BACKGROUND: Healthcare workers (HCW) are at increased risk of SARS-CoV-2 infection from both patients and other HCW with coronavirus disease 2019 (COVID-19). RT-PCR cycle threshold (Ct) values of SARS-CoV-2 ≤ 34 and the first 7-9 days of symptoms are associated with enhanced infectivity. We determined Ct values and duration of symptoms of HCW with a positive SARS-CoV-2 test. As HCW often assume their greatest risk of acquiring SARS-CoV-2 is working on a COVID-19 unit, we also determined Ct values and symptom duration of inpatients with a positive SARS-CoV-2 test. METHODS: From 6/24/2020-8/23/2020, Ct values and duration of symptoms from 13 HCW, 12 outpatients, and 28 inpatients who had a positive nasopharyngeal swab for SARS-CoV-2 were analyzed. RESULTS: Among HCW with a positive SARS-CoV-2 test, 46.2% (6/13) were asymptomatic and requested testing due to an exposure to someone with COVID-19; 83.3% (5/6) of those exposures occurred in the community rather than in the hospital. The median Ct value of HCW was 23.2, and 84.6% (11/13) had a Ct value ≤ 34. The median Ct value of 29.0 among outpatients with COVID-19 did not significantly differ from HCW. In contrast, inpatients with a positive SARS-CoV-2 test had a median Ct value of 34.0 (p = 0.003), which translated into a median ~1,000-fold lower viral load than observed in HCW. Among those with symptoms related to COVID-19, no (0/6) HCW compared to 50% (6/12) of inpatients had symptoms for at least one week (p = 0.04). CONCLUSIONS: At our institution, asymptomatic COVID-19 accounted for nearly half of the cases among HCW. Symptomatic HCW had high viral loads and short duration of symptoms, both of which are associated with peak infectivity. Infection prevention programs should educate HCW on these findings in an effort to increase adherence to the requirement to maintain six feet separation in workspaces and breakrooms, in addition to consistently wearing personal protection equipment.
BACKGROUND: Healthcare workers (HCW) are at increased risk of SARS-CoV-2 infection from both patients and other HCW with coronavirus disease 2019 (COVID-19). RT-PCR cycle threshold (Ct) values of SARS-CoV-2 ≤ 34 and the first 7-9 days of symptoms are associated with enhanced infectivity. We determined Ct values and duration of symptoms of HCW with a positive SARS-CoV-2 test. As HCW often assume their greatest risk of acquiring SARS-CoV-2 is working on a COVID-19 unit, we also determined Ct values and symptom duration of inpatients with a positive SARS-CoV-2 test. METHODS: From 6/24/2020-8/23/2020, Ct values and duration of symptoms from 13 HCW, 12 outpatients, and 28 inpatients who had a positive nasopharyngeal swab for SARS-CoV-2 were analyzed. RESULTS: Among HCW with a positive SARS-CoV-2 test, 46.2% (6/13) were asymptomatic and requested testing due to an exposure to someone with COVID-19; 83.3% (5/6) of those exposures occurred in the community rather than in the hospital. The median Ct value of HCW was 23.2, and 84.6% (11/13) had a Ct value ≤ 34. The median Ct value of 29.0 among outpatients with COVID-19 did not significantly differ from HCW. In contrast, inpatients with a positive SARS-CoV-2 test had a median Ct value of 34.0 (p = 0.003), which translated into a median ~1,000-fold lower viral load than observed in HCW. Among those with symptoms related to COVID-19, no (0/6) HCW compared to 50% (6/12) of inpatients had symptoms for at least one week (p = 0.04). CONCLUSIONS: At our institution, asymptomatic COVID-19 accounted for nearly half of the cases among HCW. Symptomatic HCW had high viral loads and short duration of symptoms, both of which are associated with peak infectivity. Infection prevention programs should educate HCW on these findings in an effort to increase adherence to the requirement to maintain six feet separation in workspaces and breakrooms, in addition to consistently wearing personal protection equipment.
Authors: Jared Bullard; Kerry Dust; Duane Funk; James E Strong; David Alexander; Lauren Garnett; Carl Boodman; Alexander Bello; Adam Hedley; Zachary Schiffman; Kaylie Doan; Nathalie Bastien; Yan Li; Paul G Van Caeseele; Guillaume Poliquin Journal: Clin Infect Dis Date: 2020-12-17 Impact factor: 9.079
Authors: Bernard La Scola; Marion Le Bideau; Julien Andreani; Van Thuan Hoang; Clio Grimaldier; Philippe Colson; Philippe Gautret; Didier Raoult Journal: Eur J Clin Microbiol Infect Dis Date: 2020-04-27 Impact factor: 3.267
Authors: Lucy Rivett; Sushmita Sridhar; Dominic Sparkes; Matthew Routledge; Nick K Jones; Ian G Goodfellow; Stephen Baker; Michael P Weekes; Sally Forrest; Jamie Young; Joana Pereira-Dias; William L Hamilton; Mark Ferris; M Estee Torok; Luke Meredith; Martin D Curran; Stewart Fuller; Afzal Chaudhry; Ashley Shaw; Richard J Samworth; John R Bradley; Gordon Dougan; Kenneth Gc Smith; Paul J Lehner; Nicholas J Matheson; Giles Wright Journal: Elife Date: 2020-05-11 Impact factor: 8.140
Authors: Wesley H Self; Mark W Tenforde; William B Stubblefield; Leora R Feldstein; Jay S Steingrub; Nathan I Shapiro; Adit A Ginde; Matthew E Prekker; Samuel M Brown; Ithan D Peltan; Michelle N Gong; Michael S Aboodi; Akram Khan; Matthew C Exline; D Clark Files; Kevin W Gibbs; Christopher J Lindsell; Todd W Rice; Ian D Jones; Natasha Halasa; H Keipp Talbot; Carlos G Grijalva; Jonathan D Casey; David N Hager; Nida Qadir; Daniel J Henning; Melissa M Coughlin; Jarad Schiffer; Vera Semenova; Han Li; Natalie J Thornburg; Manish M Patel Journal: MMWR Morb Mortal Wkly Rep Date: 2020-09-04 Impact factor: 17.586
Authors: Deanna J Buehrle; Brooke K Decker; Marilyn M Wagener; Amesh Adalja; Nina Singh; Mary C McEllistrem; M Hong Nguyen; Cornelius J Clancy Journal: Antimicrob Agents Chemother Date: 2020-10-20 Impact factor: 5.191