Serological and psychological monitoring of healthcare workers during the start of the COVID-19 pandemic
Main Article Content
Abstract
Introduction: healthcare personnel are essential in the response against COVID-19. At the beginning of the pandemic the risk of acquiring the disease in this group was unknown. We sought to estimate incidence and prevalence of anti SARS-CoV-2 antibodies, as well as burnout prevalence in a cohort of healthcare staff during the pandemic, as well as assessing the prevalence of burnout and depression in this group.
Materials and methods: prospective cohort formed by physicians tending to COVID-19 patients from march 2020 to january 2021 in a high-complexity hospital in the city of Buenos Aires. We evaluated anti SARS-CoV-2 IgM and IgG each 15 days for 3 months as well as the presence of compatible symptoms and factors associated to exposition to the virus. Patients showing signs of burnout and/or depression were referred to proper care by the mental health team in the hospital.
Results: we included 52 patients, 31 women, median age was 32 years (range 25 - 58). Median amount of self-reported hours worked each week was 48 (IQR 40 - 69.5). Initially all participants had a negative COVID-19 PCR nasopharyngeal swab; 11 (21.50% CI95% 9.62 - 32.53%) had symptomatic COVID-19 with positive antibodies. Factors showing stronger association with testing positive were anosmia/dysgeusia OR 403.33 (CI95% 47.60-3417.02), fever OR 172.53 (CI95% 28.82 - 1032.65), myalgia OR 41.97 (CI95% 8.08 - 217.84), cohabitation with confirmed COVID-19 case OR 28.17 (CI95% 5.67 - 179.97). Near 40% showed alterations in burnout or depression scales.
Discussion: the incidence rate we found was like reported values in the initial stages of the pandemic in Argentina. Another similarity was that all cases were mild; no hospitalization was required for any participant. We found an elevated incidence of alterations in the psychic sphere, both at the beginning and end of the follow up period.
Conclusions: the incidence of positive SARS-CoV-2 antibodies was around 20%. No pre or asymptomatic cases were identified. Burnout and depression incidence was high. Mental health is a component that should never be overlooked in similar situations to come.
Downloads
Article Details
Section

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
How to Cite
References
Novel Coronavirus (2019-nCoV) situation reports [Internet]. Geneva: World Health Organization; 2022 [citado 2020 abr 14]. Disponible en: https://www.who.int/timorleste/emergencies/novel-coronavirus-2019/novel-coronavirus-(2019-ncov)-situation-reports.
The Lancet. COVID-19: protecting health-care workers. Lancet. 2020;395(10228):922. https://doi.org: 10.1016/S0140-6736(20)30644-9.
Remuzzi A, Remuzzi G. COVID-19 and Italy: what next? Lancet. 2020;395(10231):1225-1228. https://doi.org/10.1016/S0140-6736(20)30627-9.
Kimball A, Hatfield KM, Arons M, et al. Asymptomatic and presymptomatic SARS-CoV-2 infections in residents of a long-term care skilled nursing facility - King County, Washington, March 2020. MMWR Morb Mortal Wkly Rep. 2020;69(13):377-381. https://doi.org/10.15585/mmwr.mm6913e1.
Buselli R, Corsi M, Baldanzi S, et al. Professional quality of life and mental health outcomes among health care workers exposed to Sars-Cov-2 (Covid-19). Int J Environ Res Public Health. 2020;17(17):6180. https://doi.org/10.3390/ijerph17176180.
Pappa S, Ntella V, Giannakas T, et al. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis. Brain Behav Immun. 2020;88:901-907. https://doi.org/10.1016/j.bbi.2020.05.026. Errata en: Brain Behav Immun. 2021;92:247. https://doi.org/10.1016/j.bbi.2020.11.023.
Mizumoto K, Kagaya K, Zarebski A, et al. Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. Euro Surveill. 2020;25(10):2000180. https://doi.org/10.2807/1560-7917.ES.2020.25.10.2000180. Errata en: Euro Surveill. 2020;25(22):20200604c. https://doi.org/10.2817/1561-7917.ES.2020.25.22.20200604c.
Gómez-Ochoa SA, Franco OH, Rojas LZ, et al. COVID-19 in health-care workers: a living systematic review and meta-analysis of prevalence, risk factors, clinical characteristics, and outcomes. Am J Epidemiol. 2021;190(1):161-175. https://doi.org/10.1093/aje/kwaa191. Errata en: Am J Epidemiol. 2021;190(1):187. https://doi.org/ 10.1093/aje/kwaa194.
Emeribe AU, Abdullahi IN, Shuwa HA, et al. Humoral immunological kinetics of severe acute respiratory syndrome coronavirus 2 infection and diagnostic performance of serological assays for coronavirus disease 2019: an analysis of global reports. Int Health. 2022;14(1):18-52. https://doi.org/10.1093/inthealth/ihab00510.
Dobaño C, Vidal M, Santano R, et al. Highly sensitive and specific multiplex antibody assays to quantify immunoglobulins M, A, and G against SARS-CoV-2 antigens. J Clin Microbiol. 2021;59(2):e01731-20. https://doi.org/10.1128/JCM.01731-20.
Li C, Zhao C, Bao J, et al. Laboratory diagnosis of coronavirus disease-2019 (COVID-19). Clin Chim Acta. 2020;510:35-46. https://doi.org/10.1016/j.cca.2020.06.045.
