Generic placeholder image

Infectious Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5265
ISSN (Online): 2212-3989

Research Article

SARS-CoV-2 Transmission Among Healthcare Workers in Iran: An Urgent Need for Early Identification and Management

Author(s): Mohammad Reza Abdolsalehi, Shima Mahmoudi, Reza Shervin Badv, Babak Pourakbari, Kayvan Mirnia, Yasmine Mahmoudieh and Setareh Mamishi*

Volume 22, Issue 1, 2022

Published on: 10 August, 2021

Article ID: e100821195494 Pages: 4

DOI: 10.2174/1871526521666210810124359

Price: $65

Abstract

Introduction: With the increasing rate of COVID-19, particularly in developing countries such as Iran, a high number of frontline service providers, including doctors and nurses, have died, making frontline healthcare workers (HCWs) more vulnerable to psychological disorders and fear and anxiety of secondary transmission to others, especially their family members. In this study, we aimed to report the incidence of COVID-19 infection among HCWs in an Iranian referral pediatrics hospital between April 2020 and July 2020.

Materials and Methods: In this retrospective cross-sectional study, HCWs and hospital staff working at Children's Medical Center, Tehran, Iran, with positive SARS-CoV-2 real-time polymerase chain reaction (RT-PCR) test results were evaluated between April 2020 and July 2020.

Results: Sixty-one out of the 1085 personnel (5.6%) including 14 pediatricians (23%), 24 nurses (39%), 9 paramedics (15%), and 14 HCWs without direct patient contact (23%) had a nasopharyngeal specimen positive SARS-CoV-2 RT-PCR test. The mean age was 39.8±10.6 years. Eleven cases (18%) had underlying diseases such as hypertension and asthma. The most common symptoms were fatigue (67%, n=41), dry cough (61%, n=37), fever (52%, n=32), headache (46%, n=28), dyspnea (43%, n=24), anosmia (28%, n=17), chills (26%, n=16), sore throat (26%, n=16), gastrointestinal symptoms (23%, n=14), and productive cough (3%, n=2). Eleven cases (18%) showed lung involvement in their chest X-rays and/or CT scans. Eighteen cases (29.5%) had lymphopenia, and 20 individuals (33%) had a high level of C-reactive protein.

Conclusion: In conclusion, in the early phase of the COVID-19 outbreak, a substantial proportion of HCWs with fever, respiratory, and other prevalent symptoms including fatigue and headache were infected with SARS-CoV-2. Therefore, implementation of infection prevention measures, isolation of confirmed HCWs, disinfection of the environment, and regular COVID-19 prevention training for HCWs are strongly recommended for the wellbeing of health workers and minimizing the spread of infection.

Keywords: Healthcare workers, SARS-CoV-2, COVID-19, transmission, management, early identification.

