Prävalenz von SARS-CoV-2 bei Mitarbeitern eines Krankenhauses der Regel-/Schwerpunktversorgung in Nordrhein-Westfalen

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Zusammenfassung

Hintergrund Wir erhoben die Prävalenz von SARS-CoV-2 in der Belegschaft eines Krankenhauses der Regel-/Schwerpunktversorgung in Nordrhein-Westfalen im Rahmen einer Querschnittsstudie.

Methode Allen 1363 Mitarbeiter wurden ein nasopharyngealer Abstrich sowie eine Serologie auf SARS-CoV-2 angeboten. Zudem wurde ein Fragebogen zu Vorerkrankungen, Kontakten zu SARS-CoV-2-positiven Personen und COVID-19-typischen Symptomen vorgelegt.

Ergebnisse 1212 MitarbeiterInnen nahmen teil. 19 von 1363 (1,4 %) Mitarbeitern waren PCR-positiv (3 während der Studie, 16 vorher). Bei 40 (3,3 %) bzw. 105 (8,6 %) Mitarbeitern wurde IgG bzw. IgA nachgewiesen, bei 32 (2,6 %) IgG und IgA. Damit wurden insgesamt 47 Mitarbeiter positiv für SARS-CoV-2 getestet. In dieser Gruppe waren die häufigsten Symptome Kopfschmerzen (56 %), Müdigkeit (49 %), Halsschmerzen (49 %) und Husten (46 %), Fieber wurde in 33 % berichtet. Positiv getestete Mitarbeiter gaben häufiger Kontakt zu einem COVID-19-Fall an (60,5 % vs. 37,3 %; p = 0,006). Mitarbeiter mit isoliertem IgA-Nachweis gaben seltener Symptome an.

Schlussfolgerung 3,9 % der Mitarbeiter eines Krankenhauses der Regel-/Schwerpunktversorgung wurden zwischen dem 27.04. und 20.05.2020 positiv auf SARS-CoV-2 getestet. Der Anteil war geringer als erwartet; mögliche Gründe sind die geringe Durchseuchung der Bevölkerung und die umfangreichen, einheitlichen hausinternen Präventionsmaßnahmen.

Abstract

Background We assessed the prevalence of SARS-CoV-2 in the staff of a general hospital in North-Rhine-Westphalia in a cross-sectional study.

Method Employees (n = 1363) were offered a nasopharyngeal swab and serology for SARS-CoV-2. Additionally, employees completed a questionnaire about preexisting conditions, contacts with SARS-CoV-2-positive individuals and COVID-19-specific symptoms.

Results 1212 employees participated. 19 of 1363 (1.4 %) employees tested positive by PCR (3 within and 16 before the study). 40 (3.3 %) and 105 (8.6 %) had IgG and IgA, respectively, 32 (2.6 %) both IgG and IgA. Overall, 47 employees tested positive. In this group, most frequently reported symptoms were headache (56 %), fatigue (49 %), sore throat (49 %), and cough (46 %); fever was reported by 33 %. SARS-CoV-2-positive employees reported more frequently contact with COVID-19 cases (60.5 % vs. 37.3 %, p = 0.006). Employees testing positive only for IgA reported less symptoms.

Conclusion Between 27.04. and 20.05.2020, 3.9 % of the employees working in a general hospital were tested positive for SARS-CoV-2. This proportion was lower than expected; possible explanations are the low level of endemic infection and the extensive, uniform in-house preventative measures.

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Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR

Victor M Corman, Olfert Landt, Marco Kaiser … (2020)

Background The ongoing outbreak of the recently emerged novel coronavirus (2019-nCoV) poses a challenge for public health laboratories as virus isolates are unavailable while there is growing evidence that the outbreak is more widespread than initially thought, and international spread through travellers does already occur. Aim We aimed to develop and deploy robust diagnostic methodology for use in public health laboratory settings without having virus material available. Methods Here we present a validated diagnostic workflow for 2019-nCoV, its design relying on close genetic relatedness of 2019-nCoV with SARS coronavirus, making use of synthetic nucleic acid technology. Results The workflow reliably detects 2019-nCoV, and further discriminates 2019-nCoV from SARS-CoV. Through coordination between academic and public laboratories, we confirmed assay exclusivity based on 297 original clinical specimens containing a full spectrum of human respiratory viruses. Control material is made available through European Virus Archive – Global (EVAg), a European Union infrastructure project. Conclusion The present study demonstrates the enormous response capacity achieved through coordination of academic and public laboratories in national and European research networks.

