Healthcare Workers’ Vulnerability to SARS-CoV-2 in Western Romania: A Study on Incidence and Risk Factors for Non-Vaccination and Reinfection

Figures & data

Figure 1 The evolution of COVID-19 incidence in the community and among medical personnel.

Figure 2 The impact on various categories of medical personnel depending on specialty.

Figure 3 Vaccine status of medical staff reported as COVID-19-positive.

Table 1 Variables with Statistically Significant Differences Between the 4 Categories of Personnel

Variable	E1 = Higher Education Medical Staff N1 = 630	E2 = Medium Education Medical Staff N2 = 979	E3 = Auxiliary Medical Staff N3 = 620	E4 = Administrative Staff N4 = 132	p
Age [median, IQR]	31.00[27.00–44.00]	41.00[33.00–47.00]	47.00[41.00–53.00]	49.00[40.00–56.00]	<0.001
F gender [n(%)]	415(65.87)	880(89.89)	490(79.03)	80(60.61)	<0.001
M gender [n(%)]	215(34.13)	99(10.11)	130(20.97)	52(39.39)
Cough [n(%)]	188(29.84)	241(24.62)	135(21.77)	25(18.94)	0.003
Fatigue [n(%)]	140(22.22)	161(16.45)	82(13.23)	16(12.12)	<0.001
Odynophagia [n(%)]	207(32.86)	327(33.40)	184(29.68)	30(22.73)	0.05
Rhinorrhea [n(%)]	190(30.16)	242(24.72)	131(21.13)	19(14.39)	<0.001
Anosmia [n(%)]	12(1.90)	23(2.35)	23(3.71)	10(7.58)	0.001
Ageusia [n(%)]	10(1.59)	14(1.43)	15(2.42)	7(5.30)	0.016
Number of symptoms [median, IQR]	2.00[0.00–3.00]	2.00[0.00–3.00]	1.00[0.00–3.00]	1.50[0.00–3.00]	0.005
Reinfection [n(%)]	72(11.43)	210(21.45)	126(20.32)	20(15.15)	<0.001
Unvaccinated [n(%)]	43(6.83)	275(28.09)	182(29.35)	30(22.73)	<0.001
Vaccinated - complete scheme [n(%)]	366(58.10)	415(42.39)	221(35.65)	48(36.36)	<0.001
Vaccinated after disease [n(%)]	217(34.44)	284(29.01)	213(34.35)	53(40.15)	0.011
No. of vaccine doses [median, IQR]	2.00[2.00–3.00]	2.00[0.00–2.00]	2.00[0.00–2.00]	2.00[1.00–3.00]	<0.001

Table 2 The Analysis of Cases Recorded During the 3 Community Waves

Variable	JAN-MAR/2021 n1 = 461	SEP-NOV/2021 n2 = 465	JAN-MAR/2022 n3 = 1304	p
Age [median, IQR]	42.00[33.00–50.00]	42.00[33.00–50.00]	41.00[30.00–48.00]	0.001
Auxiliary medical staff [n(%)]	129(27.98)	138(29.68)	312(23.93)	0.028
Higher education medical staff [n(%)]	114(24.73)	104(22.37)	384(29.45)	0.005
Resident physician [n(%)]	46(9.98)	50(10.75)	187(14.34)	0.019
Pediatric specialities [n(%)]	56(12.15)	59(12.69)	105(8.05)	0.003
Surgical specialities [n(%)]	115(24.95)	100(21.50)	376(28.83)	0.006
Paraclinical specialities [n(%)]	24(5.21)	30(6.45)	114(8.74)	0.028
Screening [n(%)]	154(33.41)	110(23.66)	54(4.14)	<0.001
Back from vacation [n(%)]	52(11.28)	45(9.68)	55(4.22)	<0.001
Asymptomatic [n(%)]	109(23.64)	75(16.13)	279(21.40)	0.012
Cough [n(%)]	71(15.40)	131(28.17)	362(27.76)	<0.001
Shivers [n(%)]	57(12.36)	81(17.42)	259(19.86)	0.001
Odynophagia [n(%)]	65(14.10)	115(24.73)	533(40.87)	<0.001
Myalgia [n(%)]	60(13.02)	90(19.35)	199(15.26)	0.024
Rhinorrhea [n(%)]	60(13.02)	147(31.61)	348(26.69)	<0.001
Anosmia [n(%)]	33(7.16)	28(6.02)	5(0.38)	<0.001
Ageusia [n(%)]	19(4.12)	22(4.73)	4(0.31)	<0.001
Number of symptoms [median, IQR]	0.00[0.00–2.00]	2.00[0.00–3.00]	2.00[0.00–3.00]	<0.001
Reinfection [n(%)]	17(3.69)	34(7.31)	370(28.38)	<0.001
Nonvaccinated [n(%)]	108(23.43)	141(30.32)	240(18.40)	<0.001
Vaccinated with Johnson & Johnson [n(%)]	92(19.96)	48(10.32)	148(11.35)	<0.001
Vaccinated with Pfizer-BioNTech[n(%)]	242(52.49)	260(55.91)	879(67.41)	<0.001
No. vaccine doses [median, IQR]	2.00[1.00–2.00]	2.00[0.00–3.00]	2.00[1.00–3.00]	<0.001
Deceased [n(%)]	2(0.43)	0(0)	0(0)	0.021
Recorded comorbidities [n(%)]	21(4.55)	17(3.66)	14(1.35)	<0.001

