Determinants of SARS-CoV-2 infection in Italian healthcare workers: a multicenter study
Paolo Boffetta, Francesco Saverio Violante, Paolo Durando, Giuseppe De Palma, Enrico Pira, Luigi Vimercati, Alfonso Cristaudo, Giancarlo Icardi, Emma Sala, Maurizio Coggiola, Silvio Tafuri, Vittorio Gattini, Pietro Apostoli, Giovanna Spatari, Working Group on SARS-CoV-2 Infection in Italian Healthcare Workers, Luigi De Maria, Antonio Caputi, Stefania Sponselli, Carmine Mastrippolito, Carlotta Zunarelli, Giulia Di Felice, Giovanni Visci, Elisa Albini, Emanuele Sansone, Cesare Tomasi, Andrea Bisioli, Lorenzo Cipriani, Alessandro Bellis, Mara Maria Tiraboschi, Emilio Paraggio, Sofia Rubino, Michele Capuzzi, Guglielmo Dini, Bianca Bruzzone, Nicoletta Debarbieri, Alfredo Montecucco, Andrea Orsi, Alborz Rahmani, Valentina Ricucci, Giovanni Guglielmi, Leonardo Fiorentino, Cinzia Brilli, Alessandro Godono, Michael Declementi, Ihab Mansour, Nicolò Milanesio, Giacomo Garzaro, Antonio Scarmozzino, A Gullino
Abstract
Healthcare workers (HCWs) are at increased risk of being infected with SARS-CoV-2, yet limited information is available on risk factors of infection. We pooled data on occupational surveillance of 10,654 HCW who were tested for SARS-CoV-2 infection in six Italian centers. Information was available on demographics, job title, department of employment, source of exposure, use of personal protective equipment (PPEs), and COVID-19-related symptoms. We fitted multivariable logistic regression models to calculate odds ratios and 95% confidence intervals of infection. The prevalence of infection ranged from 3.0 to 22.0%, and was correlated with that of the respective areas. Women were at lower risk of infection compared to men. Fever, cough, dyspnea and malaise were the symptoms most strongly associated with infection, together with anosmia and ageusia. No differences in the risk of infection were detected according to job title, or working in a COVID-19 designated department. Reported contact with a patient inside or outside the workplace was a risk factor. Use of a mask was strongly protective against risk of infection as was use of gloves. The use of a mask by the source of exposure (patient or colleague) had an independent effect in reducing infection risk.