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湖北省医护人员中严重急性呼吸冠状病毒 2 型(SARS-CoV-2)感染的流行病学和临床特征。

Epidemiological and clinical characteristics of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection among healthcare workers in Hubei Province, China.

机构信息

Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.

Institute of Preventive Medicine Information, Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei, China.

出版信息

Infect Control Hosp Epidemiol. 2021 Aug;42(8):924-930. doi: 10.1017/ice.2020.1321. Epub 2020 Nov 18.

Abstract

OBJECTIVE

To evaluate the epidemiological and clinical characteristics of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection among healthcare workers (HCWs) in Hubei Province, China.

DESIGN

Retrospective cohort study.

SETTING

Hubei Provincial Center for Disease Control and Prevention.

PARTICIPANTS

The participants in this study are cases identified by epidemiological investigation in Hubei Province, as of February 27, 2020, and were followed until March 7, 2020. In total, 1,989 HCWs and 41,137 other occupational cases were included for analysis.

METHODS

We used descriptive statistics to summarize patient characteristics.

RESULTS

Of 1,989 laboratory-confirmed HCWs, 297 (14.93%) had severe or critical cases, 73 (3.67%) had asymptomatic infections, and 18 died of coronavirus disease 2019 (COVID-19). The case fatality rate was 0.9%. The proportion of severe or critical cases decreased from the beginning to the end of the outbreak (from 21.29% to 3.52%), and the proportion of asymptomatic cases increased from 0.0% to 47.18%. Nearly half of HCWs with confirmed COVID-19 reported no known contact with COVID-19 patients (969, 48.72%). Fever and cough were the most common symptoms at disease onset in both HCWs and other occupational cases; however, HCWs had higher rates of fatigue (30.90% vs 25.02%; P < .001) and myalgia (19.15% vs 13.43%; P < .001). Additionally, compared with other occupational groups, HCWs were associated with a lower risk of death after adjustment for potential confounders (odd ratio [OR], 0.50; 95% confidence interval [CI], 0.30-0.79).

CONCLUSIONS

Compared with COVID-19 cases in other occupational groups, HCWs with COVID-19 have half the risk of death, although they have been shown to have higher rates of fatigue and myalgia.

摘要

目的

评估中国湖北省医护人员(HCWs)中严重急性呼吸冠状病毒病毒 2(SARS-CoV-2)感染的流行病学和临床特征。

设计

回顾性队列研究。

地点

湖北省疾病预防控制中心。

参与者

本研究的参与者是截至 2020 年 2 月 27 日通过流行病学调查在湖北省确定的病例,并一直随访至 2020 年 3 月 7 日。共有 1989 名 HCWs 和 41137 名其他职业病例纳入分析。

方法

我们使用描述性统计来总结患者特征。

结果

在 1989 例实验室确诊的 HCWs 中,有 297 例(14.93%)为重症或危重症病例,73 例(3.67%)为无症状感染者,18 例死于 2019 年冠状病毒病(COVID-19)。病死率为 0.9%。重症或危重症病例的比例从疫情开始到结束呈下降趋势(从 21.29%降至 3.52%),无症状病例的比例从 0.0%增加到 47.18%。近一半确诊 COVID-19 的 HCWs 报告没有已知的 COVID-19 患者接触史(969 例,48.72%)。发热和咳嗽是 HCWs 和其他职业病例发病时最常见的症状;然而,HCWs 更易出现疲劳(30.90%比 25.02%;P <.001)和肌痛(19.15%比 13.43%;P <.001)。此外,与其他职业群体相比,在校正潜在混杂因素后,HCWs 与死亡风险降低相关(比值比[OR],0.50;95%置信区间[CI],0.30-0.79)。

结论

与其他职业 COVID-19 病例相比,COVID-19 患者的 HCWs 死亡风险降低一半,尽管他们的疲劳和肌痛发生率更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/68c2/7691647/8a4be042f12f/S0899823X20013215_fig1.jpg

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