Factors Associated with SARS-CoV-2 Infection in Physician Trainees in New York City During the First COVID-19 Wave

Abstract

Background: Occupational and non-occupational risk factors for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been reported in healthcare workers (HCWs), but studies evaluating risk factors for infection among physician trainees are lacking. We aimed to identify sociodemographic, occupational, and community risk factors among physician trainees during the first wave of coronavirus disease 2019 (COVID-19) in New York City. Methods: In this retrospective study of 328 trainees at the Mount Sinai Health System (MSHS) in New York City, we administered a survey to assess risk factors for SARS-CoV-2 infection between February 1 and June 30, 2020. SARS-CoV-2 infection was determined by self-reported and laboratory-confirmed IgG antibody and reverse transcriptase-polymerase chain reaction test results. We used Bayesian generalized linear mixed effect regression to examine associations between hypothesized risk factors and infection odds. Results: The cumulative incidence of infection was 20.1%. Assignment to medical-surgical units (OR, 2.51; 95% CI, 1.18–5.34), and training in emergency medicine, critical care, and anesthesiology (OR, 2.93; 95% CI, 1.24–6.92) were independently associated with infection ('Table'). Caring for unfamiliar patient populations was protective (OR, 0.16; 95% CI, 0.03–0.73); deployment of trainees to non-routine hospital sites during COVID-19 patient surges was not significantly associated with infection. Community factors were not significantly associated with infection after adjustment for occupational factors. Conclusions: Our findings may inform tailored infection prevention strategies for physician trainees responding to the COVID-19 pandemic. Deployment of trainees in MSHS was a safe strategy to respond to surging patient volumes during the initial phases of the COVID-19 pandemic and may be safe during current international surges.

Keywords

• covid-19
• sars-cov-2
• resident
• fellow
• occupational health