Kua Justin, Patel Reshma, Nurmi Eveliina, Tian Sarah, Gill Harpreet, Wong Danny J N, Moorley Calvin, Nepogodiev Dmitri, Ahmad Imran, El-Boghdadly Kariem
Department of Targeted Intervention, Centre for Perioperative Medicine, UCL Division of Surgery and Interventional Science, University College London, University of London, London, United Kingdom.
Health Services Research Centre, National Institute of Academic Anaesthesia, Royal College of Anaesthetists, London, UK.
PeerJ. 2021 Feb 4;9:e10891. doi: 10.7717/peerj.10891. eCollection 2021.
To establish the prevalence, risk factors and implications of suspected or confirmed coronavirus disease 2019 (COVID-19) infection among healthcare workers in the United Kingdom (UK).
Cross-sectional observational study.
UK-based primary and secondary care.
Healthcare workers aged ≥18 years working between 1 February and 25 May 2020.
A composite endpoint of laboratory-confirmed diagnosis of SARS-CoV-2, or self-isolation or hospitalisation due to suspected or confirmed COVID-19.
Of 6,152 eligible responses, the composite endpoint was present in 1,806 (29.4%) healthcare workers, of whom 49 (0.8%) were hospitalised, 459 (7.5%) tested positive for SARS-CoV-2, and 1,776 (28.9%) reported self-isolation. Overall, between 11,870 and 21,158 days of self-isolation were required by the cohort, equalling approximately 71 to 127 working days lost per 1,000 working days. The strongest risk factor associated with the presence of the primary composite endpoint was increasing frequency of contact with suspected or confirmed COVID-19 cases without adequate personal protective equipment (PPE): 'Never' (reference), 'Rarely' (adjusted odds ratio 1.06, (95% confidence interval: [0.87-1.29])), 'Sometimes' (1.7 [1.37-2.10]), 'Often' (1.84 [1.28-2.63]), 'Always' (2.93, [1.75-5.06]). Additionally, several comorbidities (cancer, respiratory disease, and obesity); working in a 'doctors' role; using public transportation for work; regular contact with suspected or confirmed COVID-19 patients; and lack of PPE were also associated with the presence of the primary endpoint. A total of 1,382 (22.5%) healthcare workers reported lacking access to PPE items while having clinical contact with suspected or confirmed COVID-19 cases.
Suspected or confirmed COVID-19 was more common in healthcare workers than in the general population and is associated with significant workforce implications. Risk factors included inadequate PPE, which was reported by nearly a quarter of healthcare workers. Governments and policymakers must ensure adequate PPE is available as well as developing strategies to mitigate risk for high-risk healthcare workers during future COVID-19 waves.
确定英国医护人员中疑似或确诊的2019冠状病毒病（COVID-19）感染的患病率、风险因素及其影响。
横断面观察性研究。
英国的基层和二级医疗保健机构。
年龄≥18岁、在2020年2月1日至5月25日期间工作的医护人员。
实验室确诊的SARS-CoV-2诊断、因疑似或确诊COVID-19而自我隔离或住院的复合终点。
在6152份符合条件的回复中，1806名（29.4%）医护人员出现了复合终点，其中49人（0.8%）住院，459人（7.5%）SARS-CoV-2检测呈阳性，1776人（28.9%）报告进行了自我隔离。总体而言，该队列共需要11870至21158天的自我隔离，相当于每1000个工作日损失约71至127个工作日。与主要复合终点出现相关的最强风险因素是在没有足够个人防护装备（PPE）的情况下，与疑似或确诊COVID-19病例的接触频率增加：“从不”（参考）、“很少”（调整后的优势比1.06，[95%置信区间：0.87 - 1.29]）、“有时”（1.7 [1.37 - 2.10]）、“经常”（1.84 [1.28 - 2.63]）、“总是”（2.93，[1.75 - 5.06]）。此外，几种合并症（癌症、呼吸系统疾病和肥胖）；担任“医生”角色；使用公共交通工具上班；与疑似或确诊COVID-19患者定期接触；以及缺乏PPE也与主要终点的出现有关。共有1382名（22.5%）医护人员报告在与疑似或确诊COVID-19病例进行临床接触时无法获得PPE物品。
疑似或确诊的COVID-19在医护人员中比在普通人群中更常见，并且对劳动力有重大影响。风险因素包括PPE不足，近四分之一的医护人员报告了这一情况。政府和政策制定者必须确保提供足够的PPE，并制定策略以降低未来COVID-19疫情期间高危医护人员的风险。
