Incidence of COVID-19 Infection in Nurses and their Families: A Prospective Cohort Study in Lahore

Background: Nurses, as frontline workers, are at a higher risk of contracting COVID19 and serve as a potential source of transmitting this infection to their family members. Estimating risk in this population is critical for controlling the rate of secondary attack rate among their families. Objective: To measure the incidence of COVID-19 in nurses and their families with associated risk factors for transmission of infection. Methods: A prospective cohort study was conducted in Akhtar Saeed Medical and Dental college, Lahore and associated three hospitals. A cohort of 176 nurses was identified in March 2020 by using non-probability convenience sampling technique and was followed till September 2021. During this tenure of one and a half year, incidence was observed by following the cohort and using a self-structured questionnaire. With SPSS 23, Chi square test was applied and p value of < 0.05 was considered significant. Results: In a cohort of 176 nurses, followed for one and a half year, incidence of COVID-19 was 37(21%). Secondary attack rate among household members of these nurses was 3%. A significant association was observed between the nursing staff and exposure to their family members (p = 0.002). Vaccination rate in nurses at the start of the study was only 26%. Nurses who worked directly with COVID-19 patients reported high incidence (p = 0.009). Nurses who used Personal protective equipment (PPE) were less affected (p = 0.003). Nurses with comorbidities showed higher incidence (p =0.02). Rate of psychological distress was high (p =0.007). Conclusion: Incidence of COVID-19 among nurses was 21% with secondary attack rate of 3% in families. Protective use of N 95 mask and comorbidities were associated with incidence.