Impact of the variability of criteria for the return to work of healthcare workers with COVID-19 disease

Multicenter study in Navarra, La Rioja and Galicia. March-september 2020.

Abstract

Background: The Covid-19 pandemic caused by the SARS-CoV-2 virus has generated a great burden on health systems, and healthcare workers have been the most affected. In Spain, the Health Ministry issued common protocols regarding the return-to-work of healthcare workers presenting a negative PCR (Polymerase Chain Reaction) test result and complete resolution of symptoms. Some autonomous communities decided to include a CT (Cycle Threshold) value criterion as well. The aim of this paper was to compare the time intervals required to obtain a negative PCR result by means of both criteria.

Methods: A multicenter, cross-sectional study was performed from March to September of 2020, in the health areas of Navarra, La Rioja and Vigo (Galicia), managed by their own Occupational Risk Prevention Units. The PCR negativization time intervals were analyzed according to gender, age, professional category and the PCR repetition criteria used (clinical or defined by CT). Mean difference calculation by Student’s t-test and Kaplan-Meier survival analyzes were conducted.

Results: The sample amounted to a total of 1,052 workers: 673 from Navarra, 335 from La Rioja and 44 from Vigo, with an average age of 46 years, and of which 81% were women, 35.48% nursing personnel and 23.65% physicians. No statistically significant differences were found between the PCR negativization time periods with any of the variables, except with the CT criterion, which presented a mean of 6.49 days (95% CI, 4.96-8.02), longer and displaying positively displaced survival curves.

Conclusions: The CT criterion for carrying out the control PCR test lengthened the reincorporation of essential personnel in the fight against the pandemic.