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

Nicolás, David; Camós-Carreras, Anna; Spencer, Felipe; Arenas, Andrea; Butori, Eugenia; Maymó, Pol; Anmella, Gerard; Torrallardona-Murphy, Orla; Alves, Eduarda; García, Laura; Pereta, Irene; Castells, Eva; Seijas, Nuria; Ibáñez, Begoña; Grané, Carme; Bodro, Marta; Cardozo, Celia; Barroso, Sonia; Olive, Victoria; Tortajada, Marta; Hernández, Carme; Cucchiari, David; Coloma, Emmanuel; Pericà s, Juan M

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.