COVID-19 impact and vaccine effectiveness among healthcare workers of a large University Hospital in Lombardy, Italy

Main Article Content

Marco Mendola
Fabio Tonelli
Francesca Stefania Garletti
Daniela Greco
Michela Fiscella
Isabella Cucchi
Maria Cristina Costa
Paolo Carrer

Keywords

Sars-CoV-2, Healthcare workforce, Occupational medicine, Health Surveillance, BNT162b2 mRNA Vaccine

Abstract

Background: Healthcare Workers (HCWs) are a key element in managing the COVID-19 pandemic, but they are also at high risk of infection. Objective: The aim of this study was to describe, in a large university hospital which provided healthcare services to patients with SARS-CoV-2 infection, the course of the epidemic among HCWs and effectiveness of COVID-19 vaccination in reducing SARS-CoV-2 infection and disease. Methods: Our case series included all “Fatebenefratelli Sacco” University Hospital workers. Data were collected until the 15th of May 2021 and analysed as part of the health surveillance program carried out by the Occupational Health Unit. Results: From March 2020 until May 2021, 14.4% of workers contracted COVID-19, with the highest incidence peak recorded during the second wave of the pandemic. The prevalence of infection was slightly higher in males than in females, and a greater number of cases was found in job categories characterized by direct patient care activities. We reported a higher prevalence of “serious/critical illness” in elder workers. A clear reduction of COVID-19 incidence was found in our population during the third pandemic wave, that coincided with the start of vaccination campaign. Discussion: HCWs have been at high risk of COVID-19 infection. Male sex and advanced age appear to be predisposing factor and negative prognostic factor respectively. An out-of-hospital setting appears to be the main source of COVID-19 confirming that the correct use of protective devices during work counters the risk of infection. Vaccination seems to reduce both documented cases of infection and severe illness.

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References

1. Ren LL, Wang YM, Wu ZQ, et al. Identification of a novel coronavirus causing severe pneumonia in human: a descriptive study. Chin Med J (Engl). 2020;133(9):1015-1024. doi:10.1097/CM9.0000000000000722
2. Coronavirus Disease (COVID-19) Situation Reports. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports. (last accessed: May 2021)
3. World Health Organization (WHO). WHO Coronavirus Disease (COVID-19) Weekly Epidemiological Update - 11 May 2021
4. La Maestra S, Abbondandolo A, De Flora S. Epidemiological trends of COVID-19 epidemic in Italy over March 2020: From 1000 to 100 000 cases. J Med Virol. 2020;92(10):1956-1961. doi:10.1002/jmv.25908
5. Novel coronavirus: daily report. Italian Minister of Health. Avaiable from: https://www.salute.gov.it/portale/nuovocoronavirus/homeNuovoCoronavirus.jsp?lingua=english. (last accessed: May 2021)
6. Eurosurveillance Editorial Team. Updated rapid risk assessment from ECDC on coronavirus disease 2019 (COVID-19) pandemic: increased transmission in the EU/EEA and the UK. Euro Surveill. 2020;25(12):2003121. doi:10.2807/1560-7917.ES.2020.25.12.2003261
7. Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China [published correction appears in JAMA. 2021 Mar 16;325(11):1113]. JAMA. 2020;323(11):1061-1069. doi:10.1001/jama.2020.1585
8. Novel Coronavirus – daily vaccine report. Italian Minister of Health. Available at: https://www.governo.it/it/cscovid19/report-vaccini/. (last accessed: May 2021)
9. Dagan N, Barda N, Kepten E, et al. BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Mass Vaccination Setting. N Engl J Med. 2021;384(15):1412-1423. doi:10.1056/NEJMoa2101765
10. Superior Health Institute. COVID-19 integrated surveillance: the main national data. Avaiable at: https://www.epicentro.iss.it/coronavirus/sars-cov-2-sorveglianza-dati. (last accessed: May 2021)
11. Torresi M. Statistiche Coronavirus nel Mondo. Fonti: Worldometer, CSSE, Protezione civile. Avaiable at: https://statistichecoronavirus.it/coronavirus-italia/coronavirus-lombardia/coronavirus-milano/ (last accessed: September 2021)
12. Coronavirus: la normativa vigente. Italian Government. Avaiable at: https://www.governo.it/it/coronavirus-normativa. (last accessed: May 2021)
13. Mandić-Rajčević S, Masci F, Crespi E, et al. Source and symptoms of COVID-19 among hospital workers in Milan. Occup Med (Lond). 2020;70(9):672-679. doi:10.1093/occmed/kqaa201
14. Consonni D, Bordini L, Nava C, et al. COVID-19: What happened to the healthcare workers of a research and teaching hospital in Milan, Italy?. Acta Biomed. 2020;91(3):e2020016. Published 2020 Sep 7. doi:10.23750/abm.v91i3.10361
15. Garzaro G, Clari M, Ciocan C, et al. COVID-19 infection and diffusion among the healthcare workforce in a large university-hospital in northwest Italy. Med Lav. 2020;111(3):184-194. Published 2020 Jun 26. doi:10.23749/mdl.v111i3.9767
16. Al Maskari Z, Al Blushi A, Khamis F, et al. Characteristics of healthcare workers infected with COVID-19: A cross-sectional observational study. Int J Infect Dis. 2021;102:32-36. doi:10.1016/j.ijid.2020.10.009
17. Gholami M, Fawad I, Shadan S, et al. COVID-19 and healthcare workers: A systematic review and meta-analysis. Int J Infect Dis. 2021;104:335-346. doi:10.1016/j.ijid.2021.01.013
18. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-513. doi:10.1016/S0140-6736(20)30211-7
19. CDC COVID-19 Response Team. Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) - United States, February 12-March 16, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(12):343-346. Published 2020 Mar 27. doi:10.15585/mmwr.mm6912e2
20. Grasselli G, Zangrillo A, Zanella A, et al. Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy [published correction appears in JAMA. 2021 May 25;325(20):2120]. JAMA. 2020;323(16):1574-1581. doi:10.1001/jama.2020.5394
21. Sansone E, Tiraboschi M, Sala E, et al. Effectiveness of BNT162b2 vaccine against Sars-CoV-2 among healthcare workers. Med Lav 2021; 112, 3: 250-255. doi: 10.23749/mdl.v112i3.11747
22. European Centre for Disease Prevention and Control. Interim guidance on the benefits of full vaccination against COVID-19 for transmission risks and implications for non-pharmaceutical interventions – 21 April 2021. ECDC: Stockholm; 2021.