RESUMO
OBJECTIVE: Healthcare workers are at risk for COVID-19 contamination. It is important to protect them in order to reduce nosocomial transmission and maintain the assistance capacity of health systems. To evaluate the diagnostic test and retest strategy with RT-PCR for SARS-CoV-2 and factors associated with the diagnosis of COVID-19 among healthcare workers. PATIENTS AND METHODS: Cross-sectional study carried out in a Brazilian hospital. From April 27 to June 16, 2020, symptomatic healthcare workers underwent an RT-PCR test on upper respiratory tract specimens as soon as possible and, if negative, it was repeated close to the 5th day of symptom evolution. Working areas were divided into assistance areas dedicated or not dedicated to COVID-19 and non-assistance areas. The type of activity was divided into assistance or non-assistance activity. RESULTS: 775 individuals were evaluated. 114 were diagnosed with COVID-19, of whom 101 followed the testing protocol. A second RT-PCR identified five (4.9%) of the positive cases. Working in an area dedicated to patients with COVID-19 was more prevalent among positive cases (35.1% x 19.8%, p=0.001) as well as working in an assistance activity (80.7% x 70.8%, p=0.031). CONCLUSIONS: A second RT-PCR test after the 5th day of symptom evolution showed limited diagnostic improvement. The adoption of a single test-based strategy, carried out at the right time after the onset of symptoms, allows the optimal use of resources. Working in a COVID-19 dedicated area and in direct contact with patients is related to a higher prevalence of COVID-19 among symptomatic healthcare workers.
Assuntos
Teste de Ácido Nucleico para COVID-19/métodos , COVID-19/diagnóstico , Pessoal de Saúde , Adulto , Brasil/epidemiologia , COVID-19/epidemiologia , COVID-19/fisiopatologia , Progressão da Doença , Feminino , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional , Masculino , Pessoa de Meia-Idade , Prevalência , SARS-CoV-2 , Fatores de TempoRESUMO
Management of SARS-CoV-2 requires safe decision-making to minimize contamination. Healthcare workers and professionals in confined areas are affected by the risk of the activity and the environment. Isolation of contaminated workers and healthcare professionals requires clinical and diagnostic criteria. On the other hand, interrupting the isolation of healthcare employees and professionals is critical because diagnostic tests do not support clinical decisions. In addition to defining the best test in view of its accuracy, it is necessary to consider aspects such as the stage of the disease or cure, the viral load and the individual's own immunity. Uncertainty about natural and herd immunity to the disease leads to the development of appropriate antivirals, diagnostic tests and vaccines.