Factors associated with an increased risk of SARS-CoV-2 infection in healthcare workers in aerosol-generating disciplines

Christoph Römmele; Maria Kahn; Stephan Zellmer; Anna Muzalyova; Gertrud Hammel; Christina Bartenschlager; Albert Beyer; Jonas Rosendahl; Tilo Schlittenbauer; Johannes Zenk; Bilal Al-Nawas; Roland Frankenberger; Juergen Hoffmann; Christoph Arens; Frank Lammert; Claudia Traidl-Hoffmann; Helmut Messmann; Alanna Ebigbo

doi:10.1055/a-1845-2979

Zeitschrift für Gastroenterologie, Inhaltsverzeichnis

Z Gastroenterol 2023; 61(08): 1009-1017
DOI: 10.1055/a-1845-2979

Originalarbeit

Factors associated with an increased risk of SARS-CoV-2 infection in healthcare workers in aerosol-generating disciplines

Risikofaktoren für SARS-CoV-2-Infektionen bei medizinischem Personal in aerosol-generierenden Disziplinen

Christoph Römmele

¹III. Medizinische Klinik – Gastroenterologie und Infektiologie, Universitätsklinikum Augsburg, Augsburg, Germany (Ringgold ID: RIN39694)

,

Maria Kahn

²Hospital for Internal Medicine III – Gastroenterology and Infectious Diseases, University Hospital Augsburg, Augsburg, Germany (Ringgold ID: RIN39694)

,

Stephan Zellmer

²Hospital for Internal Medicine III – Gastroenterology and Infectious Diseases, University Hospital Augsburg, Augsburg, Germany (Ringgold ID: RIN39694)

,

Anna Muzalyova

²Hospital for Internal Medicine III – Gastroenterology and Infectious Diseases, University Hospital Augsburg, Augsburg, Germany (Ringgold ID: RIN39694)

,

Gertrud Hammel

³Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany (Ringgold ID: RIN9150)

,

Christina Bartenschlager

⁴Chair of Health Care Operations/Health Information Management, University of Augsburg, Augsburg, Germany (Ringgold ID: RIN26522)

,

Albert Beyer

⁵Medical Practice for Gastroenterology and Gastrointestinal Oncology, Altötting, Germany

,

Jonas Rosendahl

⁶Clinic for Internal Medicine I, University Hospital Halle, Halle, Germany (Ringgold ID: RIN14942)

,

Tilo Schlittenbauer

⁷Department of Oral and Maxillofacial Surgery, University Hospital Augsburg, Augsburg, Germany (Ringgold ID: RIN39694)

,

Johannes Zenk

⁸Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Augsburg, Augsburg, Germany (Ringgold ID: RIN39694)

,

Bilal Al-Nawas

⁹University Hospital Center Mainz Department of Otorhinolaryngology Head and Neck Surgery, Mainz, Germany (Ringgold ID: RIN155978)

,

Roland Frankenberger

¹⁰Department for Operative Dentistry, Endodontics, and Pediatric Dentistry, Philipps-Universitat Marburg, Marburg, Germany (Ringgold ID: RIN9377)

,

Juergen Hoffmann

¹¹Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Heidelberg, Germany (Ringgold ID: RIN27178)

,

Christoph Arens

¹²Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Magdeburg, Magdeburg, Germany (Ringgold ID: RIN39067)

,

Frank Lammert

¹³Department of Medicine II, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg, Germany (Ringgold ID: RIN39072)

¹⁴Hannover Medical School, Hannover, Germany (Ringgold ID: RIN9177)

,

Claudia Traidl-Hoffmann

¹⁵Department of Environmental Medicine, University of Augsburg Faculty of Medicine, Augsburg, Germany (Ringgold ID: RIN531257)

,

Helmut Messmann

¹⁶Department of Gastroenterology, Universitätsklinikum Augsburg, Augsburg, Germany (Ringgold ID: RIN39694)

,

Alanna Ebigbo

¹⁷III Medizinische Klinik, Universitätsklinikum Augsburg, Augsburg, Germany (Ringgold ID: RIN39694)

› Institutsangaben

Abstract

Background Healthcare workers (HCWs) are at a high risk of SARS-CoV-2 infection due to exposure to potentially infectious material, especially during aerosol-generating procedures (AGP). We aimed to investigate risk factors for SARS-CoV-2 infection among HCWs in medical disciplines with AGP.