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Remdesivir for the Treatment of Covid-19 — Final Report

John H. Beigel, Kay Tomashek, Lori Dodd … (2022)

Abstract Background Although several therapeutic agents have been evaluated for the treatment of coronavirus disease 2019 (Covid-19), none have yet been shown to be efficacious. Methods We conducted a double-blind, randomized, placebo-controlled trial of intravenous remdesivir in adults hospitalized with Covid-19 with evidence of lower respiratory tract involvement. Patients were randomly assigned to receive either remdesivir (200 mg loading dose on day 1, followed by 100 mg daily for up to 9 additional days) or placebo for up to 10 days. The primary outcome was the time to recovery, defined by either discharge from the hospital or hospitalization for infection-control purposes only. Results A total of 1063 patients underwent randomization. The data and safety monitoring board recommended early unblinding of the results on the basis of findings from an analysis that showed shortened time to recovery in the remdesivir group. Preliminary results from the 1059 patients (538 assigned to remdesivir and 521 to placebo) with data available after randomization indicated that those who received remdesivir had a median recovery time of 11 days (95% confidence interval [CI], 9 to 12), as compared with 15 days (95% CI, 13 to 19) in those who received placebo (rate ratio for recovery, 1.32; 95% CI, 1.12 to 1.55; P<0.001). The Kaplan-Meier estimates of mortality by 14 days were 7.1% with remdesivir and 11.9% with placebo (hazard ratio for death, 0.70; 95% CI, 0.47 to 1.04). Serious adverse events were reported for 114 of the 541 patients in the remdesivir group who underwent randomization (21.1%) and 141 of the 522 patients in the placebo group who underwent randomization (27.0%). Conclusions Remdesivir was superior to placebo in shortening the time to recovery in adults hospitalized with Covid-19 and evidence of lower respiratory tract infection. (Funded by the National Institute of Allergy and Infectious Diseases and others; ACTT-1 ClinicalTrials.gov number, NCT04280705.)

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SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients

Lirong Zou, Feng Ruan, Mingxing Huang … (2020)

To the Editor: The 2019 novel coronavirus (SARS-CoV-2) epidemic, which was first reported in December 2019 in Wuhan, China, and has been declared a public health emergency of international concern by the World Health Organization, may progress to a pandemic associated with substantial morbidity and mortality. SARS-CoV-2 is genetically related to SARS-CoV, which caused a global epidemic with 8096 confirmed cases in more than 25 countries in 2002–2003. 1 The epidemic of SARS-CoV was successfully contained through public health interventions, including case detection and isolation. Transmission of SARS-CoV occurred mainly after days of illness 2 and was associated with modest viral loads in the respiratory tract early in the illness, with viral loads peaking approximately 10 days after symptom onset. 3 We monitored SARS-CoV-2 viral loads in upper respiratory specimens obtained from 18 patients (9 men and 9 women; median age, 59 years; range, 26 to 76) in Zhuhai, Guangdong, China, including 4 patients with secondary infections (1 of whom never had symptoms) within two family clusters (Table S1 in the Supplementary Appendix, available with the full text of this letter at NEJM.org). The patient who never had symptoms was a close contact of a patient with a known case and was therefore monitored. A total of 72 nasal swabs (sampled from the mid-turbinate and nasopharynx) (Figure 1A) and 72 throat swabs (Figure 1B) were analyzed, with 1 to 9 sequential samples obtained from each patient. Polyester flock swabs were used for all the patients. From January 7 through January 26, 2020, a total of 14 patients who had recently returned from Wuhan and had fever (≥37.3°C) received a diagnosis of Covid-19 (the illness caused by SARS-CoV-2) by means of reverse-transcriptase–polymerase-chain-reaction assay with primers and probes targeting the N and Orf1b genes of SARS-CoV-2; the assay was developed by the Chinese Center for Disease Control and Prevention. Samples were tested at the Guangdong Provincial Center for Disease Control and Prevention. Thirteen of 14 patients with imported cases had evidence of pneumonia on computed tomography (CT). None of them had visited the Huanan Seafood Wholesale Market in Wuhan within 14 days before symptom onset. Patients E, I, and P required admission to intensive care units, whereas the others had mild-to-moderate illness. Secondary infections were detected in close contacts of Patients E, I, and P. Patient E worked in Wuhan and visited his wife (Patient L), mother (Patient D), and a friend (Patient Z) in Zhuhai on January 17. Symptoms developed in Patients L and D on January 20 and January 22, respectively, with viral RNA detected in their nasal and throat swabs soon after symptom onset. Patient Z reported no clinical symptoms, but his nasal swabs (cycle threshold [Ct] values, 22 to 28) and throat swabs (Ct values, 30 to 32) tested positive on days 7, 10, and 11 after contact. A CT scan of Patient Z that was obtained on February 6 was unremarkable. Patients I and P lived in Wuhan and visited their daughter (Patient H) in Zhuhai on January 11 when their symptoms first developed. Fever developed in Patient H on January 17, with viral RNA detected in nasal and throat swabs on day 1 after symptom onset. We analyzed the viral load in nasal and throat swabs obtained from the 17 symptomatic patients in relation to day of onset of any symptoms (Figure 1C). Higher viral loads (inversely related to Ct value) were detected soon after symptom onset, with higher viral loads detected in the nose than in the throat. Our analysis suggests that the viral nucleic acid shedding pattern of patients infected with SARS-CoV-2 resembles that of patients with influenza 4 and appears different from that seen in patients infected with SARS-CoV. 3 The viral load that was detected in the asymptomatic patient was similar to that in the symptomatic patients, which suggests the transmission potential of asymptomatic or minimally symptomatic patients. These findings are in concordance with reports that transmission may occur early in the course of infection 5 and suggest that case detection and isolation may require strategies different from those required for the control of SARS-CoV. How SARS-CoV-2 viral load correlates with culturable virus needs to be determined. Identification of patients with few or no symptoms and with modest levels of detectable viral RNA in the oropharynx for at least 5 days suggests that we need better data to determine transmission dynamics and inform our screening practices.

