Prehosp Emerg Care. 2021 Jan-Feb;25(1):39-45. doi: 10.1080/10903127.2020.1831668. Epub 2020 Oct 30.
Emerging research has examined the prevalence of severe acute respiratory syndrome virus 2 (SARS-CoV-2) infections in numerous settings, but a critical gap in knowledge is an understanding of the rate of infection among first responders.
We conducted a prospective serial serologic survey by recruiting public first responders from Cleveland area emergency medical services agencies and fire departments. Volunteers submitted a nasopharyngeal swab for SARS-CoV-2 PCR testing and serum samples to detect the presence of antibodies to SARS-CoV-2 on two visits scheduled approximately 3 weeks apart.
296 respondents completed a first visit and 260 completed the second. While 71% of respondents reported exposure to SARS-CoV-2, only 5.4% (95% CI 3.1-8.6) had positive serologic testing. No subjects had a positive PCR. On the first visit, eight (50%) of the test-positive subjects had no symptoms and only one (6.2%) sought healthcare or missed school or work. None of the subjects that tested negative on the first visit were positive on their second.
While our results show a relatively low rate of test positivity for SARS-CoV-2 amongst first responders, most were either asymptomatic or mildly symptomatic. The potential risk of asymptomatic transmission both between first responders and from first responders to vulnerable patients requires more study.
新兴研究已经在众多环境中检测到严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)感染的流行情况,但知识的一个关键缺口是了解急救人员中的感染率。
我们通过从克利夫兰地区紧急医疗服务机构和消防部门招募公共急救人员,进行了一项前瞻性系列血清学调查。志愿者在大约相隔 3 周的两次预约中提交鼻咽拭子进行 SARS-CoV-2 PCR 检测和血清样本,以检测 SARS-CoV-2 抗体的存在。
296 名受访者完成了第一次访问,260 名完成了第二次。虽然 71%的受访者报告接触过 SARS-CoV-2,但只有 5.4%(95%CI3.1-8.6)的血清学检测呈阳性。没有受试者的 PCR 检测呈阳性。在第一次访问时,8 名(50%)检测阳性的受试者无症状,只有 1 名(6.2%)寻求医疗或错过上学或工作。第一次访问检测结果为阴性的受试者在第二次访问中均为阴性。
虽然我们的结果显示急救人员中 SARS-CoV-2 的检测阳性率相对较低,但大多数人无症状或症状轻微。无症状传播的潜在风险,无论是在急救人员之间,还是从急救人员传播到弱势群体,都需要更多的研究。