This Annals of Internal Medicine case report discusses the risks and outcomes of health care workers caring for a patient with severe pneumonia prior to the patient’s COVID-19 diagnosis being known.
The patient was hospitalized for community-acquired pneumonia, required supplemental oxygen on admission, and later required intubation and mechanical ventilation in the intensive care unit (ICU). He was not diagnosed with COVID-19 until he was extubated three days later. The hospital identified 41 health care workers as having exposure to aerosol-generating procedures for at least 10 minutes at a distance of less than two meters from the patients, and all of them were placed under home isolation for two weeks, with daily monitoring. None of the exposed health care workers developed symptoms, and all subsequent tests were negative. 85% of the exposed health care workers were exposed while wearing a surgical mask, and the remainder were wearing N95 masks. The case report suggests that surgical masks, hand hygiene, and other standard procedures protected these health care workers from being infected. The authors acknowledge the difficulty of making wide conclusions from a single case report and suggest that additional studies be performed to determine how to protect health care workers from becoming infected while they are providing care for patients with COVID-19.