TY - JOUR
T1 - Diagnosed and Undiagnosed COVID-19 in US Emergency Department Health Care Personnel
T2 - A Cross-sectional Analysis
AU - Project COVERED Emergency Department Network
AU - Mohr, Nicholas M.
AU - Harland, Karisa K.
AU - Krishnadasan, Anusha
AU - Eyck, Patrick Ten
AU - Mower, William R.
AU - Willey, James
AU - Chisolm-Straker, Makini
AU - Lim, Stephen C.
AU - McDonald, L. Clifford
AU - Kutty, Preeta K.
AU - Hesse, Elisabeth
AU - Santibanez, Scott
AU - Talan, David A.
AU - Monica, Bahamon
AU - Carlson Jestin, N.
AU - Brian, Driver
AU - Brett, Faine
AU - James, Galbraith
AU - Philip, A. Giordano
AU - Haran John, P.
AU - Amanda, Higgins
AU - Jeremiah, Hinson
AU - Stacey, House
AU - Idris Ahamed, H.
AU - Efrat, Kean
AU - Elizabeth, Krebs
AU - Kurz Michael, C.
AU - Lilly, Lee
AU - Liang Stephen, Y.
AU - Montoy Juan, Carlos C.
AU - Gregory, Moran
AU - Utsav, Nandi
AU - Kavitha, Pathmarajah
AU - Paxton James, H.
AU - Yesenia, Perez
AU - Richardson Lynne, D.
AU - Rodriguez Robert, M.
AU - Richard, Rothman
AU - Schrading Walter, A.
AU - Jessica, Shuck
AU - Patricia, Slev
AU - Smithline Howard, A.
AU - Kimberly, Souffront
AU - Mark, Steele
AU - Amy, Stubbs
AU - Morgan, Swanson
AU - Josh, Tiao
AU - Torres Jesus, R.
AU - Stacy, Trent
AU - Lisandra, Uribe
N1 - Publisher Copyright:
© 2021
PY - 2021/7
Y1 - 2021/7
N2 - Study objective: We determine the percentage of diagnosed and undiagnosed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among a sample of US emergency department (ED) health care personnel before July 2020. Methods: This was a cross-sectional analysis of ED health care personnel in 20 geographically diverse university-affiliated EDs from May 13, to July 8, 2020, including case counts of prior laboratory-confirmed coronavirus disease 2019 (COVID-19) diagnoses among all ED health care personnel, and then point-in-time serology (with confirmatory testing) and reverse transcriptase–polymerase chain reaction testing in a sample of volunteers without a previous COVID-19 diagnosis. Health care staff were categorized as clinical (physicians, advanced practice providers, and nurses) and nonclinical (clerks, social workers, and case managers). Previously undiagnosed infection was based on positive SARS-CoV-2 serology or reverse transcriptase–polymerase chain reaction result among health care personnel without prior diagnosis. Results: Diagnosed COVID-19 occurred in 2.8% of health care personnel (193/6,788), and the prevalence was similar for nonclinical and clinical staff (3.8% versus 2.7%; odds ratio 1.5; 95% confidence interval 0.7 to 3.2). Among 1,606 health care personnel without previously diagnosed COVID-19, 29 (1.8%) had evidence of current or past SARS-CoV-2 infection. Most (62%; 18/29) who were seropositive did not think they had been infected, 76% (19/25) recalled COVID-19–compatible symptoms, and 89% (17/19) continued to work while symptomatic. Accounting for both diagnosed and undiagnosed infections, 4.6% (95% confidence interval 2.8% to 7.5%) of ED health care personnel were estimated to have been infected with SARS-CoV-2, with 38% of those infections undiagnosed. Conclusion: In late spring and early summer 2020, the estimated prevalence of severe acute respiratory syndrome coronavirus 2 infection was 4.6%, and greater than one third of infections were undiagnosed. Undiagnosed SARS-CoV-2 infection may pose substantial risk for transmission to other staff and patients.
AB - Study objective: We determine the percentage of diagnosed and undiagnosed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among a sample of US emergency department (ED) health care personnel before July 2020. Methods: This was a cross-sectional analysis of ED health care personnel in 20 geographically diverse university-affiliated EDs from May 13, to July 8, 2020, including case counts of prior laboratory-confirmed coronavirus disease 2019 (COVID-19) diagnoses among all ED health care personnel, and then point-in-time serology (with confirmatory testing) and reverse transcriptase–polymerase chain reaction testing in a sample of volunteers without a previous COVID-19 diagnosis. Health care staff were categorized as clinical (physicians, advanced practice providers, and nurses) and nonclinical (clerks, social workers, and case managers). Previously undiagnosed infection was based on positive SARS-CoV-2 serology or reverse transcriptase–polymerase chain reaction result among health care personnel without prior diagnosis. Results: Diagnosed COVID-19 occurred in 2.8% of health care personnel (193/6,788), and the prevalence was similar for nonclinical and clinical staff (3.8% versus 2.7%; odds ratio 1.5; 95% confidence interval 0.7 to 3.2). Among 1,606 health care personnel without previously diagnosed COVID-19, 29 (1.8%) had evidence of current or past SARS-CoV-2 infection. Most (62%; 18/29) who were seropositive did not think they had been infected, 76% (19/25) recalled COVID-19–compatible symptoms, and 89% (17/19) continued to work while symptomatic. Accounting for both diagnosed and undiagnosed infections, 4.6% (95% confidence interval 2.8% to 7.5%) of ED health care personnel were estimated to have been infected with SARS-CoV-2, with 38% of those infections undiagnosed. Conclusion: In late spring and early summer 2020, the estimated prevalence of severe acute respiratory syndrome coronavirus 2 infection was 4.6%, and greater than one third of infections were undiagnosed. Undiagnosed SARS-CoV-2 infection may pose substantial risk for transmission to other staff and patients.
UR - http://www.scopus.com/inward/record.url?scp=85100677625&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85100677625&partnerID=8YFLogxK
U2 - 10.1016/j.annemergmed.2020.12.007
DO - 10.1016/j.annemergmed.2020.12.007
M3 - Article
C2 - 33771413
AN - SCOPUS:85100677625
SN - 0196-0644
VL - 78
SP - 27
EP - 34
JO - Annals of emergency medicine
JF - Annals of emergency medicine
IS - 1
ER -