COVID-19 in health-care workers in three hospitals in the south of the Netherlands: A cross-sectional study

Reina S. Sikkema*, Suzan D. Pas, David F. Nieuwenhuijse, Áine O'Toole, Jaco J. Verweij, Anne van der Linden, Irina Chestakova, Claudia Schapendonk, Mark Pronk, Pascal Lexmond, Theo Bestebroer, Ronald J. Overmars, Stefan van Nieuwkoop, Wouter van den Bijllaardt, Robbert G. Bentvelsen, Miranda M.L. van Rijen, Anton G.M. Buiting, Anne J.G. van Oudheusden, Bram M. Diederen, Anneke M.C. BergmansAnnemiek van der Eijk, Richard Molenkamp, Andrew Rambaut, Aura Timen, Jan A.J.W. Kluytmans, Bas B. Oude Munnink, Marjolein F.Q. Kluytmans van den Bergh, Marion P.G. Koopmans

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background 10 days after the first reported case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the Netherlands (on Feb 27, 2020), 55 (4%) of 1497 health-care workers in nine hospitals located in the south of the Netherlands had tested positive for SARS-CoV-2 RNA. We aimed to gain insight in possible sources of infection in health-care workers. Methods We did a cross-sectional study at three of the nine hospitals located in the south of the Netherlands. We screened health-care workers at the participating hospitals for SARS-CoV-2 infection, based on clinical symptoms (fever or mild respiratory symptoms) in the 10 days before screening. We obtained epidemiological data through structured interviews with health-care workers and combined this information with data from whole-genome sequencing of SARS-CoV-2 in clinical samples taken from health-care workers and patients. We did an in-depth analysis of sources and modes of transmission of SARS-CoV-2 in health-care workers and patients. Findings Between March 2 and March 12, 2020, 1796 (15%) of 12022 health-care workers were screened, of whom 96 (5%) tested positive for SARS-CoV-2. We obtained complete and near-complete genome sequences from 50 healthcare workers and ten patients. Most sequences were grouped in three clusters, with two clusters showing local circulation within the region. The noted patterns were consistent with multiple introductions into the hospitals through community-acquired infections and local amplification in the community. Interpretation Although direct transmission in the hospitals cannot be ruled out, our data do not support widespread nosocomial transmission as the source of infection in patients or health-care workers.
Original languageEnglish
Pages (from-to)1273-1280
Number of pages8
JournalThe Lancet Infectious Diseases
Issue number11
Early online date2 Jul 2020
Publication statusPublished - 1 Nov 2020


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