key: cord-1052412-f0pg1sjl authors: Sali, Shahnaz; Rezaei, Mitra; Marjani, Majid; Tehrani, Shabnam; Abdolmohammadzadeh, Amirmohammad; Soheili, Amirali; Yadegarynia, Davood; Abolghasemi, Sara title: Descriptive Analysis of COVID-19 among Health Care Workers in a Tertiary Center in Iran date: 2021-03-03 journal: Tanaffos DOI: nan sha: d19522991fc34fa9b893ce76021d18c7691ac965 doc_id: 1052412 cord_uid: f0pg1sjl BACKGROUND: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) spread widely all around the world and has infected too many healthcare workers (HCWs) as the pioneers combating coronavirus disease 2019 (COVID-19). This study aims to evaluate the symptoms and outcome of medical staff from a tertiary hospital in Tehran, Iran. MATERIALS AND METHODS: The diagnoses of 29 HCWs presenting COVID-19 symptoms were confirmed by molecular and imaging studies. Epidemiologic and disease-related data were collected via phone calls and filling a questionnaire and then analyzed descriptively. RESULTS: Eighteen (62.1%) of the affected HCWs were males. The mean age of them was 41.86 years with a lower average (38.27) for females than males. Nurses comprised 41.4% of our population. Only 2 (6.9%) patients were admitted to the respiratory care unit (RCU) (), marked as critical patients. The most presented symptoms were fever (79.3%) and dyspnea (79.3%). Overall, 55.2% of them had a longer exposure time (more than a week), which was more frequent in men than women. CONCLUSION: Fever was the most prevalent symptom among the study group. Even though the clinical features of COVID-19 among HCWs cannot be copiously determined by this study, it highlights the requirement for comparative studies to illustrate differences among HCWs and the general population. There might be an association between the duration of the exposure and the risk of the infection in men. . Since then, it has spread very rapidly worldwide (3) and became a public health emergency and an "international concern" announced by the World Health Organization (WHO) (4) . By 20 December 2020, 75129306 confirmed cases and 1680794 COVID-19 related deaths have been reported globally (5) . Sali S, et al. 247 The clinical presentation of this disease is like the symptoms of older known coronavirus disease, the severe acute respiratory syndrome (SARS) including a range of symptoms from fever, dyspnea, dry cough, fatigue, and pharyngodynia in mild cases to acute respiratory distress syndrome (ARDS) and death in very severe and complicated cases (1) . Dr. Li Wenliang was the first clinician who warned about this serious condition and tragically lost his life due to SARS-CoV-2 contraction and became a member of the long list of health care workers (HCWs) to be the victim of Middle East Respiratory Syndrome (MERS), SARS, Ebola, and currently SARS-CoV-2 (6). Like him, since the beginning of this pandemic health care staff contributed a lot in this battle. As a result many of them became afflicted with SARS-CoV-2 and unfortunately, thousands of them died while helping their patients demonstrating that they are at an inevitable risk of infection, due to the more exposure to pathogens, long working shifts, exhaustion and also the shortage of knowledge and personal protective equipment (PPE) especially at the beginning of the epidemic (7, 8) . Just in China, more than 4% of patients were medical staff including nearly 3,300 persons. Likewise, up to 25th March 2020, one percent of the medical staff in Spain contracted COVID-19 and consisted 13.6% of the total confirmed cases in this country (9) . Hitherto, accurate statistics on the incidence rate of COVID-19 among medical staff are not available. Formerly, the secretary of the national headquarter of combat against COVID-19 announced that among 150,000 active HCWs (including 20,000 doctors and 100,000 nurses) more than a hundred people have died (10) , but there isn't any evidence of a distinct incidence rate for medical staff in Iran and also little is known about their health status. worldwide (11) . Furthermore, another official agent has announced that Iran stands third in the countries with the most SARS-C0V-2 afflicted HCWs after the United States and Russia (12) . It seems that HCWs have more academic knowledge and therefore use PPE such as N95 respirators, goggles, and protective clothing properly (13) , but there is a noticeable incidence rate among HCWs of our hospital leading us to report their conditions. Herein, we present the clinical manifestations, disease severity, possible exposures, the approach of diagnosis, and outcome of this disease among the HCWs in a tertiary hospital in Iran. We only knew that nearly 29 HCWs contracted COVID-19 in this hospital and got well, so through a call, we asked them about their identification (ID), the position at the hospital, whether they worked at the front-line departments, medical history with a better focus on chronic medical comorbidities (diabetes mellitus type 2, hypertension, etc.), high-risk activities such as direct and close contact with patients during visits, physical examination and check of vital signs (blood pressure, body temperature, etc.), and usage of PPE such as masks and gloves by them at least during high-risk activities. We had a better focus on the number of days they had these highrisk activities before they started developing the disease. Other data such as certain symptoms, diagnostic evidence, and medication used for treatment were also obtained. Furthermore, HCWs who were confirmed with COVID-19 diagnosis less than 15 days after the national epidemic announcement were defined as having shorttime exposure, and those working for 15 days and more were defined as having long-time exposure. According to the report of the WHO-China Joint Mission on COVID-19, patients of this study were classified into three groups: 1) Mild to moderate cases including non-pneumonia and pneumonia cases whom underwent treatment at home and self-quarantine. 2) Severe cases were admitted to the hospital general wards and had dyspnea, respiratory rate ≥30/minute, at room blood oxygen saturation ≤90%, PaO2/FiO2 ratio <300, and more than 50% of the lung field involvement within 24-48 hours. 3) Patients with respiratory failure, septic shock, and/or multiple organs dysfunction/failure, and who were admitted to the Respiratory Care Unit (RCU) were classified as critical cases (14) . All the information was then added to the SPSS software (ver. 26 .0) and the descriptive analysis was conducted. pandemic until 15 April 2020 globally (11) . Moreover, in a report from centers for disease control and prevention (CDC-US government) among 49,370 confirmed cases, 9,282 (19%) were HCWs (16) . As a study by Liu et al. (2) nurses were more frequently affected compared to the physicians, possibly due to closer and longer contacts with patients and performing more high risk (17) HCWs cannot be copiously determined by this study, it highlights the requirement for comparative studies to illustrate differences among HCWs and the general population . 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Through this article, we hope to have a chance to thank them and demonstrate how vulnerable they can be during their service. No financial support was provided for this study. All authors state no conflicts of interest relevant to this study.