Abstract
BACKGROUND: During the pandemic, a surveillance program to monitor COVID-19 infection among healthcare workers was established in Friuli Venezia Giulia Region (FVG), Italy. The aim of our study was to measure the risk of acquiring SARS-CoV-2 infection among nursing home employees by job title. METHODS: From March 1, 2020, to March 31, 2023, a retrospective population-based longitudinal study was conducted in 8880 nursing home employees. For each employee, all swabs up to the first positive result (n = 211.534) were considered. The study period was divided in six phases based on epidemic waves. Generalized estimated equations method for longitudinal binary data was applied with a time lag of a month, in each phase, obtaining an odds ratio (OR) and 95% confidence limit (95% CI) for each job category. RESULTS: In Phase 1 (1.3.2020-30.6.2020), compared with administrative assistants, jobs with high patient contact were at increased risk of infection: The OR and 95% CI were 3.52 (1.44-8.56) and 2.96 (1.15-7.66) in healthcare elementary occupation and physicians/nurses, respectively. Corresponding associations in Phase 2 (1.7.2020-31.1.2021) were 1.54 (1.18-2.02) and 1.41 (1.04-1.91). On the contrary, in Phase 6 (20.12.2021-31.3.2023) physicians/nurses were at a decreased risk (0.73 [0.58-0.91]). CONCLUSIONS: In nursing homes, the risk of COVID-19 infection varied by job title and pandemic phase. Virus higher infectivity, probability of closer contact, and better adherence to infection prevention control may explain part of these differences. Stronger nursing home-specific surveillance in patients and employees should be extended worldwide to control this high global burden of disease communities.