COVID-19 in health-care workers: lessons from SARS and MERS epidemics and perspectives for chemoprophylaxis and vaccines.

ABSTRACT

Introduction: The world is now facing the COVID-19 pandemic. Experience with SARS-CoV and MERS-CoV, and early reports about SARS-CoV-2 infection suggest that health-care settings and health-care workers (HCWs) are vulnerable in the context of the emergence of a new coronavirus.

Areas covered: To highlight the need for prophylactic strategies particularly for HCWs, we identified SARS-CoV, MERS-CoV, and SARS-CoV-2 outbreaks in health-care settings and the incidence of infections in HCWs by a search on MEDLINE and MEDxRIV (for SARS-Cov-2). To identify prophylactic strategies against, we conducted a search on MEDLINE and clinicaltrials.gov about studies involving SARS-CoV, MERS-CoV, and SARS-CoV-2.

Expert opinion: HCWs account for a great part of SARS, MERS, and SARS-CoV-2 infections, they may also contribute to the spread of the disease, particularly in health-care settings, and contribute to nosocomial outbreaks. Some preventive strategies were evaluated in previous emerging coronavirus epidemics, particularly in MERS-CoV. For COVID-19 prevention, different chemoprophylaxis with drug repositioning and new agents are under evaluation, and different vaccine candidates entered clinical development, with clinical trials. HCWs are a crucial target population for pre-exposure and post-exposure prophylaxis.

KEYWORDS:

• SARS-CoV
• MERS-CoV
• Covid-19
• healthcare workers
• healthcare personnel
• outbreaks
• nosocomial transmission
• prevention
• pre-exposure prophylaxis
• post-exposure prophylaxis
• vaccines

Article highlights

• SARS-CoV, MERS-CoV, and SARS-CoV-2 were and are responsible for nosocomial outbreaks.

• HCWs accounted for a large number of infected people during the COVID-19 pandemic.

• Protecting HCWs also mean protecting patients.

• A great number of prophylactic strategies are under evaluation: vaccines and nonvaccines

• A large number of chemoprophylactic trials has been launched: most of them focus on one drug: hydroxychloroquine.

• A COVID-19 vaccine will face the challenge of acceptance.

Declaration of interest

No, potential conflict of interest was reported by the authors.