High body mass index and night shift work are associated with COVID-19 in health care workers

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High body mass index and night shift work are associated with COVID‑19 in health care workers S. Rizza1   · L. Coppeta2 · S. Grelli3 · G. Ferrazza1 · M. Chiocchi3 · G. Vanni4 · O. C. Bonomo4 · A. Bellia1 · M. Andreoni1 · A. Magrini2 · M. Federici1 Received: 9 July 2020 / Accepted: 15 August 2020 © Italian Society of Endocrinology (SIE) 2020

Abstract Objective  To assess the magnitude of COVID-19 spread and the associated risk factors among health care workers (HCWs), we conducted an in-hospital survey in a central Italian COVID Hospital. Methods  Participants underwent nasopharyngeal swab and/or serum collection for SARS-CoV-2 IgG examination. We divided participants according to working status, into rotating-night shift workers (r-NSW) and day-workers. Results  We found 30 cases of COVID-19 infection in a total of 1180 HCWs (2.5%). Most COVID-19-positive hospital employees were r-NSWs with significantly higher BMI than that of individuals who tested negative. After adjustment for covariates, night work and BMI > 30 were associated with a markedly greater risk of COVID-19 diagnosis (OR 3.049 [95%CI 1.260–7.380] and OR 7.15 [95%CI 2.91–17.51], respectively). Conclusions  Our results describe a low prevalence of COVID-19 infection among HCWs at a central Italian COVID Hospital. COVID-19 infection risk appears to be associated with obesity and night shift work, thus supporting the need for careful health surveillance among frontline HCWs exposed to COVID-19. Keywords  SARS-CoV-2 · COVID-19 · Night shift work · Obesity · Health care worker

Introduction Since the first case of COVID-19 in Italy was reported on February 28, 2020, the number of infected patients has grown exponentially [1]. However, the infection spread in Italy was more pronounced in northern Italy (Lombardy, Piedmont, Liguria, and Veneto) than in all other Italian areas. Central-southern Italian regions had fewer cases of S. Rizza and L. Coppeta have contributed equally to the manuscript. * S. Rizza [email protected] 1

COVID-19 and consequent deaths. As of the beginning of April, 2020, the WHO reported 22,073 cases of COVID-19 among health care workers (HCWs) from 52 countries [2]. It is now clear that COVID-19 has strong infectivity and a high transmission speed, and can cause serious infections among HCWs. Although the risk factors for unfavorable outcomes including aging, male sex, and underlying comorbidities— such as obesity, hypertension, diabetes, and cardiovascular disease—have been extensively reported, uncertainty remains regarding the clinical risk factors for COVID-19 infection, particularly among frontline HCWs exposed to COVID-19 infection. To address this a lack of knowledge, here, we report the preliminary results of a COVID-19 outbreak investigation in a central Italian COVID hospital (Tor Vergata University hospital).



Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy

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Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rom