Therefore, over the whole period 24 February to 22 May, the frequency of positive test results among the 1070 asymptomatic HCWs was 17 (1.6%), and the final proportion of asymptomatic HCWs among those who tested positive was 17 (12.2%) of 139. At the time of the first positive test, 28 workers (20.1%) among the 139 with positive results reported no symptoms of these, 11 developed symptoms in subsequent weeks. Among HCWs with symptoms, the frequency of positive tests was 24.2% (122/503). The frequency of positive tests ranged from 8.0% (13/162, healthcare assistants) to 10.5% (61/582, physicians)-much higher than among clerical workers (5/137, 3.6%). The overall frequency of workers with at least one positive test result was 8.8% (139/1573 95% CI, 7.5–10.3%). The majority (1224/1573, 77.8%) had only one test performed, while 350 (22.2%) of 1573 individuals had from two to seven tests. One third of women (343/1010) and one fourth of men (137/563) reported having had at least one symptom at the time of testing or thereafter. Mean age was 44.5 years, and the majority (1104/1573, 70.2%) were physicians (including residents) or nurses/midwives. In the period 24 February 2020 to 31 March 2020, a total of 1573 HCWs, 1010 women (64.2%) and 563 men (35.8%), underwent at least a first nasopharyngeal swab test for the detection of SARS-CoV-2 ( Table 1 The study was approved by the ethical committee (368_2020bis) of our institution and was conducted in accordance with the Helsinki Declaration. For those without symptoms who tested positive as of 31 March, we verified through clinical records whether they developed symptoms thereafter. HCWs were defined as symptomatic if they manifested any of the following in the 14 days before test: fever, cough, dyspnoea, asthenia, myalgia, coryza, sore throat, headache, ageusia or dysgeusia, anosmia or parosmia, ocular symptoms, diarrhoea, nausea and vomiting. All information was collected from the infectious disease notification form associated with each test. HCWs were subdivided into physicians (including residents), nurses and midwives, healthcare assistants, health technicians and clerical workers, and technicians. All those at risk were, according to the internal protocol, identified and contacted by the hospital infection prevention unit, isolated at home and tested. We tested HCWs at risk for infection, which we defined as contact with a patient or another HCW with (or later diagnosed with) SARS-CoV-2 infection. For workers with a positive test result, we collected laboratory results as of 22 May to calculate the time to test negative. We collected occupational and clinical characteristics of all the consecutive HCWs who underwent nasopharyngeal swabbing for the detection of SARS-CoV-2 at the Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico from 24 February 2020 (the day after the first COVID-19 case occurred in a physician at our hospital) to 31 March 2020. We also calculated the median time between the day of diagnosis (first positive test) and the day the test results became negative. We assessed the frequency of positive tests among symptomatic and asymptomatic HCWs, and we evaluated the association between occupations, symptoms (type and number) and presence of infection. To answer this question, we reviewed all the nasopharyngeal swab tests performed in HCWs exposed to confirmed cases of COVID-19 at the Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico located in Milan, the capital of Lombardy, a large Italian region affected by COVID-19. Unfortunately, it is still unclear which microbiologic investigations and procedures should be adopted in HCWs in COVID-19 settings, especially with regard to those exposed to confirmed cases of COVID-19 and at risk for infection. It is therefore crucial to avoid infected HCWs, who will spread the disease. Indeed, they work in an emergency situation and are continuously at risk of being infected while also being in contact with the most fragile members of our society: those who need health assistance. Healthcare workers (HCWs) are crucial actors in the pandemic. The virus has since spread worldwide from China, causing the first pandemic of the 21st century, disrupting healthcare services in the affected countries and exacting a terrible toll of human lives.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a previously unknown virus that recently jumped from an as yet unidentified animal host to humans and is responsible for causing coronavirus disease 2019 (COVID-19).
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