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Factors Associated with SARS-CoV-2 Infection in Physician Trainees in New York City During the First COVID-19 Wave

Authors:

Kate R. Pawloski ,

Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY; Department of Surgery, Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, US
About Kate R.

MD

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Betty Kolod,

Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, US
About Betty

MD

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Rabeea F. Khan,

Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, US
About Rabeea F.

MD

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Vishal Midya,

Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY
About Vishal

PhD, MSTAT

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Tania Chen,

Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, US
About Tania

MBBS

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Adeyemi Oduwole,

Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, US
About Adeyemi

BA

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Bernard Camins,

Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, US
About Bernard

MD

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Elena Colicino,

Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, US
About Elena

PhD

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I. Michael Leitman,

Department of Surgery, Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, US
About I. Michael

MD

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Ismail Nabeel,

Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, US
About Ismail

MD, MS, MPH

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Kristin Oliver,

Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, US
About Kristin

MD, MHS

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Damaskini Valvi

Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, US
About Damaskini

MD, PhD, MPH

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Abstract

Background: Occupational and non-occupational risk factors for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been reported in healthcare workers (HCWs), but studies evaluating risk factors for infection among physician trainees are lacking. We aimed to identify sociodemographic, occupational, and community risk factors among physician trainees during the first wave of coronavirus disease 2019 (COVID-19) in New York City.

Methods: In this retrospective study of 328 trainees at the Mount Sinai Health System (MSHS) in New York City, we administered a survey to assess risk factors for SARS-CoV-2 infection between February 1 and June 30, 2020. SARS-CoV-2 infection was determined by self-reported and laboratory-confirmed IgG antibody and reverse transcriptase-polymerase chain reaction test results. We used Bayesian generalized linear mixed effect regression to examine associations between hypothesized risk factors and infection odds.

Results: The cumulative incidence of infection was 20.1%. Assignment to medical-surgical units (OR, 2.51; 95% CI, 1.18–5.34), and training in emergency medicine, critical care, and anesthesiology (OR, 2.93; 95% CI, 1.24–6.92) were independently associated with infection (Table). Caring for unfamiliar patient populations was protective (OR, 0.16; 95% CI, 0.03–0.73); deployment of trainees to non-routine hospital sites during COVID-19 patient surges was not significantly associated with infection. Community factors were not significantly associated with infection after adjustment for occupational factors.

Conclusions: Our findings may inform tailored infection prevention strategies for physician trainees responding to the COVID-19 pandemic. Deployment of trainees in MSHS was a safe strategy to respond to surging patient volumes during the initial phases of the COVID-19 pandemic and may be safe during current international surges.

How to Cite: Pawloski, K.R., Kolod, B., Khan, R.F., Midya, V., Chen, T., Oduwole, A., Camins, B., Colicino, E., Leitman, I.M., Nabeel, I., Oliver, K. and Valvi, D., 2021. Factors Associated with SARS-CoV-2 Infection in Physician Trainees in New York City During the First COVID-19 Wave. Journal of Scientific Innovation in Medicine, 4(2), p.29. DOI: http://doi.org/10.29024/jsim.132
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  Published on 10 Jun 2021
 Accepted on 23 May 2021            Submitted on 23 May 2021

Table

Adjusted effect estimates for associations of sociodemographic, occupational and community factors with SARS-CoV-2 infection.


VARIABLE MODEL 1: SOCIODEMOGRAPHIC FACTORS MODEL 2: OCCUPATIONAL FACTORS MODEL 3: COMMUNITY FACTORS MODEL 4: FINAL ADJUSTED MODEL




OR 95% CI OR 95% CI OR 95% CI OR 95% CI

Race

White (ref) 1.00 1.00

Asian 0.53 0.23, 1.24 0.53 0.24, 1.15

Black 1.34 0.45, 3.98 1.42 0.50, 4.01

Other 0.43 0.08, 2.47 0.64 0.14, 2.92

Hispanic/Latinx

No (ref) 1.00 1.00

Yes 2.18 0.73, 6.47 1.98 0.72, 5.46

Change in usual patient population

No (ref) 1.00 1.00

Yes 0.09 0.01, 0.67 0.16 0.03, 0.73

Medical/surgical unit

No (ref) 1.00 1.00

Yes 2.96 1.27, 6.91 2.51 1.18, 5.34

Ambulatory clinic

No (ref) 1.00 1.00

Yes 0.53 0.24, 1.17 0.61 0.29, 1.30

Contact >10 mins without N95 with confirmed COVID-19 case

Never (ref) 1.00 1.00

Once 1.47 0.62, 3.48 1.24 0.55, 2.75

Twice or more 1.72 0.75, 3.94 1.59 0.74, 3.43

Training specialty

Hospital-based, primarily non-procedural (ref) 1.00 1.00

High-risk procedural 4.29 1.62, 11.33 2.93 1.24, 6.92

Surgical 1.98 0.81, 4.89 1.51 0.65, 3.50

Number of children in household

0 (ref) 1.00 1.00

≥1 0.52 0.20, 1.38 0.59 0.23, 1.48

Contact >10 mins with individual confirmed or suspected COVID-19 outside of work

No (ref) 1.00 1.00

Yes 2.38 1.14, 4.98 1.58 0.78, 3.17

Primary mode of transportation to location other than work: public transit (subway or bus)

No (ref) 1.00 1.00

Yes 2.25 1.01, 5.01 1.85 0.85, 3.99

Primary mode of transportation to location other than work: private vehicle, bicycle, walking

No (ref) 1.00 1.00

Yes 0.44 0.14, 1.40 0.42 0.14, 1.27

Primary residence (zip code)

Manhattan (ref) 1.00 1.00

Queens 0.24 0.06, 0.94 0.34 0.10, 1.20

Brooklyn 0.21 0.03, 1.64 0.30 0.06, 1.62

Bronx 0.40 0.04, 3.98 0.48 0.08, 3.08

Outside of NYC 1.48 0.40, 5.49 1.51 0.44, 5.20

Competing Interests

This research was supported by the National Institute of Environmental Health Studies (P30ES023515). The authors have no conflict of interest to disclose.

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