Health-care workers in gastrointestinal endoscopy are at higher risk for SARS-CoV-2 infection compared to other aerosol-generating disciplines

  1. Christoph Römmele
  2. Alanna Ebigbo
  3. Maria Kahn
  4. Stephan Zellmer
  5. Anna Muzalyova
  6. Gertrud Hammel
  7. Christina Bartenschlager
  8. Albert Beyer
  9. Jonas Rosendahl
  10. Tilo Schlittenbauer
  11. Johannes Zenk
  12. Bilal Al-Nawas
  13. Roland Frankenberger
  14. Jürgen Hoffmann
  15. Christoph Arens
  16. Frank Lammert
  17. Claudia Traidl-Hoffmann
  18. Helmut Messmann
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Abstract

Objective

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

Design

A nationwide questionnaire-based study in in- and outpatient settings was conducted between 12/16/2020 and 01/24/2021. Data on SARS-CoV-2 infections among HCW and potential risk factors were investigated.

Results

2,070 healthcare facilities with 25,113 employees were included in the study. Despite a higher rate of pre-interventional testing, clinics treated three times more confirmed SARS-CoV-2 cases than private practices (28.8% vs. 88.4%, p<0.001). Overall infection rate among HCW accounted for 4.7%. Multivariate analysis revealed that ZIP-regions having comparably higher incidences were significantly associated with increased risk of infection. Furthermore, clinical setting and the GIE specialty have more than double the risk of infection (OR 2.63; 95% CI 2.501-2.817, p<0.01 and OR 2.35; 95% CI 2.245-2.498, p<0.01). The number of procedures performed per day was also significantly associated with an increased risk of infection (OR 1.01; 95% CI 1.007-1.014), p<0.01). No treatment of confirmed SARS-CoV-2 cases was tending to lower the risk of infection (OR 0.72; 95% CI 0.507-1.025, p=0.068).

Conclusion

HCW in GIE seem to be at higher risk of infection than those in other AGP, especially in the clinical setting. Regions having comparably higher incidences as well as the number of procedures performed per day were also significantly associated with increased risk of infection.

Significance of this study

What is already known on this subject?

Health care workers, especially those exposed to aerosol generating procedures, are assumed to have an increased risk of SARS-CoV-2 infection. However, data confirming this are lacking, especially for the outpatient care setting.

What are the new findings?

Health care workers in gastrointestinal endoscopy have a higher risk of SARS-CoV-2-infection than in other AGPs. This risk is particularly higher

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    in clinical settings compared to private practices

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    in regions having comparably higher incidences

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    the more procedures are performed per day

How might it impact on clinical practice in the foreseeable future?

Our study suggests making additional efforts to protect HCW in the gastrointestinal work field.

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