Table 3 The Analysis of Predictor Factors for the Vaccine Status of the Personnel

Variable	Non-Vaccinated n1 = 530	Completely Vaccinated n2 = 1050	p	OR [CI 95%]	p	HR [CI 95%]
Age [median, IQR]	43.00[35.00–51.00]	40.00[29.00–48.00]	<0.001	1.27[1.02–1.04]	/	/
Metropolitan area [n(%)]	73(13.77)	211(20.10)	0.002	0.63[0.47–0.85]	0.029	0.57[0.35–0.94]
Rural area [n(%)]	51(9.62)	62(5.90)	0.006	1.70[1.15–2.49]	/	/
F gender [n(%)]	451(85.09)	800(76.19)	<0.001	1.78[1.35–2.36]	/	/
Auxiliary medical staff [n(%)]	182(34.34)	221(21.05)	<0.001	1.96[1.55–2.48]	/	/
Medium education medical staff [n(%)]	275(51.89)	415(39.52)	<0.001	1.65[1.34–2.04]	/	/
Higher education medical staff [n(%)]	43(8.11)	366(34.86)	<0.001	0.16[0.12–0.23]	/	/
Nurse/midwife [n(%)]	270(50.94)	408(38.86)	<0.001	1.63[1.32–2.02]	/	/
Hospital attendant/cleaning staff [n(%)]	123(23.21)	149(14.19)	<0.001	1.82[1.40–2.38]	/	/
Specialist/consultant physician [n(%)]	24(4.53)	178(16.95)	<0.001	0.23[0.15–0.36]	<0.001	0.22[0.11–0.44]
Resident physician [n(%)]	15(2.83)	178(16.95)	<0.001	0.14[0.08–0.24]	<0.001	0.20[0.09–0.46]
Pediatric specialties[n(%)]	61(11.51)	84 (8.00)	0.022	0.15[1.05–2.12]	/	/
ICU [n(%)]	46(8.68)	139(13.24)	0.007	0.63[0.44–0.88]	/	/
Screening [n(%)]	110(20.75)	39(3.71)	<0.001	6.78[4.63–9.95]	<0.001	7.45[4.83–11.51]
Odynophagia [n(%)]	172(32.45)	423(40.29)	0.002	0.71[0.57–0.89]	/	/
Rhinorrhea [n(%)]	109(20.57)	285(27.14)	0.004	0.69[0.54–0.89]	/	/
Nausea [n(%)]	15(2.83)	13(1.24)	0.023	2.32[1.09–4.91]	0.008	3.25[1.37–7.73]
Anosmia [n(%)]	24(4.53)	3(0.29)	<0.001	16.55[4.96–55.23]	<0.001	17.48[4.85–63.07]
Ageusia [n(%)]	14(2.64)	3(0.29)	<0.001	9.47[2.71–33.09]	/	/

Table 4 The Analysis of Predictor Factors for Reinfection

Variable	Reinfection n1 = 428	First infection n2 = 1933	p	OR [CI 95%]	p	HR [CI 95%]
Medium education medical staff [n(%)]	210(49.07)	769(39.78)	<0.001	1.45[1.18–1.80]	/	/
Higher education medical staff [n(%)]	72(16.82)	558(28.87)	<0.001	0.50[0.38–0.65]	/	/
Screening [n(%)]	34(7.94)	318(16.45)	<0.001	0.44[0.30–0.63]	0.023	0.62[0.41–0.94]
Febrile syndrome [n(%)]	51(11.92)	308(15.93)	0.036	0.71[0.52–0.98]	/	/
Odynophagia [n(%)]	182(42.52)	566(29.28)	<0.001	1.90[1.53–2.36]	0.003	1.43[1.13–1.81]
Myalgia [n(%)]	43(10.05)	326(16.86)	<0.001	0.55[0.39–0.77]	<0.001	0.50[0.35–0.72]
Anosmia [n(%)]	3(0.70)	65(3.36)	0.001	0.20[0.06–0.65]	0.047	0.29[0.09–0.98]
Ageusia [n(%)]	3(0.70)	43(2.22)	0.050	0.31[0.09–1.00]	/	/
Non-vaccinated [n(%)]	135(31.54)	395(20.43)	<0.001	1.79[1.42–2.26]	<0.001	2.75[1.59–4.77]
Vaccinated with incomplete scheme [n(%)]	8(1.87)	5(0.26)	<0.001	7.34[2.39–22.56]	<0.001	17.70[5.10–68.54]
Vaccinated with complete scheme [n(%)]	254(59.35)	796(41.18)	<0.001	2.08[1.68–2.58]	<0.001	7.99[5.33–11.99]
Vaccinated with Pfizer-BioNTech [n(%)]	225(52.57)	1218(63.01)	<0.001	0.65[0.53–0.80]	0.046	0.61[0.38–0.99]
No. of vaccine doses [median, IQR]	2.00[0.00–2.00]	2.00[1.00–3.00]	<0.001	0.76[0.68–0.83]	<0.001	0.49[0.37–0.47]