SARS-CoV-2 Infection Among Healthcare Workers in Tijuana, Mexico: A Cross-Sectional Study

Authors

  • José Adrián Yamamoto-Moreno Universidad Autónoma de Baja California, Facultad de Medicina y Psicología, Tijuana; Instituto Mexicano del Seguro Social, Hospital de Gineco-Obstetricia y Unidad de Medicina Familiar No. 7, Tijuana, México https://orcid.org/0000-0002-2468-5943
  • Cecilia Pineda-Aguilar Physician, Universidad Autónoma de Baja California, Facultad de Medicina y Psicología, Tijuana; Instituto Mexicano del Seguro Social, Hospital de Gineco-Obstetricia y Unidad de Medicina Familiar No. 7, Tijuana, México.
  • Samuel Ruiz-Pérez Universidad Autónoma de Baja California, Facultad de Medicina y Psicología, Tijuana, Mexico.
  • Gloria Liliana Gortarez-Quintana Universidad Autónoma de Baja California, Facultad de Medicina y Psicología, Tijuana, Mexico.
  • Marco Antonio Ruiz-Dorado Instituto Mexicano del Seguro Social, Hospital de Gineco-Obstetricia y Unidad de Medicina Familiar No. 7, Tijuana, México.

DOI:

https://doi.org/10.5195/ijms.2020.625

Keywords:

COVID-19, SARS-CoV-2, Coronavirus, Health personnel, Healthcare workers

Abstract

Background: Healthcare workers (HCW) are a high-risk group for contraction of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. The aim of this study was to estimate the effect size of being a HCW and acquiring coronavirus disease 2019 (COVID-19) at the Mexican Institute of Social Security (IMSS) in Tijuana, Mexico.

Methods: A cross-sectional study of the Epidemiologic Surveillance Online Notification System database was conducted, including entries from Tijuana City between March 11, 2020 to May 1, 2020. Multiple imputation was performed for SARS-CoV-2 RT-PCR result where data was missing. Prevalence odds ratios (POR) were calculated to estimate the effect size of HCWs contracting COVID-19 compared to the general population (GP).

Results: From a total of 10,216 entries, 6,256 patients were included for analysis. HCW status was significantly associated with higher odds of acquiring COVID-19, (POR=1.730, 95% Confidence Interval [95%CI]=1.459;2.050). Nurses had double odds (POR=2.339, 95%CI=1.804;3.032) than the GP. Physicians had a POR=1.828 (95%CI=0.766;1.380). Resident physician status was double the likelihood of the GP (POR=2.166, 95%CI=0.933;5.025). Meanwhile, being an intern had a protective factor (POR=0.253, 95%CI=0.085;0.758). Among medical specialties, emergency medicine had the highest exposure-effect association, followed by anesthesiologists.

Conclusion: HCW had up to 73% increased odds of acquiring COVID-19 than the GP in Tijuana, Mexico. Nurses were the group with the highest likelihood out of all HCW, as a result of prolonged and close contact with patients. Emergency medicine and anesthesiology were the medical specialties with the highest odds of infection because they frequently perform aerosol-generating procedures.

Metrics

Metrics Loading ...

Author Biographies

José Adrián Yamamoto-Moreno, Universidad Autónoma de Baja California, Facultad de Medicina y Psicología, Tijuana; Instituto Mexicano del Seguro Social, Hospital de Gineco-Obstetricia y Unidad de Medicina Familiar No. 7, Tijuana, México

José Adrián Yamamoto-Moreno is a recently graduated physician from a 7-year program at Universidad Autónoma de Baja California in México. He was awarded the Carlos Slim Foundation scholarship for excellence in Medicine and served as National Officer of Medical Publications in Asociación Mexicana de Médicos en Formación (AMMEF) from 2019-2020.

Cecilia Pineda-Aguilar, Physician, Universidad Autónoma de Baja California, Facultad de Medicina y Psicología, Tijuana; Instituto Mexicano del Seguro Social, Hospital de Gineco-Obstetricia y Unidad de Medicina Familiar No. 7, Tijuana, México.

Physician.

Samuel Ruiz-Pérez, Universidad Autónoma de Baja California, Facultad de Medicina y Psicología, Tijuana, Mexico.

Medical student.

Gloria Liliana Gortarez-Quintana, Universidad Autónoma de Baja California, Facultad de Medicina y Psicología, Tijuana, Mexico.

Medical student.

Marco Antonio Ruiz-Dorado, Instituto Mexicano del Seguro Social, Hospital de Gineco-Obstetricia y Unidad de Medicina Familiar No. 7, Tijuana, México.

