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      Prevalencia de infección por SARS-CoV-2 durante la primera oleada de la pandemia entre personal sanitario y no sanitario del Hospital General de Segovia, Castilla y León Translated title: Prevalence of SARS-CoV-2 infection during the first wave of the pandemic among health and non-health personnel of the General Hospital of Segovia, Castilla y León

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          Abstract

          Introducción

          Los trabajadores sanitarios y no sanitarios (TSyNS) de un hospital están más expuestos al contagio por SARS-CoV-2 que la población general. Estudiamos la prevalencia de esta infección en los trabajadores del hospital de Segovia tras la primera ola.

          Material y métodos

          Estudio monocéntrico, observacional, transversal, realizado entre el 29 de abril y el 14 de mayo de 2020. Se diagnosticó la infección mediante test de inmunocromatografía capilar para anticuerpos IgG y/o IgM, o PCR. Se estudiaron variables laborales, de salud, y de exposición.

          Resultados

          Participaron en el estudio 1.335 TSyNS de un total 1.667 (80,1%), un 79,3% mujeres, con una edad media de 47,3 años, y de 47,1 para los hombres. La prevalencia de infectados fue del 21,95%, el 24,7% asintomáticos. La edad presentó una OR significativa de 1,02/año. La exposición extralaboral aumentó la prevalencia un 16,8%. El uso continuado del Equipo de Protección Individual (EPI) y la administración de nebulizaciones presentaron una OR de 0,54 y 0,46 respectivamente. Los síntomas asociados a mayor prevalencia fueron anosmia (OR 9,31), ageusia (OR 3,05), y fiebre (OR 1,94). Hasta la fecha, el 75% de los TSyTNS infectados lo hicieron en la primera ola.

          Conclusiones

          La prevalencia es mayor entre los TSyNS que en la población general. La edad se asocia a una mayor prevalencia de infección. Casi un 25% de los infectados fue asintomático. El uso de EPI de forma continuada se asoció a menor prevalencia. Los síntomas con mayor asociación fueron fiebre, anosmia, y ageusia.

          Translated abstract

          Introduction

          Health and non-health workers (H&NH-W) in a hospital are more exposed to SARS-CoV-2 infection than the general population. We studied the prevalence of this infection in these workers of Segovia´s Hospital after the first epidemic wave.

          Material and methods

          Mono centric, observational, cross-sectional study, carried out between April 29 and May 14, 2020. The infection was diagnosed by capillary immuno-chromatography test for IgG and / or IgM antibodies, or PCR. Work, health, and exposure variables were studied.

          Results

          A total of 1,335 H&NH-W participated in the study out of a total of 1,667 (80.1%), 79.3% women, with a mean age of 47.3 years, and 47.1 for men. The prevalence of infected was 21.95%, 24.7% asymptomatic. Age presented a significant OR of 1.02/year. Exposure outside of work increased the prevalence by 16.8%. The continued use of Personal Protective Equipment (PPE) and the administration of nebulizations presented an OR of 0.54 and 0.46 respectively. The symptoms associated with the highest prevalence were anosmia (OR 9.31), ageusia (OR 3.05), and fever (OR 1.94). Today, about 75% of H&NH-W were infected in the first wave.

          Conclusions

          The prevalence is higher among healthcare workers than the population they serve. Age is associated with a higher prevalence of infection. Almost a quarter of those infected were asymptomatic. The continuous use of PPE was associated with a lower prevalence, for that the administration of nebulisations could be safe. The symptoms with the greatest association were fever, anosmia, and ageusia.

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          Most cited references7

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          Prevalence of Asymptomatic SARS-CoV-2 Infection

          Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly throughout the world since the first cases of coronavirus disease 2019 (COVID-19) were observed in December 2019 in Wuhan, China. It has been suspected that infected persons who remain asymptomatic play a significant role in the ongoing pandemic, but their relative number and effect have been uncertain. The authors sought to review and synthesize the available evidence on asymptomatic SARS-CoV-2 infection. Asymptomatic persons seem to account for approximately 40% to 45% of SARS-CoV-2 infections, and they can transmit the virus to others for an extended period, perhaps longer than 14 days. Asymptomatic infection may be associated with subclinical lung abnormalities, as detected by computed tomography. Because of the high risk for silent spread by asymptomatic persons, it is imperative that testing programs include those without symptoms. To supplement conventional diagnostic testing, which is constrained by capacity, cost, and its one-off nature, innovative tactics for public health surveillance, such as crowdsourcing digital wearable data and monitoring sewage sludge, might be helpful.
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            Prevalence of SARS-CoV-2 in Spain (ENE-COVID): a nationwide, population-based seroepidemiological study

