학술논문
Incidence and Prevalence of Coronavirus Disease 2019 Within a Healthcare Worker Cohort During the First Year of the Severe Acute Respiratory Syndrome Coronavirus 2 Pandemic
Document Type
article
Author
Doernberg, Sarah B; Holubar, Marisa; Jain, Vivek; Weng, Yingjie; Lu, Di; Bollyky, Jenna B; Sample, Hannah; Huang, Beatrice; Craik, Charles S; Desai, Manisha; Rutherford, George W; Maldonado, Yvonne; Bhargava, Parul; Bohn, Markus; Chao, Jessica; Ghahremani, Jacob; Glidden, David; Gonzales, Ralph; Jaladanki, Sravya; Julien, Aida; Lowenstein, Daniel; Miller, Steve; Mustoe, Audrey; Paoletti, Marcus; Villa, Rodolfo; Wan, Emerald; Williams, Aimee; Brown, Lillian; Chuang, Jessica; Marquez, Carina; Padda, Guntas; Rubio, Luis; Valdivieso, Daisy; Abad, Rosebay; Bet, Anthony; Bollyky, Jenna; Fung, Jeffrey; Graber, Anna; Holderman, Cole; Kelley, Hannah; Kempema, Amanda; Kong, Christina; Leung, Christopher; Lohmann, Joseph; Minor, Lloyd; Orozco, Lorena; Pinsky, Benjamin A; Saxeena, Jamie; Sklar, Matthew; Tang, Hilary; Wiese, Jasmine; Crawford, Emily; DeRisi, Joe
Source
Clinical Infectious Diseases. 75(9)
Subject
Language
Abstract
BackgroundPreventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2_ infections in healthcare workers (HCWs) is critical for healthcare delivery. We aimed to estimate and characterize the prevalence and incidence of coronavirus disease 2019 (COVID-19) in a US HCW cohort and to identify risk factors associated with infection.MethodsWe conducted a longitudinal cohort study of HCWs at 3 Bay Area medical centers using serial surveys and SARS-CoV-2 viral and orthogonal serological testing, including measurement of neutralizing antibodies. We estimated baseline prevalence and cumulative incidence of COVID-19. We performed multivariable Cox proportional hazards models to estimate associations of baseline factors with incident infections and evaluated the impact of time-varying exposures on time to COVID-19 using marginal structural models.ResultsA total of 2435 HCWs contributed 768 person-years of follow-up time. We identified 21 of 2435 individuals with prevalent infection, resulting in a baseline prevalence of 0.86% (95% confidence interval [CI], .53%-1.32%). We identified 70 of 2414 incident infections (2.9%), yielding a cumulative incidence rate of 9.11 cases per 100 person-years (95% CI, 7.11-11.52). Community contact with a known COVID-19 case was most strongly correlated with increased hazard for infection (hazard ratio, 8.1 [95% CI, 3.8-17.5]). High-risk work-related exposures (ie, breach in protective measures) drove an association between work exposure and infection (hazard ratio, 2.5 [95% CI, 1.3-4.8). More cases were identified in HCWs when community case rates were high.ConclusionsWe observed modest COVID-19 incidence despite consistent exposure at work. Community contact was strongly associated with infections, but contact at work was not unless accompanied by high-risk exposure.