From the, Department of Geriatrics, Renmin Hospital of Wuhan University, Wuhan, China.
Department of Hand Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
J Intern Med. 2020 Dec;288(6):725-736. doi: 10.1111/joim.13160. Epub 2020 Sep 21.
Epidemiological and clinical features of patients with COVID-19 have been reported, but none of them focused on medical staff, and few predictors of the duration of viral shedding have been reported. It is urgent to help healthcare workers prevent and recover quickly from the coronavirus disease 2019 (COVID-19).
We enrolled 140 medical workers with COVID-19 in Wuhan. Epidemiological, demographic, clinical, laboratory, radiological treatment and clinical outcome data were collected, and predictors of the duration of viral shedding were explored through multivariable linear regression analysis.
The medical staff with COVID-19 presented mild clinical symptoms and showed a low frequency of abnormal laboratory indicators. All the medical staff were cured and discharged, of whom 96 (68.6%) were female, 39 (27.9%) had underlying diseases, the median age was 36.0 years, and 104 (74.3%) were infected whilst working in hospital. The median duration of viral shedding was 25.0 days (IQR:20.0-30.0). Multivariable linear regression analysis showed reducing viral shedding duration was associated with receiving recombinant human interferon alpha (rIFN-α) treatment, whilst the prolonged duration of viral shedding correlated with the use of glucocorticoid treatment, the durations from the first symptom to hospital admission and the improvement in chest computed tomography (CT) evidence. Moreover, infected healthcare workers with lymphocytes less than 1.1 × 10 /L on admission had prolonged viral shedding.
Medical staff with timely medical interventions show milder clinical features. Glucocorticoid treatment and lymphocytes less than 1.1 × 109/L are associated with prolonged viral shedding. Early admission and rIFN-α treatment help shorten the duration of viral shedding.
已有关于 COVID-19 患者的流行病学和临床特征的报道,但没有专门针对医务人员的报道,也很少有关于病毒脱落持续时间的预测因素的报道。帮助医务人员预防和从冠状病毒病 2019(COVID-19)中快速恢复是当务之急。
我们在武汉招募了 140 名 COVID-19 医务人员。收集了流行病学、人口统计学、临床、实验室、影像学治疗和临床结局数据,并通过多变量线性回归分析探讨了病毒脱落持续时间的预测因素。
COVID-19 医务人员表现出轻微的临床症状,实验室指标异常频率较低。所有医务人员均治愈出院,其中 96 名(68.6%)为女性,39 名(27.9%)有基础疾病,中位年龄为 36.0 岁,104 名(74.3%)在医院工作时感染。病毒脱落的中位持续时间为 25.0 天(IQR:20.0-30.0)。多变量线性回归分析表明,缩短病毒脱落持续时间与接受重组人干扰素-α(rIFN-α)治疗有关,而病毒脱落持续时间延长与糖皮质激素治疗、从首发症状到入院的时间以及胸部 CT 证据改善有关。此外,入院时淋巴细胞计数<1.1×109/L 的感染医务人员病毒脱落持续时间延长。
及时接受医学干预的医务人员表现出较轻的临床特征。糖皮质激素治疗和淋巴细胞计数<1.1×109/L 与病毒脱落持续时间延长有关。早期入院和 rIFN-α 治疗有助于缩短病毒脱落持续时间。