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口腔保健工作者中第一波 COVID-19 的患病率和风险指标:一项法国的流行病学调查。

Prevalence and risk indicators of first-wave COVID-19 among oral health-care workers: A French epidemiological survey.

机构信息

UFR Odontologie, Dental Medicine Department, AP-HP, Bretonneau Hospital, Université de Paris, Paris, France.

Laboratory of Orofacial Neurobiology (EA7543), Université de Paris, Paris, France.

出版信息

PLoS One. 2021 Feb 11;16(2):e0246586. doi: 10.1371/journal.pone.0246586. eCollection 2021.

Abstract

BACKGROUND

Previous studies have highlighted the increased risk of contracting the COVID-19 for health-care workers and suggest that oral health-care workers may carry the greatest risk. Considering the transmission route of the SARS-CoV-2 infection, a similar increased risk can be hypothesized for other respiratory infections. However, no study has specifically assessed the risk of contracting COVID-19 within the dental profession.

METHODS

An online survey was conducted within a population of French dental professionals between April 1 and April 29, 2020. Univariable and multivariable logistic regression analyses were performed to explore risk indicators associated with laboratory-confirmed COVID-19 and COVID-19-related clinical phenotypes (i.e. phenotypes present in 15% or more of SARS-CoV-2-positive cases).

RESULTS

4172 dentists and 1868 dental assistants responded to the survey, representing approximately 10% of French oral health-care workers. The prevalence of laboratory-confirmed COVID-19 was 1.9% for dentists and 0.8% for dental assistants. Higher prevalence was found for COVID-19-related clinical phenotypes both in dentists (15.0%) and dental assistants (11.8%). Chronic kidney disease and obesity were associated with increased odds of laboratory-confirmed COVID-19, whereas working in a practice limited to endodontics was associated with decreased odds. Chronic obstructive pulmonary disease, use of public transportation and having a practice limited to periodontology were associated with increased odds of presenting a COVID-19-related clinical phenotype. Moreover, changes in work rhythm or clinical practice were associated with decreased odds of both outcomes.

CONCLUSIONS

Although oral health-care professionals were surprisingly not at higher risk of COVID-19 than the general population, specific risk indicators could exist, notably among high aerosol-generating dental subspecialties such as periodontology. Considering the similarities between COVID-19-related clinical phenotypes other viral respiratory infections, lessons can be learned from the COVID-19 pandemic regarding the usefulness of equipping and protecting oral health-care workers, notably during seasonal viral outbreaks, to limit infection spread.

IMPACT

Results from this study may provide important insights for relevant health authorities regarding the overall infection status of oral health-care workers in the current pandemic and draw attention to particular at-risk groups, as illustrated in the present study. Protecting oral health-care workers could be an interesting public health strategy to prevent the resurgence of COVID-19 and/or the emergence of new pandemics.

摘要

背景

先前的研究强调了医护人员感染 COVID-19 的风险增加,并表明口腔保健工作者可能面临更大的风险。考虑到 SARS-CoV-2 感染的传播途径,可以假设其他呼吸道感染的风险也会增加。然而,尚无研究专门评估牙科专业人员感染 COVID-19 的风险。

方法

2020 年 4 月 1 日至 4 月 29 日期间,对法国牙科专业人员进行了一项在线调查。采用单变量和多变量逻辑回归分析,探讨与实验室确诊的 COVID-19 和 COVID-19 相关临床表型(即 SARS-CoV-2 阳性病例中 15%或以上出现的表型)相关的风险指标。

结果

4172 名牙医和 1868 名牙科助理对该调查做出了回应,占法国口腔保健工作者的大约 10%。牙医的实验室确诊 COVID-19 患病率为 1.9%,牙科助理为 0.8%。牙医(15.0%)和牙科助理(11.8%)中 COVID-19 相关临床表型的患病率更高。慢性肾脏病和肥胖与实验室确诊 COVID-19 的几率增加相关,而仅从事牙髓病学的实践与几率降低相关。慢性阻塞性肺病、使用公共交通工具以及从事牙周病学实践与 COVID-19 相关临床表型的几率增加相关。此外,工作节奏或临床实践的改变与这两种结果的几率降低相关。

结论

尽管口腔保健专业人员感染 COVID-19 的风险似乎并不高于一般人群,但仍可能存在特定的风险指标,尤其是在高气溶胶生成的牙科亚专业领域,如牙周病学。考虑到 COVID-19 相关临床表型与其他病毒性呼吸道感染的相似性,可以从 COVID-19 大流行中吸取有关装备和保护口腔保健工作者的有用经验教训,尤其是在季节性病毒爆发期间,以限制感染传播。

影响

本研究的结果可能为相关卫生当局提供有关当前大流行中口腔保健工作者整体感染状况的重要见解,并提请注意本研究中所示的特定高危群体。保护口腔保健工作者可能是预防 COVID-19 再次爆发和/或新大流行的一种有趣的公共卫生策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/706d/7877573/0c2b5b66d95d/pone.0246586.g001.jpg

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