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Characteristics of 1573 healthcare workers who underwent nasopharyngeal swab testing for SARS-CoV-2 in Milan, Lombardy, Italy.
Clin Microbiol Infect. 2020 Oct; 26(10):1413.e9-1413.e13.CM

Abstract

OBJECTIVES

The management of healthcare workers (HCWs) exposed to confirmed cases of coronavirus disease 2019 (COVID-19) is still a matter of debate. We aimed to assess in this group the attack rate of asymptomatic carriers and the symptoms most frequently associated with infection.

METHODS

Occupational and clinical characteristics of HCWs who underwent nasopharyngeal swab testing for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a university hospital from 24 February 2020 to 31 March 2020 were collected. For those who tested positive and for those who tested positive but who were asymptomatic, we checked the laboratory and clinical data as of 22 May to calculate the time necessary for HCWs to then test negative and to verify whether symptoms developed thereafter. Frequencies of positive tests were compared according to selected variables using multivariable logistic regression models.

RESULTS

There were 139 positive tests (8.8%) among 1573 HCWs (95% confidence interval, 7.5-10.3), with a marked difference between symptomatic (122/503, 24.2%) and asymptomatic (17/1070, 1.6%) workers (p < 0.001). Physicians were the group with the highest frequency of positive tests (61/582, 10.5%), whereas clerical workers and technicians had the lowest frequency (5/137, 3.6%). The likelihood of testing positive for COVID-19 increased with the number of reported symptoms; the strongest predictors of test positivity were taste and smell alterations (odds ratio = 76.9) and fever (odds ratio = 9.12). The median time from first positive test to a negative test was 27 days (95% confidence interval, 24-30).

CONCLUSIONS

HCWs can be infected with SARS-CoV-2 without displaying any symptoms. Among symptomatic HCWs, the key symptoms to guide diagnosis are taste and smell alterations and fever. A median of almost 4 weeks is necessary before nasopharyngeal swab test results are negative.

Authors+Show Affiliations

Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. Electronic address: andrea.lombardi@policlinico.mi.it.Epidemiology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.Epidemiology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.Medical Direction, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.Clinical Laboratory, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.Medical Direction, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.Epidemiology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.Occupational Health Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, Italy.Clinical Laboratory, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Centre for Multidisciplinary Research in Health Science (MACH), University of Milan, Milan, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32569835

Citation

Lombardi, A, et al. "Characteristics of 1573 Healthcare Workers Who Underwent Nasopharyngeal Swab Testing for SARS-CoV-2 in Milan, Lombardy, Italy." Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases, vol. 26, no. 10, 2020, pp. 1413.e9-1413.e13.
Lombardi A, Consonni D, Carugno M, et al. Characteristics of 1573 healthcare workers who underwent nasopharyngeal swab testing for SARS-CoV-2 in Milan, Lombardy, Italy. Clin Microbiol Infect. 2020;26(10):1413.e9-1413.e13.
Lombardi, A., Consonni, D., Carugno, M., Bozzi, G., Mangioni, D., Muscatello, A., Castelli, V., Palomba, E., Cantù, A. P., Ceriotti, F., Tiso, B., Pesatori, A. C., Riboldi, L., Bandera, A., Lunghi, G., & Gori, A. (2020). Characteristics of 1573 healthcare workers who underwent nasopharyngeal swab testing for SARS-CoV-2 in Milan, Lombardy, Italy. Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases, 26(10), e9-e13. https://doi.org/10.1016/j.cmi.2020.06.013
Lombardi A, et al. Characteristics of 1573 Healthcare Workers Who Underwent Nasopharyngeal Swab Testing for SARS-CoV-2 in Milan, Lombardy, Italy. Clin Microbiol Infect. 2020;26(10):1413.e9-1413.e13. PubMed PMID: 32569835.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characteristics of 1573 healthcare workers who underwent nasopharyngeal swab testing for SARS-CoV-2 in Milan, Lombardy, Italy. AU - Lombardi,A, AU - Consonni,D, AU - Carugno,M, AU - Bozzi,G, AU - Mangioni,D, AU - Muscatello,A, AU - Castelli,V, AU - Palomba,E, AU - Cantù,A P, AU - Ceriotti,F, AU - Tiso,B, AU - Pesatori,A C, AU - Riboldi,L, AU - Bandera,A, AU - Lunghi,G, AU - Gori,A, Y1 - 2020/06/20/ PY - 2020/05/06/received PY - 2020/06/09/revised PY - 2020/06/13/accepted PY - 2020/6/23/pubmed PY - 2020/9/30/medline PY - 2020/6/23/entrez KW - COVID-19 KW - Healthcare operators KW - Nasopharyngeal swab KW - Nosocomial transmission KW - SARS-CoV-2 SP - 1413.e9 EP - 1413.e13 JF - Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases JO - Clin Microbiol Infect VL - 26 IS - 10 N2 - OBJECTIVES: The management of healthcare workers (HCWs) exposed to confirmed cases of coronavirus disease 2019 (COVID-19) is still a matter of debate. We aimed to assess in this group the attack rate of asymptomatic carriers and the symptoms most frequently associated with infection. METHODS: Occupational and clinical characteristics of HCWs who underwent nasopharyngeal swab testing for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a university hospital from 24 February 2020 to 31 March 2020 were collected. For those who tested positive and for those who tested positive but who were asymptomatic, we checked the laboratory and clinical data as of 22 May to calculate the time necessary for HCWs to then test negative and to verify whether symptoms developed thereafter. Frequencies of positive tests were compared according to selected variables using multivariable logistic regression models. RESULTS: There were 139 positive tests (8.8%) among 1573 HCWs (95% confidence interval, 7.5-10.3), with a marked difference between symptomatic (122/503, 24.2%) and asymptomatic (17/1070, 1.6%) workers (p < 0.001). Physicians were the group with the highest frequency of positive tests (61/582, 10.5%), whereas clerical workers and technicians had the lowest frequency (5/137, 3.6%). The likelihood of testing positive for COVID-19 increased with the number of reported symptoms; the strongest predictors of test positivity were taste and smell alterations (odds ratio = 76.9) and fever (odds ratio = 9.12). The median time from first positive test to a negative test was 27 days (95% confidence interval, 24-30). CONCLUSIONS: HCWs can be infected with SARS-CoV-2 without displaying any symptoms. Among symptomatic HCWs, the key symptoms to guide diagnosis are taste and smell alterations and fever. A median of almost 4 weeks is necessary before nasopharyngeal swab test results are negative. SN - 1469-0691 UR - https://www.unboundmedicine.com/medline/citation/32569835/Characteristics_of_1573_healthcare_workers_who_underwent_nasopharyngeal_swab_testing_for_SARS_CoV_2_in_Milan_Lombardy_Italy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1198-743X(20)30354-2 DB - PRIME DP - Unbound Medicine ER -