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西班牙某医院医护人员 COVID-19 感染的临床因素、预防行为和时间结局。

Clinical Factors, Preventive Behaviours and Temporal Outcomes Associated with COVID-19 Infection in Health Professionals at a Spanish Hospital.

机构信息

Service of Preventive Medicine and Public Health, Hospital Universitario Clínico San Cecilio, 18016 Granada, Spain.

Department of Preventive Medicine and Public Health, University of Granada, 18016 Granada, Spain.

出版信息

Int J Environ Res Public Health. 2020 Jun 16;17(12):4305. doi: 10.3390/ijerph17124305.

DOI:10.3390/ijerph17124305
PMID:32560180
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7345067/
Abstract

The novel coronavirus disease (COVID-19) outbreak has quickly spread around the world, with Spain being one of the most severely affected countries. Healthcare professionals are an important risk group given their exposure. The aims of this study were to determine the prevalence of symptoms, main concerns as patients, preventive behaviours of healthcare professionals, and the different temporal outcomes associated with the negativization of PCR results. A total of 238 professionals were analysed and follow-up was conducted from 11 March to 21 April 2020 through clinical records, in-depth surveys, and telephone interviews. Symptoms, concerns, and preventive measures were documented, and temporal outcomes (start and end of symptoms, first positive PCR, and negativization of PCR) were analysed through survival analyses. A high prevalence of gastrointestinal symptoms (especially in women and older professionals), fever, cough, and fatigue were reported. The main concern was contagion in the work and home environment. Professionals (especially men) reported low use of face masks before the pandemic. Our analysis indicates that the median times for the negativization of PCR testing to confirm the resolution of infection is 15 days after the end of symptoms, or 25 days after the first positive PCR test. Our results suggest that these times are longer for women and for professionals aged ≥55 years, therefore follow-up strategies should be optimized in light of both variables. This is the first study we are aware of to report factors associated with the time to negativization of PCR results. We present the first rigorous estimates of time outcomes and hope that these data can be valuable to continue feeding the prediction models that are currently being developed. Similar studies are required to corroborate our results.

摘要

新型冠状病毒病(COVID-19)疫情在全球迅速蔓延,西班牙是受影响最严重的国家之一。鉴于医护人员的接触风险,他们是一个重要的高危群体。本研究旨在确定症状的流行率、作为患者的主要关注点、医护人员的预防行为,以及与 PCR 结果转阴相关的不同时间结局。共分析了 238 名专业人员,从 2020 年 3 月 11 日至 4 月 21 日通过临床记录、深入调查和电话访谈进行随访。记录了症状、关注点和预防措施,并通过生存分析分析了时间结局(症状开始和结束、首次阳性 PCR 检测和 PCR 转阴)。报告了较高的胃肠道症状(尤其是在女性和年龄较大的专业人员中)、发热、咳嗽和疲劳的流行率。主要关注点是在工作和家庭环境中的传染。专业人员(尤其是男性)报告在大流行前低频率使用口罩。我们的分析表明,PCR 检测转阴以确认感染痊愈的中位时间是症状结束后 15 天,或首次阳性 PCR 检测后 25 天。我们的结果表明,女性和年龄≥55 岁的专业人员的这些时间更长,因此应根据这两个变量优化随访策略。这是我们所知的第一个报告与 PCR 结果转阴时间相关的因素的研究。我们首次提出了时间结局的严格估计,希望这些数据对继续为当前正在开发的预测模型提供信息是有价值的。需要进行类似的研究来证实我们的结果。

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