Krastinova Evguenia, Garrait Valérie, Lecam Marie-Thérèse, Coste André, Varon Emmanuelle, Delacroix Isabelle, Si Ali Amine, Jung Camille, Smati Mounira, Cherbit Muriel, Maître Bernard, Pairon Jean-Claude, Andujar Pascal
Internal Medicine Department, Centre Hospitalier Intercommunal de Créteil, Creteil, France
COREVIH SUD, Paris, France.
Occup Environ Med. 2020 Dec 4;78(7):479-85. doi: 10.1136/oemed-2020-106866.
Although healthcare workers (HCWs) have been particularly affected by SARS-CoV-2, detailed data remain scarce. In this study, we investigated infection rates, clinical characteristics, occupational exposure and household transmission among all symptomatic HCWs screened by SARS-CoV-2 RT-PCR between 17 March (French lockdown) and 20 April.
SARS-CoV-2 RT-PCR was proposed to symptomatic (new cough or dyspnoea) HCWs at Creteil Hospital in one of the Parisian suburbs most severely affected by COVID-19. Data on occupational profile, living situation and household, together with self-isolation and mask use at home were collected, as well as the number of cases in the household.
The incidence rate of symptomatic SARS-CoV-2 was estimated to be 5% (110/2188). A total of 110 (35%) of the 314 HCWs tested positive and 9 (8%) were hospitalised. On multivariate analysis, factors independently associated with positive RT-PCR were occupational profile with direct patient facing (OR 3.1, 95% CI 1.1 to 8.8), p<0.03), and presence of anosmia (OR 5.7, 95% CI 3.1 to 10.6), p<0.0001). Being a current smoker was associated with negative RT-PCR (OR 0.3, 95% CI 0.1 to 0.7), p=0.005). Transmission from HCWs to household members was reported in 9 (14%) cases, and 2 deaths occurred. Overall, self-isolation was possible in 52% of cases, but only 31% of HCWs were able to wear a mask at home.
This is the first study to report infection rates among HCWs during the peak of the SARS-CoV-2 epidemic in France and the lockdown period, highlighting the risk related to occupational profile and household transmission.
尽管医护人员受严重急性呼吸综合征冠状病毒2（SARS-CoV-2）影响尤为严重，但详细数据仍然匮乏。在本研究中，我们调查了3月17日（法国封锁）至4月20日期间，所有通过SARS-CoV-2逆转录聚合酶链反应（RT-PCR）筛查的有症状医护人员的感染率、临床特征、职业暴露和家庭传播情况。
在受2019冠状病毒病（COVID-19）影响最严重的巴黎郊区之一的克雷泰伊医院，对有症状（新发咳嗽或呼吸困难）的医护人员进行SARS-CoV-2 RT-PCR检测。收集了职业概况、生活状况和家庭情况的数据，以及在家自我隔离和使用口罩的情况，还有家庭中的病例数。
有症状的SARS-CoV-2发病率估计为5%（110/2188）。在接受检测的314名医护人员中，共有110人（35%）检测呈阳性，9人（8%）住院治疗。多因素分析显示，与RT-PCR阳性独立相关的因素包括直接面对患者的职业概况（比值比[OR] 3.1，95%置信区间[CI] 1.1至8.8，p<0.03），以及嗅觉丧失（OR 5.7，95% CI 3.1至10.6，p<0.0001）。当前吸烟者与RT-PCR阴性相关（OR 0.3，95% CI 0.1至0.7，p=0.005）。有9例（14%）报告了医护人员向家庭成员的传播，并有2例死亡。总体而言，52%的病例可以进行自我隔离，但只有31%的医护人员在家中能够佩戴口罩。
这是第一项报告法国SARS-CoV-2疫情高峰期及封锁期间医护人员感染率的研究，突出了与职业概况和家庭传播相关的风险。
