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评估墨西哥城医护人员中 2019 年冠状病毒病(COVID-19)负担:基于数据的行动呼吁。

Assessing the Burden of Coronavirus Disease 2019 (COVID-19) Among Healthcare Workers in Mexico City: A Data-Driven Call to Action.

机构信息

Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico.

Dirección de Investigación, Instituto Nacional de Geriatría, Mexico City, Mexico.

出版信息

Clin Infect Dis. 2021 Jul 1;73(1):e191-e198. doi: 10.1093/cid/ciaa1487.

Abstract

BACKGROUND

Healthcare workers (HCWs) could be at increased occupational risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections due to increased exposure. Information regarding the burden of coronavirus disease 2019 (COVID-19) epidemic in HCWs living in Mexico is scarce. Here, we aimed to explore the epidemiology, symptoms, and risk factors associated with adverse outcomes in HCWs in Mexico City.

METHODS

We explored data collected by the National Epidemiological Surveillance System in Mexico City, in HCWs who underwent real-time reverse transcription polymerase chain reaction (RT-PCR) test. We explored COVID-19 outcomes in HCWs and the performance of symptoms to detect SARS-CoV-2 infection.

RESULTS

As of 20 September 2020, 57 758 HCWs were tested for SARS-CoV-2 and 17 531 were confirmed (30.35%); 6610 were nurses (37.70%), 4910 physicians (28.0%), 267 dentists (1.52%), and 5744 laboratory personnel and other HCWs (32.76%). Overall, 2378 HCWs required hospitalization (4.12%), 2648 developed severe COVID-19 (4.58%), and 336 required mechanical-ventilatory support (.58%). Lethality was recorded in 472 (.82%) cases. We identified 635 asymptomatic SARS-CoV-2 infections (3.62%). Compared with general population, HCWs had higher incidence, testing, asymptomatic cases, and mortality rates. No individual symptom offers adequate performance to detect SARS-CoV2. Older HCWs with chronic noncommunicable diseases and severe respiratory symptoms were associated with higher risk for adverse outcome; physicians were at higher risk compared with nurses and other HCWs.

CONCLUSIONS

We report a high prevalence of SARS-CoV-2 infection in HCWs in Mexico City. Symptoms as a screening method are not efficient to discern those HCWs with a positive PCR-RT test. Particular attention should focus on HCWs with risk factors to prevent adverse outcomes.

摘要

背景

由于接触增加,医护人员(HCWs)可能面临更高的严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)感染的职业风险。关于居住在墨西哥的医护人员中 2019 年冠状病毒病(COVID-19)流行的负担的信息很少。在这里,我们旨在探讨墨西哥城医护人员的流行病学、症状和与不良结局相关的危险因素。

方法

我们探讨了墨西哥城国家流行病学监测系统收集的接受实时逆转录聚合酶链反应(RT-PCR)检测的医护人员的数据。我们探讨了 COVID-19 在医护人员中的结局以及症状在检测 SARS-CoV-2 感染方面的表现。

结果

截至 2020 年 9 月 20 日,对 57758 名医护人员进行了 SARS-CoV-2 检测,其中 17531 例为确诊病例(30.35%);6610 名为护士(37.70%),4910 名为医生(28.0%),267 名为牙医(1.52%),5744 名为实验室人员和其他医护人员(32.76%)。总体而言,2378 名医护人员需要住院治疗(4.12%),2648 名医护人员发展为严重 COVID-19(4.58%),336 名医护人员需要机械通气支持(0.58%)。记录的病死率为 472 例(8.2%)。我们发现 635 例无症状 SARS-CoV-2 感染(3.62%)。与一般人群相比,医护人员的发病率、检测率、无症状病例和死亡率均较高。没有任何单个症状可以提供足够的性能来检测 SARS-CoV2。患有慢性非传染性疾病和严重呼吸道症状的老年医护人员与不良结局的风险增加相关;与护士和其他医护人员相比,医生的风险更高。

结论

我们报告了墨西哥城医护人员中 SARS-CoV-2 感染的高患病率。症状作为一种筛查方法,不能有效地辨别那些 PCR-RT 检测阳性的医护人员。应特别关注有危险因素的医护人员,以预防不良结局。

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