The Role Of Routine SARS-Cov-2 Screening Of Healthcare-Workers In Acute Care Hospitals: A Systematic Review

Abstract

Background: The risk of SARS-CoV-2 infection among healthcare workers (HCWs) remains a concern, particularly in safeguarding vulnerable patient populations and preventing clinics from becoming COVID-19 transmission hubs. Asymptomatic transmission underscores the importance of routine screening to detect infections early and break transmission chains.

Methods: A systematic review was conducted [1]using Cochrane COVID-19 Study Register, Web of Science, and WHO COVID-19 Global literature to assess non-incident related testing of HCWs with polymerase chain reaction (PCR) tests . Studies were included, with a focus on risk of bias and representativeness assessment.

Results: Thirty-nine studies with varied designs were identified, spanning data collection across different regions globally. The sample sizes ranged from 70 to 9449 HCWs, with 1.9% testing positive for SARS-CoV-2 out of 51,700 asymptomatic HCWs. Positive test rates ranged from 0% to 14.3%, and no studies reported reductions in infected person-days due to HCW screening.

Discussion and Conclusions: Heterogeneous positivity rates may stem from regional differences, lockdown measures, and limitations in swab sensitivity. High prevalence in certain studies suggests the importance of HCW screening in high-incidence areas and during pandemics. However, with low case numbers and increasing vaccination rates among HCWs, cost-benefit considerations are crucial, especially during low-incidence periods. Further evaluation is warranted as data on reductions in infected person-days from HCW screening become available.