Risk Factors for Reverse Transcriptase Polymerase Chain Reaction Positivity for SARS-CoV-2 among Health Care Workers in a Group of Tertiary Care Hospitals in Mumbai: A Cross-sectional Study

Health Care Workers (HCWs) can acquire or transmit Corona Virus Disease 2019 (COVID-19) from and to patients respectively. There is limited data on risk factors for Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection among HCWs. Aim: To evaluate the risk factors for SARS-CoV-2 infection amongst HCWs of tertiary care hospitals in Mumbai, Maharashtra, India. Materials and Methods: A questionnaire based cross-sectional study was conducted among 801 HCWs from three tertiary care hospitals. Data regarding demography, co-morbidities (hypertension, diabetes, heart disease, cancer, immunosuppressive therapy, asthma), symptoms, contact with confirmed cases of COVID-19 and protective precautions at the work place was collected. Infection diagnosed by Respiratory Tract samples- Reverse Trancriptase Polymerase Chain Reaction (RT-PCR) test was correlated with the above factors. Results: Of the participants, 50.1% were working in designated COVID-19 area; 85.1% had no co-morbidity. A total of 62 of the 801 (7.75%) HCWs had a history of positive RT-PCR for SARS-CoV-2. Only asthma was associated with a significant higher in infection rate. Loss of taste/smell (30%), acute febrile illness (46.4%), acute respiratory illness (18.5%) were more common in persons with RT-PCR positivity (p<0.05). Visit to fever clinic, positive household member, and a definite history of exposure to a COVID-19 positive patient, were significantly associated with higher risk of infection. Working in designated COVID-19 hospital was not a significant risk factor (8.5% vs 5.6%). HCWs on Hydroxychloroquine (HCQ) prophylaxis had significantly lower rate of infection. Conclusion: Rate of SARS-CoV-2 positivity among HCWs was 7.7%. Presence of symptoms, especially, loss of taste/smell, fever and respiratory symptoms are associated with high positive rates. Working in a designated COVID hospital was not a risk factor for increased rate of infection. HCQ prophylaxis is associated with reduced rate of COVID-19 among HCWs.