2314. Association Between Behavior and Risk of COVID-19 in a Cohort of Healthcare Personnel
Authors: Shoemaker Holly , Li Haojia , Zhang Yue , Mayer Jeanmarie , Rubin Michael , Millar Morgan M , Gesteland Per H , Pavia Andrew T , Keegan Lindsay T , Braunfeld Jordan , Stratford Kristina , Samore Matthew H 
Published: November 2023

Abstract

Background
Social behaviors are associated with COVID-19 infection. Most studies assessing exposure risk from daily activities were performed in the general population. Less is known about the impact of social behavior on the risk of COVID-19 among healthcare personnel (HCP), who have a higher risk of exposure at work and more awareness of prevention measures than the general population.

Methods
We conducted a prospective cohort study, with monthly surveys from Dec 2021 to June 2022 of HCP at an academic healthcare system. Each survey asked HCP if they had been tested for SARS-CoV-2, their results, and if they had engaged in any of 9 common social activities outside of work (see figure). A composite social activities exposure measure was defined as the count of “Yes” to the social activities at the previous survey, with a possible range from 0-9. Similarity of current overall social behavior compared to pre-pandemic was also reported on a scale of 0-10, with 10 reflecting the same level as pre-pandemic. We employed mixed effect logistic regression, weighted for dropout using covariate balancing propensity scores, to estimate the association between previously reported social behavior and activities and testing positive for SARS-CoV-2 after adjusting for covariates (see table).

Results
Recruitment emails were sent to 10,321 HCP, with 1,802 (17.5%) consenting to participate and 1,302 (72.3%) completing 2 or more surveys. 981 HCP reported being tested for SARS-CoV-2 with at least one positive test reported by 277 HCP (28.2%). Engaging in overall social behavior more similar to pre-pandemic levels was found to be statistically significantly associated with an increased likelihood of testing positive for SARS-CoV-2 (OR 1.32, 95% CI 1.11-1.56). However, while there was a trend to testing positive with an increased number of social activities reported at the previous survey, it was not significant (OR 1.06, 95% CI 0.95-1.18).
Temporal Trends of Social Activities in Healthcare Workers
Reported social activities of healthcare workers at an academic healthcare system from late November 2021 to May 2022.
Association Between Social Activity Measures and Positive COVID-19 Test
1. Similarity of social behavior at the previous survey with pre-pandemic behavior reported on a scale of 0-10, with 10 reflecting the same level of activity as pre-pandemic. 2. Count of “Yes” to the social activities at the previous survey, with a possible range from 0-9. 3. Covariates adjusted: calendar month, age, gender, clinic role, working location, general health, comorbidities, household status, illnesses reported at the previous survey, time since last vaccine, and time since the previous survey.

Conclusion
This study, which included the Omicron surge, saw HCP participation in a range of social activities. Reporting levels of social activity similar to pre-pandemic levels was associated with an increased risk of subsequent COVID-19. This feedback is important for HCP consideration of exposures outside of work.

Disclosures
Jeanmarie Mayer, MD, GlaxoSmithKline: Stocks/Bonds Andrew T. Pavia, MD, GlaxoSmith Kline: Advisor/Consultant|Sanofi: Advisor/Consultant