Internal medicine specialist.

References

Bhagavathula AS, Aldhaleei WA, Rahmani J, Mahabadi MA, Bandari DK. Knowledge and Perceptions of COVID-19 Among Health Care Workers: Cross-Sectional Study. J Med Internet Res. 2020 Apr 30;6(2):e19160.

Koh D. Occupational risks for COVID-19 infection. Occup Med (Lond). 2020 Mar 12;70(1):3-5

Udugama B, Kadhiresan P, Kozlowski HN, Malekjahani A, Osborne M, Li VYC, et al. Diagnosing COVID-19: The Disease and Tools for Detection. ACS Nano. 2020 Apr 28;14(4):3822–35.

Munster VJ, Koopmans M, van Doremalen N, van Riel D, de Wit E. A novel coronavirus emerging in China - Key questions for impact assessment. N Engl J Med. 2020 Feb 20;382(8):692–4.

Ran L, Chen X, Wang Y, Wu W, Zhang L, Tan X. Risk Factors of Healthcare Workers with Corona Virus Disease 2019: A Retrospective Cohort Study in a Designated Hospital of Wuhan in China. Clin Infect Dis. 2020 Nov 19;71(16):2218–21.

Hunter E, Price DA, Schim van der Loeff I, Baker KF, Lendrem D, Lendrem C, et al. First experience of COVID-19 screening of health-care workers in England. Lancet. 2020 May 2;395(10234):e77–78

Chang D, Xu H, Rebaza A, Sharma L, Dela Cruz CS. Protecting health-care workers from subclinical coronavirus infection. Lancet Respir Med. 2020 Mar;8(3):e13.

World Health Organization. Report of the WHO-China Joint Mission on Coronavirus Disease2019 (COVID-19). Available from: https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf. Last updated Feb 24, 2020; cited Nov 30, 2020.

García-Méndez N, Lagarda Cuevas J, Otzen T, Manterola C. Anesthesiologists and the High Risk of Exposure to COVID-19. Anesth Analg. 2020 Aug;131(2):e92–93.

Li R, Pei S, Chen B, Song Y, Zhang T, Yang W, et al. Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV-2). Science. 2020 May;493(5):489–93.

Wu Z, McGoogan JM. Characteristics of and Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020 Apr 7;323(13):1239–42.

Hamed E, Abd Elhamid M, Alemrayat B. Suspected cases of COVID-19: study protocol for reporting characteristics and the outcomes. Fam Med Community Heal. 2020 Apr;8(2):e000400.

Yeo C, Kaushal S, Yeo D. Enteric involvement of coronaviruses: is fecal-oral transmisssion of SARS-CoV-2 possible? Lancet Gastroenterol Hepatol. 2020 Apr;5(4):335–7.

Dijkhuizen LGM, Gelderman HT, Dujist WLJM. Review: The safe handling of a corpse (suspected) with COVID-19. J Forensic Leg Med. 2020 Jul;73:101999.

Shah PS, Diambomba Y, Acharya G, Morris SK, Bitnun A. Classification system and case definition for SARS-CoV-2 infection in pregnant women, fetuses, and neonates. Acta Obstet Gynecol Scand. 2020 May;99(5):565–8.

Huh S. How to train health personnel to protect themselves from SARS-CoV-2 (novel coronavirus) infection when caring for a patient or suspected case. J Educ Eval Health Prof. 2020 Jan;17:10.

Zhang Z, Liu S, Xiang M, Li S, Zhao D, Huang C, et al. Protecting healthcare personnel from 2019-nCoV infection risks: lessons and suggestions. Front Med. 2020 Apr;14(2):229–31.

Gobierno de Mexico. Versión estenográfica. Conferencia de prensa. Informe diario sobre coronavirus COVID-19 en México 24-03-2020. Available from: https://www.gob.mx/presidencia/articulos/version-estenografica-conferencia-de-prensa-informe-diario-sobre-coronavirus-covid-19-en-mexico-240978?fbclid=IwAR0eb_SC3RN2f921tq-qw79EFSQIfpPNKzVHF5qsR0zTfBWtvccyvoM9rTg. Last updated Mar 24, 2020; cited May 26, 2020.

Wilder-Smith A, Teleman MD, Heng BH, Earnest A, Ling AE, Leo YS. Asymptomatic SARS coronavirus infection among healthcare workers, Singapore. Emerg Infect Dis. 2005 Jul;11(7):1142–5.

