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卫生保健工作者大规模 SARS-CoV-2 检测的卫生监测与应对:意大利威尼托大区维罗纳的一家大型医院的案例研究。

Health Surveillance and Response to SARS-CoV-2 Mass Testing in Health Workers of a Large Italian Hospital in Verona, Veneto.

机构信息

Section of Occupational Medicine, Department of Diagnostics and Public Health, University of Verona, 37134 Verona VR, Italy.

Clinical Unit of Occupational Medicine, University Hospital of Verona, 37134 Verona VR, Italy.

出版信息

Int J Environ Res Public Health. 2020 Jul 15;17(14):5104. doi: 10.3390/ijerph17145104.

Abstract

Italy presented the first largest COVID-19 outbreak outside of China. Veneto currently ranks fourth among the Italian regions for COVID-19 confirmed cases (~19,000). This study presents health surveillance data for SARS-CoV-2 in 6100 health workers (HW) employed in a large public hospital. Workers underwent oropharyngeal and nasopharyngeal swabs, with a total of 5942 participants (97.5% of the population). A total of 11,890 specimens were tested for SARS-CoV-2 infection using PCR, identifying the viral genes E, RdRP, and N. Positive tests were returned for 238 workers (cumulative incidence of 4.0%, similar in both COVID and nonCOVID units). SARS-CoV-2 risk was not affected by gender, age, or job type, whereas work setting and occupation were both predictors of infection. The risk was higher in medical wards (OR 2.7, 95% CI 1.9-3.9) and health services (OR 4.3, 95% CI 2.4-7.6), and lower in surgical wards and administration areas. To our knowledge, this study represents the largest available HW case list swab-tested for SARS-CoV-2, covering almost the total workforce. Mass screening enabled the isolation of HW, improved risk assessment, allowed for close contacts of and infected HW to return to work, provided evidence of SARS-CoV-2 diffusion, and presented solid ground to prevent nosocomial SARS-CoV-2 infections. The ongoing concurrent sero-epidemiological study aims to enable the improvement of health surveillance to maintain the safety of HWs and the communities they serve.

摘要

意大利是中国境外首次出现最大规模 COVID-19 疫情的国家。威尼托大区目前是意大利 COVID-19 确诊病例数排名第四的地区(约 19000 例)。本研究报告了对一家大型公立医院的 6100 名卫生工作者(HW)进行 SARS-CoV-2 健康监测的数据。对这些工人进行了咽拭子和鼻拭子检测,共检测了 5942 名参与者(占总人数的 97.5%)。使用 PCR 对 SARS-CoV-2 感染进行了总共 11890 次检测,鉴定出病毒基因 E、RdRP 和 N。238 名工人的检测结果呈阳性(累计发病率为 4.0%,在 COVID 和非 COVID 科室中相似)。SARS-CoV-2 风险不受性别、年龄或工作类型的影响,但工作环境和职业均是感染的预测因素。在医疗病房(OR 2.7,95%CI 1.9-3.9)和卫生服务部门(OR 4.3,95%CI 2.4-7.6)的感染风险较高,而在外科病房和行政区域的感染风险较低。据我们所知,这项研究代表了目前可获得的最大规模的 HW 病例列表拭子检测,涵盖了几乎所有的员工。大规模筛查使 HW 得以隔离,改善了风险评估,使 HW 及其密切接触者能够返回工作岗位,提供了 SARS-CoV-2 扩散的证据,并为预防医院内 SARS-CoV-2 感染奠定了坚实的基础。正在进行的同期血清流行病学研究旨在提高健康监测水平,以确保 HW 和他们所服务的社区的安全。

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