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Original research
Household transmission and incidence of positive SARS-CoV-2 RT-PCR in symptomatic healthcare workers, clinical course and outcome: a French hospital experience
  1. Evguenia Krastinova1,2,3,4,
  2. Valérie Garrait1,2,
  3. Marie-Thérèse Lecam5,
  4. André Coste6,7,
  5. Emmanuelle Varon8,
  6. Isabelle Delacroix1,
  7. Amine Si Ali9,
  8. Camille Jung10,
  9. Mounira Smati8,
  10. Muriel Cherbit11,
  11. Bernard Maître7,12,
  12. Jean-Claude Pairon5,7,
  13. Pascal Andujar5,7
  1. 1 Internal Medicine Department, Centre Hospitalier Intercommunal de Créteil, Creteil, France
  2. 2 COREVIH SUD, Paris, France
  3. 3 Access-to-care unit, CHI de Créteil, Créteil, France
  4. 4 Groupe de recherche et d’étude des Maladies Infectieuses-Paris Sud Est (Gremlin Paris Sud-Est), ERES, Sorbonne University, IPLESP, Inserm UMR 1136, Paris, France
  5. 5 Department of Occupational and Environmental Medicine, Centre Hospitalier Intercommunal de Créteil, Creteil, France
  6. 6 Ear, Nose and Throat Department, Centre Hospitalier Intercommunal de Créteil, Creteil, France
  7. 7 Health School, Université Paris-Est Créteil Val de Marne, Creteil, France
  8. 8 Laboratory of Medical Biology, Centre Hospitalier Intercommunal de Créteil, Creteil, France
  9. 9 Disease Control and Prevention Unit, Centre Hospitalier Intercommunal de Créteil, Creteil, France
  10. 10 Clinical Research Center, Centre Hospitalier Intercommunal de Créteil, Creteil, France
  11. 11 Occupational Medicine Unit, Centre Hospitalier Intercommunal de Créteil, Creteil, France
  12. 12 Pulmonary Department, Centre Hospitalier Intercommunal de Créteil, Creteil, France
  1. Correspondence to Dr Evguenia Krastinova, Internal Medicine Department, Centre Hospitalier Intercommunal de Créteil, Creteil 94000, France; evguenia.krastinova{at}chicreteil.fr

Abstract

Objectives Although healthcare workers (HCWs) have been particularly affected by SARS-CoV-2, detailed data remain scarce. In this study, we investigated infection rates, clinical characteristics, occupational exposure and household transmission among all symptomatic HCWs screened by SARS-CoV-2 RT-PCR between 17 March (French lockdown) and 20 April.

Methods SARS-CoV-2 RT-PCR was proposed to symptomatic (new cough or dyspnoea) HCWs at Creteil Hospital in one of the Parisian suburbs most severely affected by COVID-19. Data on occupational profile, living situation and household, together with self–isolation and mask use at home were collected, as well as the number of cases in the household.

Results The incidence rate of symptomatic SARS-CoV-2 was estimated to be 5% (110/2188). A total of 110 (35%) of the 314 HCWs tested positive and 9 (8%) were hospitalised. On multivariate analysis, factors independently associated with positive RT-PCR were occupational profile with direct patient facing (OR 3.1, 95% CI 1.1 to 8.8), p<0.03), and presence of anosmia (OR 5.7, 95% CI 3.1 to 10.6), p<0.0001). Being a current smoker was associated with negative RT-PCR (OR 0.3, 95% CI 0.1 to 0.7), p=0.005). Transmission from HCWs to household members was reported in 9 (14%) cases, and 2 deaths occurred. Overall, self-isolation was possible in 52% of cases, but only 31% of HCWs were able to wear a mask at home.

Conclusion This is the first study to report infection rates among HCWs during the peak of the SARS-CoV-2 epidemic in France and the lockdown period, highlighting the risk related to occupational profile and household transmission.

  • hygiene / occupational hygiene
  • virology
  • health care workers
  • viruses

Data availability statement

Data are available upon reasonable request (pascal.andujar@chicreteil.fr or evguenia.krastinova@chicreteil.fr).

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/oemed-2020-106866

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    Data availability statement

    Data are available upon reasonable request (pascal.andujar@chicreteil.fr or evguenia.krastinova@chicreteil.fr).

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    Footnotes

    • Correction notice This article has been corrected since it was published Online First. An additional affiliation has been added for EK.

    • Contributors EK, CJ, J-CP and PA conceived and designed the analysis. EK, VG, M-TL, AC, EV, ID, AS, MS, MC, BM, J-CP and PA collected the data. EK, J-CP and PA contributed data or analysis tools. EK and PA performed the analysis. EK, J-CP and PA wrote the paper.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.