Secretaría de Salud. Lineamiento técnico de uso y manejo del equipo de protección personal ante la pandemia por COVID-19. Available from: https://coronavirus.gob.mx/wp-content/uploads/2020/05/Lineamiento_uso_manejo_EPP_COVID-19.pdf. Last updated May 12, 2020; cited May 26, 2020.

He X, Lau EHY, Wu P, Deng X, Wang J, Hao X, et al. Temporal dynamics in viral shedding and transmissibility of COVID-19. Nat Med. 2020 May;26(5):672–5.

Gandhi M, Yokoe DS, Havlir D V. Asymptomatic Transmission, the Achilles’ Heel of Current Strategies to Control Covid-19. N Engl J Med. 2020 May 28;382(22):2158–60.

Wang J, Zhou M, Liu F. Reasons for healthcare workers becoming infected with novel coronavirus disease 2019 (COVID-19) in China. J Hosp Infect. 2020 May;105(1):100–101.

Chen MIC, Lee VJM, Barr I, Lin C, Goh R, Lee C, et al. Risk factors for pandemic (H1N1) 2009 virus seroconversion among hospital staff, Singapore. Emerg Infect Dis. 2010 Oct;16(10):1554–61.

Jackson D, Anders R, Padula W V, Daly J, Davidson PM. Vulnerability of nurse and physicians with COVID-19: Monitoring and surveillance needed. J Clin Nurs. 2020 Oct;29(19-20):3584–87.

Bernard H, Fischer R, Mikolajczyk RT, Kretzschmar M, Wildner M. Nurses’ contacts and potential for infectious disease transmission. Emerg Infect Dis. 2009 Sep;15(9):1438–44.

Huang L, Lin G, Tang L, Yu L, Zhou Z. Special attention to nurses’ protection during the COVID-19 epidemic. Crit Care. 2020 Mar 27;24(1):120.

Wei L, Fang T, Fang L-Q, de Vlas SJ, Ma H-J, Zhou J-P, et al. Risk factors for SARS infection among hospital healthcare workers in Beijing: a case control study. Trop Med Int Heal. 2009 Oct 7;14(1):52–9.

Prieto-Miranda SE, Jiménez-Bernardino CA, Cázares-Ramírez G, De Vera-Haro MJ, Esparza-Pérez RI. [Working hours and their repercussions on resident doctors in a second level hospital]. 2015 Nov;31:669–79. Esp

Acosta-Fernández M, Aguilera-Velasco MA, Pozos-Radillo BE, Torres-López TM, Parra Osorio L. [Experiences of Mexican resident physicians during their first year of education]. Inv Ed Med. 2017 Nov 8;6(23):169–79. Esp

Weiss P, Kryger M, Knauert M. Impact of extended duty hours on medical trainees. Sleep Health. 2016 Dec;2(4):309–15.

Ridout KK, Ridout SJ, Guille C, Mata DA, Akil H, Sen S. Physician-Training Stress and Accelerated Cellular Aging. Biol Psychiatry. 2019 Nov 1;86(9):725–30.

Dirección General de Calidad y Educación en Salud. Statement No DGCES-DG-0436-2020 Undergraduate Intern Physicians During Phase II of contingency due to COVID-19 pandemic. Mexico City; Apr 7, 2020. Available from: https://www.amfem.edu.mx/index.php/acerca/comunicados?start=3. Last updated Apr 7, 2020; cited May 26, 2020.

Whiteside T, Kane E, Aljohani B, Alsamman M, Pormand A. Redesigning emergency department operations amidst a viral pandemic. Am J Emerg Med. 2020 Jul;38(7):1448–53.

Canova V, Lederer Schlpfer H, Piso RJ, Droll A, Fenner L, Hoffmann T, et al. Transmission risk of SARS-CoV-2 to healthcare workers – observational results of a primary care hospital contact tracing. Swiss Med Wkly. 2020 Apr 25;150:w20257.

Weissman DN, de Perio MA, Radonovich Jr LL. COVID-19 and risks posed to personnel during endotracheal intubation. JAMA. 2020 May 26;323(20):2027–8.

Published

2020-12-09

How to Cite

Yamamoto-Moreno, J. A., Pineda-Aguilar, C., Ruiz-Pérez, S., Gortarez-Quintana, G. L., & Ruiz-Dorado, M. A. (2020). SARS-CoV-2 Infection Among Healthcare Workers in Tijuana, Mexico: A Cross-Sectional Study. International Journal of Medical Students, 8(3), 220–230. https://doi.org/10.5195/ijms.2020.625

Issue

Section

Original Article

Categories

Similar Articles

You may also start an advanced similarity search for this article.