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      A prospective cohort of SARS-COV2 infected health care workers: Clinical characteristics, outcomes and follow up strategy

      research-article
      , MD PhD 1 , 2 , 9 , , MD 3 , , MD 3 , , MD 2 , , MD 2 , , MD 2 , , MD 4 , , MD 1 , 2 , , MD 1 , 2 , , RN 2 , , RN 2 , , RN 2 , , MsC RN 2 , , MsC RN 2 , , RN 2 , , MD PhD 2 , 5 , , MD 2 , 5 , 6 , , MD 6 , , MD 6 , , PhD MsC RN FERS 2 , 9 , 10 , , MD PhD 7 , , MD 1 , 2 , 9 , , MD PhD MPH 1 , 2 , 8
      Open Forum Infectious Diseases
      Oxford University Press
      COVID-19, SARS-CoV-2, hospital at home, health care workers, coronavirus

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          Abstract

          Background

          During the COVID-19 outbreak health care workers (HCWs) were at a high risk of infection. Strategies to reduce in-hospital transmission between HCWs and to safely manage infected HCWs are lacking. Our aim was to describe an active strategy for the management of COVID-19 in SARS-CoV-2 infected HCWs and investigate its outcomes.

          Methods

          A prospective cohort study of SARS-CoV-2 infected health care workers in a tertiary teaching hospital in Barcelona, Spain, was performed. An active strategy of weekly PCR screening for SARS-CoV-2 on HCWs was established by the Occupational Health department. Every positive HCW was admitted to the Hospital at Home Unit with daily assessment online and in-person discretionary visits. Clinical and epidemiological data were recorded.

          Results

          Of the 590 HCWs included in the cohort, 134 (22%) were asymptomatic at diagnosis, and 15% (89 patients) remained asymptomatic during follow up. A third of positive cases were detected during routine screening. The most frequent symptoms were cough (68%), hyposmia/anosmia (49%) and fever (41%). 10% of the patients required specific treatment at home, while only 4% of the patients developed pneumonia. Seventeen patients required a visit to the Outpatient clinic for further evaluation, and six of these (1%) required hospital admission. None of the HCWs included in this cohort required ICU admission or died.

          Conclusions

          Active screening for SARS-CoV-2 among HCWs for early diagnosis and stopping in-hospital transmission chains proved efficacious in our institution, particularly due to the high percentage of asymptomatic HCWs. Follow up of HCWs in Hospital at Home units is safe and effective, with low rates of severe infection and readmission.

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          Author and article information

          Journal
          Open Forum Infect Dis
          Open Forum Infect Dis
          ofid
          Open Forum Infectious Diseases
          Oxford University Press (US )
          2328-8957
          08 December 2020
          : ofaa592
          Affiliations
          [1 ] Internal Medicine Service, Hospital Clinic Barcelona , Barcelona, Spain
          [2 ] Hospital at Home Unit, Medical and Nurse Direction, Hospital Clinic Barcelona , Barcelona, Spain
          [3 ] Ophthalmology Service, Hospital Clínic Barcelona , Barcelona, Spain
          [4 ] Psychiatry Service, Hospital Clínic Barcelona , Barcelona, Spain
          [5 ] Infectious Disease Service, Hospital Clínic Barcelona , Barcelona, Spain
          [6 ] Human Resources Department, Workplace Health and Safety Service, Hospital Clinic Barcelona , Barcelona, Spain
          [7 ] Renal Transplant Unit, Nephrology Service, Hospital Clinic Barcelona , Barcelona, Spain
          [8 ] Vall d’Hebron Institute for Research (VHIR) , Barcelona, Spain
          [9 ] University of Barcelona , Barcelona, Spain
          [10 ] Institut d’Investigació August Pi i Sunyer (IDIBAPS) , Barcelona, Spain
          Author notes
          Corresponding author: David Nicolás. Hospital Clinic Barcelona. Villarroel street 170 sn, 08036 Barcelona. Phone #+34-932275400 (ext 9368). E-mail address: dnicolas@ 123456clinic.cat .
          Alternate corresponding author: Juan M Pericás. Vall d’Hebron Institute for Research (VHIR). Barcelona, Spain. Phone #+34-666630248. E-mail address: pericasjm@ 123456gmail.com .
          Author information
          http://orcid.org/0000-0002-1968-5287
          Article
          ofaa592
          10.1093/ofid/ofaa592
          7798565
          33537362
          e63d5f9d-d3af-4402-9631-9d12fa310074
          © The Author(s) 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America.

          This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence ( http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

          History
          : 02 September 2020
          Categories
          Major Article
          AcademicSubjects/MED00290
          Custom metadata
          PAP
          accepted-manuscript

          covid-19,sars-cov-2,hospital at home,health care workers,coronavirus

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