Chu DKW, Pan Y, Cheng SMS, et al. Molecular diagnosis of a novel coronavirus (2019-nCoV) causing an outbreak of pneumonia. Clin Chem. 2020;66(4):549-555. https://doi.org/10.1093/clinchem/hvaa029.
Novel coronavirus v2 [Internet]. Anatolia Geneworks; 2021 [citado 2022 feb 7]. Disponible en:https://www.anatoliageneworks.com/en/kits/bosphore-novel-coronavirus-2019-ncov-detection-kit-v2.
Argentina. Ministerio de Salud. Recomendaciones para el uso de los EPP [Internet]. Buenos Aires: el Ministerio 2020 mar 19 [citado 2022 feb 2]. Disponible en: https://www.argentina.gob.ar/salud/coronavirus/recomendaciones-uso-epp.
Maslach C, Jackson SE. MBI – Human services survey for medical personnel [Internet]. Mind Garden; 2022 [citado 2021 mar 1]. Disponible en: https://www.mindgarden.com/315-mbi-human-services-survey-medical-personnel.
Beck AT, Steer RA, Carbin, MG. Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation. Clin Psychol Rev. 1988;8(1):77-100. https://doi.org/10.1016/0272-7358(88)90050-5.
Pappa S, Ntella V, Giannakas T, et al. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: a systematic review and meta-analysis. Brain Behav Immun. 2020;88:901-907. https://doi.org/10.1016/j.bbi.2020.05.026. Errata en: Brain Behav Immun. 2021;92:247. https://doi.org/10.1016/j.bbi.2020.11.023.
Argentina. Gobierno de la Provincia de Buenos Aires. En Quilmes, una trabajadora de terapia intensiva es la primera en recibir la vacuna en el Hospital Provincial [Internet]. 2020 dic 29 [citado 2021 oct 25]. Disponible en: https://www.gba.gob.ar/saludprovincia/noticias/en_quilmes_una_trabajadora_de_terapia_intensiva_es_la_primera_en_recibir_la.
Insúa C, Stedile G, Figueroa V, et al. Seroprevalence of SARS-CoV-2 antibodies among physicians from a children's hospital. Arch Argent Pediatr. 2020;118(6):381-385. https://doi.org/10.5546/aap.2020.eng.381.
Fukuda H, Seyama K, Ito K, et al. SARS-CoV-2 seroprevalence in healthcare workers at a frontline hospital in Tokyo. Sci Rep. 2021;11(1):8380. https://doi.org/10.1038/s41598-021-87688-9. Errata en: Sci Rep. 2021;11(1):16042. https://doi.org/10.1038/s41598-021-95498-2.
Lumley SF, O'Donnell D, Stoesser NE, et al. Antibody status and incidence of SARS-CoV-2 infection in health care workers. N Engl J Med. 2021;384(6):533-540. https://doi.org/10.1056/NEJMoa2034545.
Sims MD, Maine GN, Childers KL, et al. Coronavirus disease 2019 (COVID-19) seropositivity and asymptomatic rates in healthcare workers are associated with job function and masking. Clin Infect Dis. 2021;73(Suppl 2):S154-S162. https://doi.org/10.1093/cid/ciaa1684.
Dzinamarira T, Murewanhema G, Mhango M, et al. COVID-19 prevalence among healthcare workers. A systematic review and meta-analysis. Int J Environ Res Public Health. 2021;19(1):146. https://doi.org/10.3390/ijerph19010146.
Effectiveness of public health measures in reducing the incidence of covid-19, SARS-CoV-2 transmission, and covid-19 mortality: systematic review and meta-analysis. BMJ. 2021;375:n2997. https://doi.org/10.1136/bmj.n2997. Errata en: BMJ. 2021;375:e068302. https://doi.org/10.1136/bmj-2021-068302.
Liu Y, Tang JW, Lam TTY. Transmission dynamics of the COVID-19 epidemic in England. Int J Infect Dis. 2021;104:132-138. https://doi.org/10.1016/j.ijid.2020.12.055.
Dubey S, Biswas P, Ghosh R, et al. Psychosocial impact of COVID-19. Diabetes Metab Syndr. 2020t;14(5):779-788. https://doi.org/10.1016/j.dsx.2020.05.035.
Salehi M, Amanat M, Mohammadi M, et al. The prevalence of post-traumatic stress disorder related symptoms in Coronavirus outbreaks: a systematic-review and meta-analysis. J Affect Disord. 2021;282:527-538. https://doi.org/10.1016/j.jad.2020.12.188.
Restauri N, Sheridan AD. Burnout and posttraumatic stress disorder in the coronavirus disease 2019 (COVID-19) pandemic: intersection, impact, and interventions. J Am Coll Radiol. 2020;17(7):921-926. https://doi.org/10.1016/j.jacr.2020.05.021.
Dzinamarira T, Murewanhema G, Mhango M, et al. COVID-19 prevalence among healthcare workers. A systematic review and meta-analysis. Int J Environ Res Public Health. 2021;19(1):146. https://doi.org/10.3390/ijerph19010146.
Fernandes LL, Pacheco VB, Borges L, et al. Saliva in the diagnosis of COVID-19: a review and new research directions. J Dent Res. 2020;99(13):1435-1443. https://doi.org/10.1177/0022034520960070.