliver T Keppler (OT)

Max von Pettenkofer Institute, Virology, National Reference Center for Retroviruses, Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany.
German Center for Infection Research (DZIF), Partner Site Munich, Munich, Germany.

Matthias Klein (M)

Emergency Department, LMU Klinikum, Ludwig-Maximilians-Universität München, Munich, Germany.
Department of Neurology, LMU Klinikum, Ludwig-Maximilians-Universität München, Munich, Germany.

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