            Summary Background Spain is one of the European countries most affected by the COVID-19 pandemic. Serological surveys are a valuable tool to assess the extent of the epidemic, given the existence of asymptomatic cases and little access to diagnostic tests. This nationwide population-based study aims to estimate the seroprevalence of SARS-CoV-2 infection in Spain at national and regional level. Methods 35 883 households were selected from municipal rolls using two-stage random sampling stratified by province and municipality size, with all residents invited to participate. From April 27 to May 11, 2020, 61 075 participants (75·1% of all contacted individuals within selected households) answered a questionnaire on history of symptoms compatible with COVID-19 and risk factors, received a point-of-care antibody test, and, if agreed, donated a blood sample for additional testing with a chemiluminescent microparticle immunoassay. Prevalences of IgG antibodies were adjusted using sampling weights and post-stratification to allow for differences in non-response rates based on age group, sex, and census-tract income. Using results for both tests, we calculated a seroprevalence range maximising either specificity (positive for both tests) or sensitivity (positive for either test). Findings Seroprevalence was 5·0% (95% CI 4·7–5·4) by the point-of-care test and 4·6% (4·3–5·0) by immunoassay, with a specificity–sensitivity range of 3·7% (3·3–4·0; both tests positive) to 6·2% (5·8–6·6; either test positive), with no differences by sex and lower seroprevalence in children younger than 10 years ( 10%) and lower in coastal areas (<3%). Seroprevalence among 195 participants with positive PCR more than 14 days before the study visit ranged from 87·6% (81·1–92·1; both tests positive) to 91·8% (86·3–95·3; either test positive). In 7273 individuals with anosmia or at least three symptoms, seroprevalence ranged from 15·3% (13·8–16·8) to 19·3% (17·7–21·0). Around a third of seropositive participants were asymptomatic, ranging from 21·9% (19·1–24·9) to 35·8% (33·1–38·5). Only 19·5% (16·3–23·2) of symptomatic participants who were seropositive by both the point-of-care test and immunoassay reported a previous PCR test. Interpretation The majority of the Spanish population is seronegative to SARS-CoV-2 infection, even in hotspot areas. Most PCR-confirmed cases have detectable antibodies, but a substantial proportion of people with symptoms compatible with COVID-19 did not have a PCR test and at least a third of infections determined by serology were asymptomatic. These results emphasise the need for maintaining public health measures to avoid a new epidemic wave. Funding Spanish Ministry of Health, Institute of Health Carlos III, and Spanish National Health System.
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              Seroprevalence of antibodies against SARS-CoV-2 among health care workers in a large Spanish reference hospital

              Health care workers (HCW) are a high-risk population to acquire SARS-CoV-2 infection from patients or other fellow HCW. This study aims at estimating the seroprevalence against SARS-CoV-2 in a random sample of HCW from a large hospital in Spain. Of the 578 participants recruited from 28 March to 9 April 2020, 54 (9.3%, 95% CI: 7.1–12.0) were seropositive for IgM and/or IgG and/or IgA against SARS-CoV-2. The cumulative prevalence of SARS-CoV-2 infection (presence of antibodies or past or current positive rRT-PCR) was 11.2% (65/578, 95% CI: 8.8–14.1). Among those with evidence of past or current infection, 40.0% (26/65) had not been previously diagnosed with COVID-19. Here we report a relatively low seroprevalence of antibodies among HCW at the peak of the COVID-19 epidemic in Spain. A large proportion of HCW with past or present infection had not been previously diagnosed with COVID-19, which calls for active periodic rRT-PCR testing in hospital settings.
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                Author and article information

                Journal
                Rev Esp Quimioter
                Rev Esp Quimioter
                Sociedad Española de Quimioterapia
                Revista Española de Quimioterapia
                Sociedad Española de Quimioterapia
                0214-3429
                1988-9518
                17 January 2022
                2022
                : 35
                : 2
                : 157-164
                Affiliations
                [1 ]Servicio de Urgencias. Hospital General de Segovia. España.
                [2 ]Centro de Salud, Segovia Rural. Segovia. España
                Author notes
                Correspondencia: Julio César Santos Pastor Hospital General de Segovia. C/ Luis Erik Clavería Neurólogo S/N. 40002. Segovia. España. E-mail: jsantosp@ 123456saludcastillayleon.es
                Article
                revespquimioter-35-157
                10.37201/req/094.2021
                8972690
                35037752
                e5950aaa-1c02-42e6-8e5d-f2f88f1fd41b
                © The Author 2021

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)( https://creativecommons.org/licenses/by-nc/4.0/).

                History
                : 25 June 2021
                : 08 September 2021
                : 25 October 2021
                : 15 November 2021
                Categories
                Original

                infección por coronavirus,prevalencia,estudio transversal,personal hospitalario,factores de riesgo,coronavirus infections,prevalence,cross-sectional studies,hospital personnel,risk factors

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