Risk Groups for SARS-CoV-2 Infection among Healthcare Workers: Community Versus Hospital Transmission

Background: We aimed to detect the risk factors for SARS-CoV-2 infection among healthcare workers (HCWs) in 2020 before the vaccination era. Methods: We surveyed SARS-CoV-2 infection among the HCWs in a hospital through screening for antibody levels and the detection of viral RNA by RT-PCR between May 2020 and December 2020. Occupational and non-occupational potential predictors of disease were surveyed for the HCWs included in this study. Results: Among 1925 personnel in the hospital, 1732 were included to the study with a response rate of 90%. The overall infection rate of HCWs was 16.3% at the end of 2020, before vaccinations started. In the multivariate analysis, being janitorial staff (OR: 2.24, CI: 1.21-4.14, p = 0.011), being a medical secretary (OR: 4.17, CI: 2.12-8.18, p < 0.001), having at least one household member with a COVID-19 diagnosis (OR: 8.98, CI: 6.64-12.15, p < 0.001), and number of household members > 3 (OR: 1.67, CI: 1.26-2.22, p < 0.001) were found to be significantly associated with SARS-CoV-2 infection. Conclusions: Medical secretaries and janitorial staff were under increased risk of SARS-CoV-2 infection. The community-hospital gradient can explain the mode of transmission for infection among HCWs. In the setting of this study, community measures were less strict, whereas hospital infection control was adequate and provided necessary personal protective equipment. Increasing risk in larger households and households with diagnosed COVID-19 patient indicates the community-acquired transmission of the infection.