Adherence of healthcare workers to COVID-19 infection prevention practices and its relationship with SARS-CoV-2 seropositivity

Background: Infection prevention and control (IPC) practices against COVID-19 should be adopted by healthcare workers (HCWs) at their workplaces to protect themselves, their patients, and their families from infection. Purpose: This study aimed to describe the relationship between the healthcare-related COVID-19 infection prevention measures adopted by HCWs and their SARS-CoV-2 seropositivity. Research Design: This cross-sectional study was conducted during the second and third COVID-19 waves in Egypt. Study Sample: The study included 416 unvaccinated HCWs from 39 hospitals in Egypt. Data Collection: Sociodemographic data, as well as COVID-19 IPC measures done at work, and protective measures performed by their healthcare facilities were collected. SARS-CoV-2 spike protein antibodies were measured by ELISA. Results: 58.2% of participants were seropositive for SARS-CoV-2. Among the previously undiagnosed HCWs, 125/271 (46.1%) were seropositive. Predictors of seropositivity were rural residence (aOR = 5.096; 95% CI: 1.583-16.403, p = 0.006), previous COVID-19 infection (aOR = 4.848, 95% CI: 2.933-8.015, p = 0.000), and examining 10-20 suspected COVID-19 patients daily (aOR = 2.329; 95% CI: 1.331-4.077, p = 0.003. Reporting low satisfaction (25-50%) with infection control implementation, working more than 40 h per week, reporting to "sometimes abiding by hand hygiene" compared to those who reported to "always" adhere to hand hygiene and shorter duration of hand washing (<20 s) were associated with significantly higher odds of seropositivity. Conclusions: Poor infection control measures and the high workload of HCWs (longer working hours and examining more patients) were modifiable risk factors for SARS-CoV-2 seropositivity among HCWs. Hand hygiene was better among HCWs working in urban versus rural areas.