Liu Jie, Ouyang Liu, Yang Dan, Han Xiaoyu, Cao Yukun, Alwalid Osamah, Wu Hanping, Shi Heshui, Yang Fan, Zheng Chuansheng
Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, China.
Int J Med Sci. 2021 Jan 29;18(6):1492-1501. doi: 10.7150/ijms.54257. eCollection 2021.
As of 11 Feb 2020, a total of 1,716 medical staff infected with laboratory-confirmed the severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) in China had been reported. The predominant cause of the infection among medical staff remains unclear. We sought to explore the epidemiological, clinical characteristics and prognosis of infected medical staff. Medical staff who infected with SARS-Cov-2 and admitted to Union Hospital, Wuhan between 16 Jan to 25 Feb, 2020 were included in this single-centered, retrospective study. Data were compared by occupation and analyzed with the Kaplan-Meier and Cox regression methods. A total of 101 medical staff (32 males and 69 females; median age: 33) were included in this study and 74.3% were nurses. A small proportion of the cohort had contact with specimens (3%) as well as patients infected with SARS-Cov-2 in fever clinics (15%) and isolation wards (3%). 80% of medical staff showed abnormal IL-6 levels and 33% had lymphocytopenia. Chest CT mainly manifested as bilateral (62%), septal/subpleural (77%) and groundglass opacities (48%). The major differences between doctors and nurses manifested in laboratory indicators. As of the last observed date, no patient was transferred to intensive care unit or died. Fever (HR=0.57; 95% CI 0.36-0.90) and IL-6 levels greater than 2.9 pg/ml (HR=0.50; 95% CI 0.30-0.86) were unfavorable factors for discharge. Our findings suggested that the infection of medical staff mainly occurred at the early stages of SARS-CoV-2 epidemic in Wuhan, and only a small proportion of infection had an exact mode. Meanwhile, medical staff infected with COVID-19 have relatively milder symptoms and favorable clinical course than ordinary patients, which may be partly due to their medical expertise, younger age and less underlying diseases. The potential risk factors of fever and IL-6 levels greater than 2.9 pg/ml could help to identify medical staff with poor prognosis at an early stage.
截至2020年2月11日，中国共报告了1716名实验室确诊感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的医护人员。医护人员感染的主要原因仍不清楚。我们试图探讨感染医护人员的流行病学、临床特征和预后。本单中心回顾性研究纳入了2020年1月16日至2月25日期间感染SARS-CoV-2并入住武汉协和医院的医护人员。数据按职业进行比较，并用Kaplan-Meier和Cox回归方法进行分析。本研究共纳入101名医护人员（男性32名，女性69名；中位年龄：33岁），其中74.3%为护士。该队列中一小部分人接触过标本（3%）以及在发热门诊（15%）和隔离病房（3%）感染SARS-CoV-2的患者。80%的医护人员白细胞介素-6水平异常，33%有淋巴细胞减少。胸部CT主要表现为双侧（62%）、间隔/胸膜下（77%）和磨玻璃影（48%）。医生和护士之间的主要差异体现在实验室指标上。截至最后观察日期，无患者转入重症监护病房或死亡。发热（HR=0.57；95%CI 0.36-0.90）和白细胞介素-6水平大于2.9 pg/ml（HR=0.50；95%CI 0.30-0.86）是出院的不利因素。我们的研究结果表明，医护人员感染主要发生在武汉SARS-CoV-2疫情的早期阶段，只有一小部分感染有确切的感染途径。同时，感染新型冠状病毒肺炎（COVID-19）的医护人员症状相对较轻，临床病程良好，这可能部分归因于他们的医学专业知识、较年轻的年龄和较少的基础疾病。发热和白细胞介素-6水平大于2.9 pg/ml的潜在危险因素有助于早期识别预后不良的医护人员。
