The Spread of COVID-19 Among 15,000 Physical Therapists in Italy: A Cross-Sectional Study

Abstract

Abstract Objectives The purpose of this study was to explore the prevalence, personal- and work-related exposures, and signs and symptoms among physical therapists during the first wave of coronavirus disease 2019 (COVID-19) in Italy. Methods This cross-sectional, survey-based study collected demographic and exposure data from physical therapists from April to May 2020. All physical therapists working in inpatient and outpatient care in Italy were eligible. A self-administered questionnaire was distributed among all eligible physical therapists to collect (1) demographic characteristics, (2–3) personal- and work-related exposures, and (4) signs and symptoms of COVID-19. Factors associated with a COVID-19–positive nasopharyngeal swab (NPS) were explored through logistic regression models and multivariate methods. Results A total of 15,566 respondents completed the survey, with a response rate of 43.3%, achieving high statistical precision (99% CI, 1% type I error). Among physical therapists who received NPS testing, 13.1% (95% CI = 12.1–14.1%) had a positive result, with a peak reached in March 2020 (36%). The top 5 symptoms were fatigue and tiredness (69.1%), loss of smell (64.5%), aches and pains (60.8%), loss of taste (58.3%), and headache (51.1%). No symptoms were reported by 8.9%. Working in a health care institution (odds ratio [OR] = 12.0; 95% CI = 7.8–18.4), being reallocated to a different unit (OR = 1.9; 95% CI = 1.3–2.7), and changing job tasks (OR = 1.6; 95% CI = 1.2–2.3) increased the risk of being COVID-19 positive. In therapists with a confirmed diagnosis of COVID-19, comorbidities were associated with male sex and age older than 51 years. Conclusion During the first wave in Italy, almost 1 out of 7 physical therapists tested positive on the COVID-19 NPS test. Considering personal- and work-related exposures, health care organizations should adopt prevention measures and adequate preparedness to prevent high rate of infections during future pandemics. Impact This is the largest investigation about the spread of and main risk factors for COVID-19 in the physical therapy field.