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在加拿大一家三级保健中心对无症状医护人员进行 SARS-CoV-2 感染的前瞻性观察研究和血清学调查。

Prospective observational study and serosurvey of SARS-CoV-2 infection in asymptomatic healthcare workers at a Canadian tertiary care center.

机构信息

University Health Network, Toronto, Ontario, Canada.

Ontario Institute for Cancer Research, Toronto, Ontario, Canada.

出版信息

PLoS One. 2021 Feb 16;16(2):e0247258. doi: 10.1371/journal.pone.0247258. eCollection 2021.


DOI:10.1371/journal.pone.0247258
PMID:33592074
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7886177/
Abstract

Health care workers (HCWs) are at higher risk for SARS-CoV-2 infection and may play a role in transmitting the infection to vulnerable patients and members of the community. This is particularly worrisome in the context of asymptomatic infection. We performed a cross-sectional study looking at asymptomatic SARS-CoV-2 infection in HCWs. We screened asymptomatic HCWs for SARS-CoV-2 via PCR. Complementary viral genome sequencing was performed on positive swab specimens. A seroprevalence analysis was also performed using multiple assays. Asymptomatic health care worker cohorts had a combined swab positivity rate of 29/5776 (0.50%, 95%CI 0.32-0.75) relative to a comparative cohort of symptomatic HCWs, where 54/1597 (3.4%) tested positive for SARS-CoV-2 (ratio of symptomatic to asymptomatic 6.8:1). SARS-CoV-2 seroprevalence among 996 asymptomatic HCWs with no prior known exposure to SARS-CoV-2 was 1.4-3.4%, depending on assay. A novel in-house Coronavirus protein microarray showed differing SARS-CoV-2 protein reactivities and helped define likely true positives vs. suspected false positives. Our study demonstrates the utility of routine screening of asymptomatic HCWs, which may help to identify a significant proportion of infections.

摘要

医护人员(HCWs)感染 SARS-CoV-2 的风险较高,并且可能在将感染传播给脆弱的患者和社区成员方面发挥作用。在无症状感染的情况下,这尤其令人担忧。我们进行了一项横断面研究,研究了 HCWs 中的无症状 SARS-CoV-2 感染。我们通过 PCR 对无症状 HCWs 进行了 SARS-CoV-2 筛查。对阳性拭子标本进行了补充病毒基因组测序。还使用多种检测方法进行了血清流行率分析。与症状性 HCWs 的对照组相比,无症状医护人员队列的综合拭子阳性率为 29/5776(0.50%,95%CI 0.32-0.75),其中 54/1597(3.4%)检测出 SARS-CoV-2 阳性(症状性与无症状性之比为 6.8:1)。在 996 名未接触过 SARS-CoV-2 的无症状 HCWs 中,根据检测方法的不同,SARS-CoV-2 血清流行率为 1.4-3.4%。一种新的内部冠状病毒蛋白微阵列显示出不同的 SARS-CoV-2 蛋白反应性,并有助于确定真正的阳性与疑似假阳性。我们的研究表明,对无症状 HCWs 进行常规筛查是有用的,这可能有助于发现很大一部分感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/043e/7886177/c9edf66f8113/pone.0247258.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/043e/7886177/6ba32db8f0f9/pone.0247258.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/043e/7886177/c9edf66f8113/pone.0247258.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/043e/7886177/6ba32db8f0f9/pone.0247258.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/043e/7886177/c9edf66f8113/pone.0247258.g002.jpg

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[3]
Occurrence and transmission potential of asymptomatic and presymptomatic SARS-CoV-2 infections: Update of a living systematic review and meta-analysis.

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[4]
SARS-CoV-2 Seroprevalence Among Health Care Workers in Major Private and Public Hospitals With COVID-19 Patient's Referral in Tehran, Iran.

Front Public Health. 2022

[5]
SARS-CoV-2 seroprevalence in health care workers from 10 hospitals in Quebec, Canada: a cross-sectional study.

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[6]
Transmission of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) from pre and asymptomatic infected individuals: a systematic review.

Clin Microbiol Infect. 2022-2

[7]
COVID-19 Prevention and Control Measures in Workplace Settings: A Rapid Review and Meta-Analysis.

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[8]
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本文引用的文献

[1]
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Sci Rep. 2020-8-20

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