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Author and article information

Journal

Journal ID (nlm-ta): Dtsch Med Wochenschr

Journal ID (iso-abbrev): Dtsch Med Wochenschr

Journal ID (doi): 10.1055/s-00000011

Title: Deutsche Medizinische Wochenschrift (1946)

Publisher: Georg Thieme Verlag KG (Rüdigerstraße 14, 70469 Stuttgart, Germany )

ISSN (Print): 0012-0472

ISSN (Electronic): 1439-4413

Publication date (Print): March 2021

Publication date (Electronic): 29 January 2021

Volume: 146

Issue: 5

Pages: e30-e38

Affiliations

[1 ]Labor Dr. Wisplinghoff, Köln, Deutschland

[2 ]Arbeitsmedizin, St.-Antonius-Hospital Eschweiler, Eschweiler, Deutschland

[3 ]Kompetenzzentrum Epidemiologie und Versorgungsforschung bei Pflegeberufen (CVcare), Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg, Deutschland

[4 ]Institut für Virologie und klinische Mikrobiologie, Universität Witten/Herdecke, Witten, Deutschland; Institut für medizinische Mikrobiologie, Immunologie und Hygiene, Universität zu Köln, Köln, Deutschland

[5 ]Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege (BGW), Abteilung Arbeitsmedizin, Gefahrstoffe und Gesundheitswissenschaften (AGG), Hamburg, Deutschland

[6 ]Klinik für Plastische und Ästhetische Chirurgie, Hand- und Wiederherstellungschirurgie, Ärztlicher Direktor (in Vertretung für die Betriebsleitung), St.-Antonius-Hospital Eschweiler, Eschweiler, Deutschland

[7 ]Klinik für Akut- und Notfallmedizin, St.-Antonius-Hospital Eschweiler, Eschweiler, Deutschland

Author notes

Korrespondenzadresse Dr. Martin Platten Labor Dr. Wisplinghoff Horbeller Str. 18–2050858 KölnDeutschland+49/2 21/9 40 50 53 67 m.platten@ 123456wisplinghoff.de

Article

DOI: 10.1055/a-1322-5355

PMC ID: 7920642

PubMed ID: 33513626

SO-VID: 5576229f-7cc9-4fe1-8c67-cdaec9437c9a

Copyright © The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.

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Prävalenz von SARS-CoV-2 bei Mitarbeitern eines Krankenhauses der Regel-/Schwerpunktversorgung in Nordrhein-Westfalen Translated title: Prevalence of SARS-CoV-2 in employees of a general hospital in Northrhine-Westphalia, Germany

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Novel Coronavirus Disease COVID-19

Most cited references 25

Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR

Remdesivir for the Treatment of Covid-19 — Final Report

SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients

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