Risk factors of SARS-CoV-2 infection in healthcare workers: a retrospective study of a nosocomial outbreak

Xuan Wang; Xiaobing Jiang; Qimin Huang; Han Wang; David Gurarie; Martial Ndeffo-Mbah; Fei Fan; Peng Fu; Mary Ann Horn; Anirban Mondal; Charles King; Shuai Xu; Hongyang Zhao; Yansen Bai

Sleep Medicine: X (Dec 2020)

Risk factors of SARS-CoV-2 infection in healthcare workers: a retrospective study of a nosocomial outbreak

Xuan Wang,
Xiaobing Jiang,
Qimin Huang,
Han Wang,
David Gurarie,
Martial Ndeffo-Mbah,
Fei Fan,
Peng Fu,
Mary Ann Horn,
Anirban Mondal,
Charles King,
Shuai Xu,
Hongyang Zhao,
Yansen Bai

Affiliations

Xuan Wang: Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
Xiaobing Jiang: Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
Qimin Huang: Department of Mathematics, Applied Mathematics and Statistics, Case Western Reserve University, Cleveland, OH, 44106, USA
Han Wang: Department of Biochemistry, Case Western Reserve University, Cleveland, OH, 44106, USA
David Gurarie: Department of Mathematics, Applied Mathematics and Statistics, Case Western Reserve University, Cleveland, OH, 44106, USA; Center for Global Health and Diseases, School of Medicine, Case Western Reserve University, Cleveland, OH, 44106, USA
Martial Ndeffo-Mbah: Department of Veterinary and Integrative Biosciences, College of Veterinary and Biomedical Sciences, Texas A&M University, College Station, TX, 77840, USA; School of Public Health, Texas A&M University, College Station, TX, 77840, USA
Fei Fan: Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
Peng Fu: Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
Mary Ann Horn: Department of Mathematics, Applied Mathematics and Statistics, Case Western Reserve University, Cleveland, OH, 44106, USA
Anirban Mondal: Department of Mathematics, Applied Mathematics and Statistics, Case Western Reserve University, Cleveland, OH, 44106, USA
Charles King: Center for Global Health and Diseases, School of Medicine, Case Western Reserve University, Cleveland, OH, 44106, USA
Shuai Xu: Computer and Data Science Department, Case Western Reserve University, Cleveland, OH, 44106, USA
Hongyang Zhao: Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China; Corresponding author. Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Yansen Bai: Department of Occupational and Environmental Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China; Corresponding author. Department of Occupational and Environmental Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, China.

Journal volume & issue: Vol. 2
p. 100028

Abstract

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Background: Healthcare workers (HCWs) are at the forefront of fighting against the COVID-19 pandemic. However, they are at high risk of acquiring the pathogen from infected patients and transmitting to other HCWs. We aimed to investigate risk factors for nosocomial COVID-19 infection among HCWs in a non-COVID-19 hospital yard. Methods: Retrospective data collection on demographics, lifestyles, contact status with infected subjects for 118 HCWs (including 12 COVID-19 HCWs) at Union Hospital of Wuhan, China. Sleep quality and working pressure were evaluated by the Pittsburgh Sleep Quality Index (PSQI) and The Nurse Stress Index (NSI), respectively. The follow-up duration was from Dec 25, 2019, to Feb 15, 2020. Results: A high proportion of COVID-19 HCWs had engaged in night shift-work (75.0% vs. 40.6%) and felt working under pressure (66.7% vs. 32.1%) than uninfected HCWs. SARS-CoV-2 infected HCWs had significantly higher scores of PSQI and NSI than uninfected HCWs (P < 0.001). Specifically, scores of 5 factors (sleep quality, sleep time, sleep efficiency, sleep disorder, and daytime dysfunction) in PSQI were higher among infected HCWs. For NSI, its 5 subscales (nursing profession and work, workload and time allocation, working environment and resources, patient care, management and interpersonal relations) were all higher in infected than uninfected nurse. Furthermore, total scores of PSQI (HR = 2.97, 95%CI = 1.86−4.76; P <0.001) and NSI (HR = 4.67, 95%CI = 1.42−15.45; P = 0.011) were both positively associated with the risk of SARS-CoV-2 infection. Conclusion: Our analysis shows that poor sleep quality and higher working pressure may increase the risk of nosocomial SARS-CoV-2 infection among HCWs.

Published in Sleep Medicine: X

ISSN: 2590-1427 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine
Website: https://www.journals.elsevier.com/sleep-medicine-x

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