Methods A nationwide questionnaire-based study in private practices and hospital settings was conducted between 12/16/2020 and 01/24/2021. Data on SARS-CoV-2 infections among HCWs and potential risk factors of infection were investigated.

Results 2070 healthcare facilities with 25113 employees were included in the study. The overall infection rate among HCWs was 4.7%. Multivariate analysis showed that regions with higher incidence rates had a significantly increased risk of infection. Furthermore, hospital setting and HCWs in gastrointestinal endoscopy (GIE) had more than double the risk of infection (OR 2.63; 95% CI 2.50–2.82, p<0.01 and OR 2.35; 95% CI 2.25–2.50, p<0.01). For medical facilities who treated confirmed SARS-CoV-2 cases, there was a tendency towards higher risk of infection (OR 1.39; 95% CI 1.11–1.63, p=0.068).

Conclusion Both factors within and outside medical facilities appear to be associated with an increased risk of infection among HCWs. Therefore, GIE and healthcare delivery setting were related to increased infection rates. Regions with higher SARS-CoV-2 incidence rates were also significantly associated with increased risk of infection.

Zusammenfassung

Hintergrund Medizinisches Personal ist durch die Exposition gegenüber potenziell infektiösem Material einem erhöhten Infektionsrisiko ausgesetzt. Dies gilt insbesondere für Fachdisziplinen mit aerosolgenerierenden Prozeduren (AGP). Hierfür gibt es jedoch kaum Daten, insbesondere für den ambulanten Versorgungssektor. Ziel dieser Studie war es, die Häufigkeit sowie potenzielle Risikofaktoren für SARS-CoV-2-Infektionen bei medizinischem Personal von aerosolgenerierenden Disziplinen zu erheben und zu identifizieren.

Methoden Zwischen dem 16.12.2020 und 24.01.2021 wurde eine bundesweite Umfrage in den Disziplinen der gastrointestinalen Endoskopie (GIE); Hals-, Nasen-, Ohrenheilkunde (HNO); Mund-, Kiefer-, Gesichtschirurgie (MKG) und der Zahn-, Mund-, Kieferheilkunde (ZMK) durchgeführt. Hierbei wurden Daten zu SARS-CoV-2-Infektionen beim medizinischen Personal sowie potenzielle Risikofaktoren erfasst.

Ergebnisse 25113 Beschäftigte in 2070 Einrichtungen wurden in die Studie eingeschlossen. Die Gesamtinfektionsrate unter dem medizinischen Personal betrug 4,7 %. Die multivariate Analyse zeigte, dass Regionen mit höheren Inzidenzraten ein deutlich erhöhtes Infektionsrisiko aufwiesen. Außerdem war das Infektionsrisiko in Krankenhäusern und bei Beschäftigten der GIE um mehr als das Zweifache erhöht (OR 2,63; p<0,01 und OR 2,35; p<0,01). Ein tendenziell erhöhtes Infektionsrisiko bestand in Einrichtungen, die bestätigte SARS-CoV-2-Fälle behandelt haben (OR 1,39; p=0,068).

Fazit Das SARS-CoV-2-Infektionsrisiko für medizinisches Personal wird sowohl von Faktoren innerhalb als auch Faktoren außerhalb von medizinischen Einrichtungen bestimmt. Die Fachrichtung der GIE sowie die Tätigkeit in einem Krankenhaus beeinflussen signifikant die Infektionsraten. Eine höhere SARS-CoV-2-Inzidenzrate in der Region geht ebenfalls mit einem signifikant erhöhten Infektionsrisiko einher.

Schlüsselwörter

Aerosol-generating procedures - SARS-CoV-2 - Prevalence - endoscopy - risk factors - COVID-19

Keywords

aerosol-generating procedures - SARS-CoV-2 infection prevalence - pre-interventional testing - gastro-enterological endoscopy - COVID-19 incidence

Volltext

Referenzen

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