Graphical Abstract
[1]
Mamishi S, Heydari H, Aziz-Ahari A, et al. Novel coronavirus disease 2019 (COVID-19) outbreak in children in Iran: Atypical CT manifestations and mortality risk of severe COVID-19 infection. J Microbiol Immunol Infect 2020; S1684-1182(20): 30177-8.
[http://dx.doi.org/10.1016/j.jmii.2020.07.019] [PMID: 32814650]
[2]
Shah J, Monroe-Wise A, Talib Z, et al. Mental health disorders among healthcare workers during the COVID-19 pandemic: A cross-sectional survey from three major hospitals in Kenya. BMJ Open 2021; 11(6) ,e050316
[http://dx.doi.org/10.1136/bmjopen-2021-050316] [PMID: 34108174]
[3]
Wilbiks JMP, Best LA, Law MA, Roach SP. Evaluating the mental health and well-being of Canadian healthcare workers during the COVID-19 outbreak. Healthc Manage Forum 2021; 34(4): 205-10.
[http://dx.doi.org/10.1177/08404704211021109] [PMID: 34098760]
[4]
Ollarves-Carrero MF, et al. Anosmia in a healthcare worker with COVID-19 in Madrid, Spain. Travel medicine and infectious disease 2020; 35 :101666
[5]
Meena SP, Jhirwal M, Puranik AK, et al. Awareness and experience of health-care workers during coronavirus disease 2019 pandemic. J Educ Health Promot 2021; 10: 110.
[PMID: 34084857]
[6]
Garduño-Orbe B, Sánchez-Rebolledo JM, Cortés-Rafael M, et al. SARS-CoV-2 reinfection among healthcare workers in Mexico: Case report and literature review. Medicina (Kaunas) 2021; 57(5): 442.
[http://dx.doi.org/10.3390/medicina57050442] [PMID: 34063699]
[7]
Cheng VC-C, Wong S-C, Yuen K-Y. Estimating coronavirus disease 2019 infection risk in health care workers. JAMA Netw Open 2020; 3(5): e209687-7.
[http://dx.doi.org/10.1001/jamanetworkopen.2020.9687] [PMID: 32437571]
[8]
Rezaei N. COVID-19 affects healthy pediatricians more than pediatric patients. Infect Control Hosp Epidemiol 2020; 41(9): 1106-7.
[http://dx.doi.org/10.1017/ice.2020.139] [PMID: 32297847]
[9]
Ekbatani MS, Hassani SA, Tahernia L, et al. Atypical and novel presentations of Coronavirus Disease 2019: A case series of three children. Br J Biomed Sci 2021; 78(1): 47-52.
[http://dx.doi.org/10.1080/09674845.2020.1785102] [PMID: 32552415]
[10]
Mahmoudi S, Mehdizadeh M, Shervin Badv R, et al. The coronavirus disease 2019 (covid-19) in children: A study in an Iranian children’s referral hospital. Infect Drug Resist 2020; 13: 2649-55.
[http://dx.doi.org/10.2147/IDR.S259064] [PMID: 32801803]
[11]
Mamishi S, Movahedi Z, Mohammadi M, et al. Multisystem inflammatory syndrome associated with SARS-CoV-2 infection in 45 children: a first report from Iran. Epidemiol Infect 2020; 148 ,e196
[http://dx.doi.org/10.1017/S095026882000196X] [PMID: 32854812]
[12]
Sabetian G, Moghadami M, Hashemizadeh Fard Haghighi L, et al. COVID-19 infection among healthcare workers: A cross-sectional study in southwest Iran. Virol J 2021; 18(1): 58.
[http://dx.doi.org/10.1186/s12985-021-01532-0] [PMID: 33731169]
[13]
Kluytmans-van den Bergh MFQ, Buiting AGM, Pas SD, et al. Prevalence and clinical presentation of health care workers with symptoms of coronavirus disease 2019 in 2 Dutch hospitals during an early phase of the pandemic. JAMA Netw Open 2020; 3(5): e209673-3.
[http://dx.doi.org/10.1001/jamanetworkopen.2020.9673] [PMID: 32437576]
[14]
Lai X, Wang M, Qin C, et al. Coronavirus disease 2019 (COVID-2019) infection among health care workers and implications for prevention measures in a tertiary hospital in Wuhan, China. JAMA Netw Open 2020; 3(5): e209666-6.
[http://dx.doi.org/10.1001/jamanetworkopen.2020.9666] [PMID: 32437575]
[15]
Chas J, et al. Broad-based SARS-CoV-2 testing program for healthcare workers in a primary care hospital in France. Infect Dis Now 2021; 51(6): 556-9.
[16]
Reusken CB, Buiting A, Bleeker-Rovers C, et al. Rapid assessment of regional SARS-CoV-2 community transmission through a convenience sample of healthcare workers, the Netherlands, 2020. Euro Surveill 2020; 25(12) ,2000334
[http://dx.doi.org/10.2807/1560-7917.ES.2020.25.12.2000334] [PMID: 32234115]
[17]
Cheng VC, Chan JF, To KK, Yuen KY. Clinical management and infection control of SARS: Lessons learned. Antiviral Res 2013; 100(2): 407-19.
[http://dx.doi.org/10.1016/j.antiviral.2013.08.016] [PMID: 23994190]
[18]
Cheng VCC, Wong SC, Chen JHK, et al. Escalating infection control response to the rapidly evolving epidemiology of the coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 in Hong Kong. Infect Control Hosp Epidemiol 2020; 41(5): 493-8.
[http://dx.doi.org/10.1017/ice.2020.58] [PMID: 32131908]
[19]
Rezaei M, Sadeghi M, Korourian A, et al. Comparative evaluation of SARS-CoV-2 IgG assays against nucleocapsid and spike antigens. Hum Antibodies 2021; 29(2): 109-13.
[http://dx.doi.org/10.3233/HAB-210440] [PMID: 33720878]
[20]
Bestilleiro RS, Señaris DM, Rodríguez MJP, et al. Nosocomial infection outbreak due to SARS-COV-2 in a hospital unit of particularly vulnerable patients. Int J Med Sci 2021; 18(10): 2146-54.
[http://dx.doi.org/10.7150/ijms.53270] [PMID: 33859521]
[21]
Heinzerling A, et al. Transmission of COVID-19 to health care personnel during exposures to a hospitalized patient. Solano County, California 2020; 69(15): 472-6.
[22]
Arons MM, Hatfield KM, Reddy SC, et al. Presymptomatic SARS-CoV-2 infections and transmission in a skilled nursing facility. N Engl J Med 2020; 382(22): 2081-90.
[http://dx.doi.org/10.1056/NEJMoa2008457] [PMID: 32329971]
[23]
Mamishi S, Pourakbari B, Teymuri M, Babamahmoodi A, Mahmoudi S. Management of hospital infection control in Iran: A need for implementation of multidisciplinary approach. Osong Public Health Res Perspect 2014; 5(4): 179-86.
[http://dx.doi.org/10.1016/j.phrp.2014.06.001] [PMID: 25379367]
[24]
Drobnik J, Susło R, Pobrotyn P, et al. COVID-19 among healthcare workers in the university clinical hospital in Wroclaw, Poland. Int J Environ Res Public Health 2021; 18(11): 5600.
[http://dx.doi.org/10.3390/ijerph18115600] [PMID: 34073925]
[25]
Mahmoudi S, Rezaei M, Mansouri N, Marjani M, Mansouri D. Immunologic features in coronavirus disease 2019: Functional exhaustion of T cells and cytokine storm. J Clin Immunol 2020; 40(7): 974-6.
[http://dx.doi.org/10.1007/s10875-020-00824-4] [PMID: 32648027]
[26]
Bandyopadhyay S, Baticulon RE, Kadhum M, et al. Infection and mortality of healthcare workers worldwide from COVID-19: A systematic review. BMJ Glob Health 2020; 5(12) :e003097
[http://dx.doi.org/10.1136/bmjgh-2020-003097] [PMID: 33277297]
[27]
Mehta S, Machado F, Kwizera A, et al. COVID-19: a heavy toll on health-care workers. Lancet Respir Med 2021; 9(3): 226-8.
[http://dx.doi.org/10.1016/S2213-2600(21)00068-0] [PMID: 33556317]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy