A Prospective Cohort of SARS-CoV-2-Infected Health Care Workers: Clinical Characteristics, Outcomes, and Follow-up Strategy
Authors: Nicolás David , Camós-Carreras Anna , Spencer Felipe , Arenas Andrea , Butori Eugenia , Maymó Pol , Anmella Gerard , Torrallardona-Murphy Orla , Alves Eduarda , García Laura , Pereta Irene , Castells Eva , Seijas Nuria , Ibáñez Begoña , Grané Carme , Bodro Marta , Cardozo Celia , Barroso Sonia , Olive Victoria , Tortajada Marta , Hernández Carme , Cucchiari David , Coloma Emmanuel , Pericàs Juan M ,   Hospital Clinic Hospital at Home Team, Martinez Gemma , Castells Antoni , Feu Faust , Cadenas Roser , Varela Pilar , Barroso Sonia , Tortajada Marta , Olive Victoria , Nicolás David , Coloma Emmanuel , Bodro Marta , Cardozo Celia , Pericás Juan M , Calvo Júlia , López-Soto Alfons , Soriano Álex , Nicolás Josep M , Llufriu Sara , Anmella Gerard , Camos Anna , Spencer Felipe , Escudero Lucía , Dotti Marina , Teresa Carrión M , Opazo Valeria , Parrado Alba , Giralt Joan , Bernal Carolina , Romero Barbara , Boquera Clàudia , Sánchez Miriam , Feu Silvia , Casablanca Anna , Cayado Ana , Carreras Xavier , Pablo Figueroa J , Marín Sara , Castro Rafa , Oliva Cristian , Arenas Andrea , Butori Eugenia , Torrallardona Orla , Maymo Pol , Alves Eduarda , García Laura , Pereta Irene , Castells Eva , Seijas Nuria , Ibáñez Begoña , Grané Carme , Hernández Carme , Serralabós Jùlia , Alvès Elisenda , Rabaneda Neus , Hidalgo Judit , Avalos Maribel , Carbonell Anna , Subirana Núria , Navas Regina , Aranda Carmen , Rodríguez Magali , Salas Marta , Suárez Adolfo , Fernández Ana , Martínez Alba , Barta Ariadna , Escobar Cristina , Moreno Laura , Jawara Mohammed , Cano Susana , Román Mariana , Martinez Maria , Jiménez David , Rosero Elisabeth , Román Mariana , Llop Lourdes , Asenjo Maria 
Published: December 2020

Abstract

Background
During the coronavirus disease 2019 (COVID-19) outbreaks, health care workers (HCWs) are at a high risk of infection. Strategies to reduce in-hospital transmission between HCWs and to safely manage infected HCWs are lacking. Our aim was to describe an active strategy for the management of COVID-19 in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–infected HCWs and investigate its outcomes.

Methods
A prospective cohort study of SARS-CoV-2-infected health care workers in a tertiary teaching hospital in Barcelona, Spain, was performed. An active strategy of weekly polymerase chain reaction screening of HCWs for SARS-CoV-2 was established by the Occupational Health department. Every positive HCW was admitted to the Hospital at Home Unit with daily assessment online and in-person discretionary visits. Clinical and epidemiological data were recorded.

Results
Of the 590 HCWs included in the cohort, 134 (22%) were asymptomatic at diagnosis, and 15% (89 patients) remained asymptomatic during follow-up. A third of positive cases were detected during routine screening. The most frequent symptoms were cough (68%), hyposmia/anosmia (49%), and fever (41%). Ten percent of the patients required specific treatment at home, while only 4% of the patients developed pneumonia. Seventeen patients required a visit to the outpatient clinic for further evaluation, and 6 of these (1%) required hospital admission. None of the HCWs included in this cohort required intensive care unit admission or died.

Conclusions
Active screening for SARS-CoV-2 among HCWs for early diagnosis and stopping in-hospital transmission chains proved efficacious in our institution, particularly due to the high percentage of asymptomatic HCWs. Follow-up of HCWs in Hospital at Home units is safe and effective, with low rates of severe infection and readmission.