SARS-CoV-2 infection among healthcare workers whom already received booster vaccination during epidemic outbreak of omicron variant in Taiwan

Wang-Huei Sheng; Hao-Chun Chang; Sui-Yuan Chang; Ming-Ju Hsieh; Yu-Cheng Chen; Yu-Yun Wu; Sung-Ching Pan; Jann-Tay Wang; Yee-Chun Chen

doi:10.1016/j.jfma.2022.12.003

SARS-CoV-2 infection among healthcare workers whom already received booster vaccination during epidemic outbreak of omicron variant in Taiwan

J Formos Med Assoc. 2023 May;122(5):376-383. doi: 10.1016/j.jfma.2022.12.003. Epub 2022 Dec 16.

Authors

Wang-Huei Sheng¹, Hao-Chun Chang², Sui-Yuan Chang³, Ming-Ju Hsieh⁴, Yu-Cheng Chen⁵, Yu-Yun Wu⁶, Sung-Ching Pan⁷, Jann-Tay Wang⁸, Yee-Chun Chen⁷

Affiliations

¹ Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan; School of Medicine, National Taiwan University College of Medicine, Taipei City, Taiwan. Electronic address: whsheng@ntu.edu.tw.
² Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu County, Taiwan.
³ Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Laboratory Medicine, National Taiwan University Hospital, Taipei City, Taiwan.
⁴ Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan; Occupational Safety and Health Office, National Taiwan University Hospital, Taipei, Taiwan.
⁵ Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan.
⁶ Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.
⁷ Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan; Infection Control Center, National Taiwan University Hospital, Taipei, Taiwan.
⁸ Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan; School of Medicine, National Taiwan University College of Medicine, Taipei City, Taiwan.

Abstract

Background/purpose: Healthcare workers (HCWs) are at risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection due to occupational exposure. We aim to investigate the prevalence and risk factors of SARS-CoV-2 infection among HCWs during epidemic outbreak of omicron variant in Taiwan.

Methods: Sequential reserved serum samples collected from our previous study during December 2021 and July 2022 were tested for antibodies against SARS-CoV-2 nucleocapsid protein (NP). Diagnosis of SARS-CoV-2 infection was defined as positive either of anti-SARS-CoV-2 nucleoprotein, rapid antigen test or polymerase chain reaction. Retrospective chart review and a questionnaire were used to access the symptoms and risk factors for SARS-CoV-2 infection.

Results: Totally 300 participants (69.3% female) with a median age of 37.9 years were enrolled. A significant increase incidence of SARS-CoV-2 infection was found before and during community outbreak (11.91 versus 230.93 per 100,000 person-days, P < 0.001), which was a trend paralleling that observed in the general population. For 61 SARS-CoV-2 infected participants, nine (14.8%) were asymptomatic. Multivariate analysis revealed recent contact with a SARS-CoV-2 infected household (odds ratio [OR], 7.01; 95% confidence interval [95% CI], 3.70-13.30; P < 0.001) and co-existed underlying autoimmune diseases (OR, 4.46; 95% CI, 1.28-15.51; P = 0.019) were significant risk factors associated with acquisition of SARS-CoV-2 infection among HCWs.

Conclusion: Community factors, such as closely contact with SARS-CoV-2 infected individuals and underlying immune suppression status, were significant factors for acquisition of SARS-CoV-2 infection among HCWs. We suggest the application of appropriate infection control measures for HCWs should be maintained to reduce risk of SARS-CoV-2 infection.

Keywords: Anti-SARS-CoV-2 nucleocapsid protein antibody; Coronavirus disease 2019 (COVID-19); Healthcare workers; Risk factors; Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2).

MeSH terms

Adult
COVID-19* / epidemiology
COVID-19* / prevention & control
Disease Outbreaks / prevention & control
Female
Health Personnel
Humans
Male
Retrospective Studies
SARS-CoV-2
Taiwan / epidemiology
Vaccination

Supplementary concepts

SARS-CoV-2 variants