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Portuguese Journal of Public Health
Print version ISSN 2504-3137On-line version ISSN 2504-3145
Abstract
LUCACCIONI, Héloïse et al. Risk of COVID-19 in Health Professionals: A Case-Control Study, Portugal. Port J Public Health [online]. 2021, vol.39, n.3, pp.137-144. Epub Dec 31, 2021. ISSN 2504-3137. https://doi.org/10.1159/000519472.
Introduction:
Health professionals face higher occupational exposure to SARS-CoV-2. We aimed to estimate the risk of COVID-19 test positivity in health professionals compared to non-health professionals.
Methods:
We conducted a test-negative case-control study using Portuguese national surveillance data (January to May 2020). Cases were suspected cases who tested positive for SARS-CoV-2; controls were suspected cases who tested negative. We used multivariable logistic regression modelling to estimate the odds ratio of a positive COVID-19 test (RT-PCR; primary outcome), comparing health professionals and non-health professionals (primary exposure), and adjusting for the confounding effect of demographic, clinical, and epidemiological characteristics, and the modification effect of the self-reported epidemiological link (i.e., self-reported contact with a COVID-19 case or person with COVID-19-like symptoms).
Results:
Health professionals had a 2-fold higher risk of a positive COVID-19 test result (aOR = 1.89, 95% CI 1.69-2.11). However, this association was strongly modified by the self-report of an epidemiological link such that, among cases who did report an epidemiological link, being a health professional was a protective factor (aOR = 0.90, 95% CI 0.82-0.98).
Conclusion:
Our findings suggest that health professionals might be primarily infected by unknown contacts, plausibly in the healthcare setting, but also that their occupational exposure does not systematically translate into a higher risk of transmission. We suggest that this could be interpreted in light of different types and timing of exposure, and variability in risk perception and associated preventive behaviours.
Keywords : COVID-19; SARS-CoV-2; Health professionals; Portugal.