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Updated: Oct 9, 2025
Author Spotlight: Advancements in Multiplex Detection of Respiratory Viruses
Published on: November 10, 2023
COVID-19 outbreaks in hospital workers during the first COVID-19 wave
L Piapan1, P De Michieli1, F Ronchese1
1Unit of Occupational Medicine, Department of Medical Sciences, University of Trieste, Trieste 34100, Italy.
Insights
Hospital workers faced a 5% COVID-19 infection rate, primarily from patient and colleague contact early in the pandemic. Regular testing and follow-up proved vital for early detection and infection control among healthcare workers.
Area of Science:
- Infectious Diseases
- Epidemiology
- Occupational Health
Background:
- Healthcare workers (HCWs) are critical in infection prevention and patient care.
- The COVID-19 pandemic posed significant risks to frontline HCWs.
- Understanding workplace transmission is key to protecting healthcare staff.
Purpose of the Study:
- To determine the prevalence of hospital-acquired COVID-19 among HCWs at the University Hospital of Trieste.
- To identify factors associated with COVID-19 infection in HCWs exposed to patients with the virus.
- To evaluate the impact of early pandemic measures on infection rates.
Main Methods:
- A cohort of 963 HCWs with potential COVID-19 exposure was followed from March 1 to May 31.
- Nasopharyngeal swabs for SARS-CoV-2 detection via RT-PCR were performed every 3 days.
- Data on symptoms, workplace exposure, and implemented control measures were collected.
Main Results:
- 193 HCWs (5%) tested positive for COVID-19, with 86% exhibiting symptoms.
- Five major outbreaks occurred, with four preceding universal masking.
- Higher infection risk was observed in high-risk wards (OR 13.4), symptomatic individuals (OR 5.4), and those with close contacts (OR 2.23).
Conclusions:
- Hospital-acquired COVID-19 in HCWs was primarily linked to patient and colleague contact, especially in the early pandemic phase before universal masking.
- Proactive surveillance through repetitive testing facilitated early case identification, even before symptom onset.
- These findings underscore the importance of consistent infection control measures and surveillance for HCWs during pandemics.
Background:
Health care workers (HCWs) are on the frontline, playing a crucial role in the prevention of infection and treatment of patients.
Aims:
This study was aimed to evaluate the prevalence of hospital-acquired coronavirus disease 2019 (COVID-19) infection at work and related factors at the University Hospital of Trieste workers exposed to COVID-19 patients.
Methods:
From March 1 to May 31, of 4216 employees, 963 were in contact with COVID-19 patients or colleagues and were followed up. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in nasopharyngeal swabs was determined every 3 days, by RT-PCR.
Results:
During the follow-up period, 193 workers were positive for COVID-19 (5%), and 165 of these (86%) were symptomatic. We identified five major cluster outbreaks of COVID-19 infection in Trieste Hospitals, four of which occurred before the implementation of universal masking for HCWs and patients (1-14 March 2020). COVID-19 infection was significantly higher in high-risk ward workers (Infectious Diseases, and Geriatric and Emergency Medicine, odds ratio [OR] 13.4; 95% confidence interval [CI] 5.8-31), in subjects with symptoms (OR 5.4; 95% CI 2.9-10) and in those with contacts with COVID-19 patients and colleagues (OR 2.23; 95% CI 1.01-4.9).
Conclusions:
Hospital workers were commonly infected due to contact with COVID-19 patients and colleagues, mainly in the first 15 days of the pandemic, before the implementation of universal mask wearing of HCWs and patients. Repetitive testing and follow-up permitted the identification of COVID-19 cases before symptom onset, obtaining better infection prevention and control.
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