Estimating COVID-19 recovery time in a cohort of Italian healthcare workers who underwent surveillance swab testing. (July 2021)

• Record Type: Journal Article
• Authors: Benoni, R.; Campagna, I.; Panunzi, S.; Varalta, M.S.; Salandini, G.; De Mattia, G.; Turrina, G.; Moretti, F.; Lo Cascio, G.; Spiteri, G.; Porru, S.; Tardivo, S.; Poli, A.; Bovo, C.
• Is Part Of: Public health. Volume 196(2021)
• Page Start: 52
• Page End: 58
• Publication Date: 2021-07
• Subjects: COVID-19 -- Healthcare workers -- Health surveillance -- Recovery time -- Swab test; Public health -- Periodicals; Public health -- Periodicals; Electronic journals; 362.1
• DOI: 10.1016/j.puhe.2021.05.014
• Languages: English
• ISSNs: 0033-3506

Abstract

Abstract: Objectives: The COVID-19 pandemic is putting a huge strain on the provision and continuity of care. The length of sickness absence of the healthcare workers as a result of SARS-CoV-2 infection plays a pivotal role in hospital staff management. Therefore, the aim of this study was to explore the timing of COVID-19 recovery and viral clearance, and its predictive factors, in a large sample of healthcare workers. Study design: This is a retrospective cohort study. Methods: The analysis was conducted on data collected during the hospital health surveillance programme for healthcare staff at the University Hospital of Verona; healthcare workers were tested for SARS-CoV-2 through RT-PCR with oronasopharyngeal swab samples. The health surveillance programme targeted healthcare workers who either had close contact with SARS-CoV-2–infected patients or were tested as part of the screening-based strategy implemented according to national and regional requirements. Recovery time was estimated from the first positive swab to two consecutive negative swabs, collected 24 h apart, using survival analysis for both right-censored and interval-censored data. Cox proportional hazard was used for multivariate analysis. Results: During the health surveillance programme, 6455 healthcare workers were tested for SARS-CoV-2 and 248 (3.8%, 95% confidence interval [CI]: 3.4–4.3) reported positive results; among those who tested positive, 49% were asymptomatic, with a median age of 39.8 years, which is significantly younger than symptomatic healthcare workers (48.2 years, P < 0.001). Screening tests as part of the health surveillance programme identified 31 (12.5%) of the positive cases. Median recovery time was 24 days (95% CI: 23–26) and 21.5 days (95% CI: 15.5–30.5) in right- and interval-censoring analysis, respectively, with no association with age, sex or presence of symptoms. Overall, 63% of participants required >20 days to test negative on two consecutive swabs. Hospitalised healthcare workers (4.8%) were older and had a significantly longer recovery time compared with non-hospitalised healthcare workers in both analyses (33.5 vs 24 days, P = 0.005). Conclusions: Recovery from COVID-19 and viral clearance may take a long time, especially in individuals who are hospitalised. To detect asymptomatic cases, screening programmes for healthcare workers is recommended.