Department of Respiratory and Critical Care Medicine, NHC Key Laboratory of Pulmonary Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China; Wuhan Red Cross Hospital, Wuhan, Hubei, China.
Clin Microbiol Infect. 2020 Dec;26(12):1670-1675. doi: 10.1016/j.cmi.2020.08.038. Epub 2020 Sep 7.
To describe the fraction of asymptomatic health-care workers (HCWs) in two designated hospitals for coronavirus disease 2019 (COVID-19) treatment in Wuhan and explore the factors associated with asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.
All HCWs in Wuhan Union Hospital and Wuhan Red Cross Hospital with either positive SARS-CoV-2 nucleic acid or positive antibody test before 18 April 2020 were included. Exposure, epidemiological and demographic information were retrospectively collected by a structured questionnaire. Medical records were also reviewed for clinical characteristics and CT images of HCWs.
As of 18 April 2020, a total of 424 HCWs were identified. Among them, 276 (65.1%) were symptomatic and 148 (34.9%) were asymptomatic. Fifty-five (19.9%) families of the symptomatic HCWs and 16 (10.8%) families of the asymptomatic HCWs were infected with SARS-CoV-2. HCWs with infected family members tended to be symptomatic (OR 2.053, 95% CI 1.130-3.730; p 0.018). Multivariable logistic regression analysis exhibited that performing tracheal intubation or extubation (OR 4.057, 95% CI 1.183-13.909; p 0.026) was associated with an increased likelihood of symptomatic SARS-CoV-2 infection, whereas consistent use of N95 respirators (OR 0.369, 95% CI 0.201-0.680; p 0.001) and eye protection (OR 0.217, 95% CI 0.116-0.404; p < 0.001) were associated with an increased likelihood of asymptomatic SARS-CoV-2 infection.
Asymptomatic SARS-CoV-2 infection in HCWs comprised a considerable proportion of HCW infections during the pandemic of COVID-19. Those who performed tracheal intubation or extubation were most likely to develop related symptoms, whereas those taking aggressive measures, including consistent use of N95 masks and eye protection, tended to be asymptomatic cases.
描述武汉市两家指定新冠肺炎治疗医院的无症状医护人员（HCW）比例，并探讨与无症状严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染相关的因素。
纳入 2020 年 4 月 18 日前在武汉协和医院和武汉红十字会医院接受 SARS-CoV-2 核酸或抗体检测阳性的所有 HCW。通过结构化问卷回顾性收集暴露、流行病学和人口统计学信息。还查阅了 HCW 的临床特征和 CT 图像的病历记录。
截至 2020 年 4 月 18 日，共确定了 424 名 HCW。其中，276 名（65.1%）有症状，148 名（34.9%）无症状。55 名（19.9%）有症状 HCW 的家庭成员和 16 名（10.8%）无症状 HCW 的家庭成员感染了 SARS-CoV-2。有感染家庭成员的 HCW 更可能出现症状（OR 2.053，95%CI 1.130-3.730；p 0.018）。多变量逻辑回归分析显示，进行气管插管或拔管（OR 4.057，95%CI 1.183-13.909；p 0.026）与 SARS-CoV-2 感染相关症状的可能性增加有关，而持续使用 N95 口罩（OR 0.369，95%CI 0.201-0.680；p 0.001）和眼部保护（OR 0.217，95%CI 0.116-0.404；p<0.001）与 SARS-CoV-2 感染无症状的可能性增加有关。
在 COVID-19 大流行期间，HCW 中无症状 SARS-CoV-2 感染占 HCW 感染的相当大比例。进行气管插管或拔管的人最有可能出现相关症状，而采取包括持续使用 N95 口罩和眼部保护在内的积极措施的人往往无症状。
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