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Risk and protective factors for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection among healthcare workers: A test-negative case–control study in Québec, Canada

Published online by Cambridge University Press:  09 September 2022

Sara Carazo Open the ORCID record for Sara Carazo [Opens in a new window] ,
Jasmin Villeneuve ,
Denis Laliberté ,
Yves Longtin Open the ORCID record for Yves Longtin [Opens in a new window] ,
Denis Talbot ,
Richard Martin ,
Geoffroy Denis ,
Francine Ducharme ,
Bianka Paquet-Bolduc  and
Geneviève Anctil
...Show all authors
Sara Carazo*
Affiliation:
Institut national de santé Publique du Québec, Québec, Québec, Canada
Jasmin Villeneuve
Affiliation:
Institut national de santé Publique du Québec, Québec, Québec, Canada
Denis Laliberté
Affiliation:
Direction de la santé publique de la Capitale-Nationale, CIUSSS de la Capitale-Nationale, Québec, Québec, Canada Faculty of Medicine, Laval University, Québec, Québec, Canada
Yves Longtin
Affiliation:
Infection Prevention and Control Unit, Jewish General Hospital, Montreal, Québec, Canada McGill University Faculty of Medicine, Montreal, Québec, Canada
Denis Talbot
Affiliation:
Faculty of Medicine, Laval University, Québec, Québec, Canada Centre de recherche du CHU de Québec—Université Laval, Québec, Québec, Canada
Richard Martin
Affiliation:
Institut national de santé Publique du Québec, Québec, Québec, Canada
Geoffroy Denis
Affiliation:
McGill University Faculty of Medicine, Montreal, Québec, Canada CIUSSS Centre Sud de Montréal, Montreal, Québec, Canada
Francine Ducharme
Affiliation:
Faculté des sciences infirmières, Université de Montréal, Montreal, Québec, Canada Centre de recherche de l’Institut de gériatrie de Montréal, Montreal, Québec, Canada
Bianka Paquet-Bolduc
Affiliation:
Infection Prevention and Control Unit, Institut Universitaire en cardiologie et pneumologie de Québec, Québec, Québec, Canada
Geneviève Anctil
Affiliation:
Institut national de santé Publique du Québec, Québec, Québec, Canada
Sandrine Hegg-Deloye
Affiliation:
Centre de recherche du CHU de Québec—Université Laval, Québec, Québec, Canada
Gaston De Serres
Affiliation:
Institut national de santé Publique du Québec, Québec, Québec, Canada Faculty of Medicine, Laval University, Québec, Québec, Canada Centre de recherche du CHU de Québec—Université Laval, Québec, Québec, Canada
*
Author for correspondence: Sara Carazo, E-mail: sara.carazo@inspq.qc.ca
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Abstract

Objectives:

In Québec, Canada, we evaluated the risk of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection associated with (1) the demographic and employment characteristics among healthcare workers (HCWs) and (2) the workplace and household exposures and the infection prevention and control (IPC) measures among patient-facing HCWs.

Design:

Test-negative case-control study.

Setting:

Provincial health system.

Participants:

HCWs with PCR-confirmed coronavirus disease 2019 (COVID-19) diagnosed between November 15, 2020, and May 29, 2021 (ie, cases), were compared to HCWs with compatible symptoms who tested negative during the same period (ie, controls).

Methods:

Adjusted odds ratios (aORs) of infection were estimated using regression logistic models evaluating demographic and employment characteristics (all 4,919 cases and 4,803 controls) or household and workplace exposures and IPC measures (2,046 patient-facing cases and 1,362 controls).

Results:

COVID-19 risk was associated with working as housekeeping staff (aOR, 3.6), as a patient-support assistant (aOR, 1.9), and as nursing staff (aOR, 1.4), compared to administrative staff. Other risk factors included being unexperienced (aOR, 1.5) and working in private seniors’ homes (aOR, 2.1) or long-term care facilities (aOR, 1.5), compared to acute-care hospitals. Among patient-facing HCWs, exposure to a household contact was reported by 9% of cases and was associated with the highest risk of infection (aOR, 7.8). Most infections were likely attributable to more frequent exposure to infected patients (aOR, 2.7) and coworkers (aOR, 2.2). Wearing an N95 respirator during contacts with COVID-19 patients (aOR, 0.7) and vaccination (aOR, 0.2) were the measures associated with risk reduction.

Conclusion:

In the context of the everchanging SARS-CoV-2 virus with increasing transmissibility, measures to ensure HCW protection, including vaccination and respiratory protection, and patient safety will require ongoing evaluation.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 44 , Issue 7 , July 2023 , pp. 1121 - 1130
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Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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Footnotes

PREVIOUS PRESENTATION. Some of these data were presented in an official report of the “Institut Nationale de Santé Publique de Québec” [in French]. Available at their website: https://www.inspq.qc.ca/sites/default/files/publications/3192-enquete-epidemiologique-travailleurs-sante-covid-19.pdf.

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