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医护人员和大学员工中严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)与暴露风险之间的关联——一项横断面研究

Association between SARS-CoV-2 and exposure risks in health care workers and university employees - a cross-sectional study.

作者信息

Nygren David, Norén Jonas, De Marinis Yang, Holmberg Anna, Fraenkel Carl-Johan, Rasmussen Magnus

机构信息

Division of Infection Medicine, Department for Clinical Sciences Lund, Lund University, Lund, Sweden.

Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.

出版信息

Infect Dis (Lond). 2021 Jun;53(6):460-468. doi: 10.1080/23744235.2021.1892819. Epub 2021 Mar 9.

Abstract

BACKGROUND

In health care workers SARS-CoV-2 has been shown to be an occupational health risk, often associated with transmission between health care workers. Yet, insufficient information on transmission dynamics has been presented to elucidate the precise risk factors for contracting SARS-CoV-2 in this group.

METHODS

In this cross-sectional study, we investigated association between questionnaire answers on potential exposure situations and SARS-CoV-2-positivity. Health care workers with and without COVID-19-patient contact at nine units at Skåne University Hospitals in Malmö and Lund, Sweden and university employees from Lund University, Sweden were enrolled. To limit impact of health care worker to health care worker transmission, units with known outbreaks were excluded. A SARS-CoV-2-positive case was defined by a previous positive PCR or anti-SARS-CoV-2 IgG in the .

RESULTS

SARS-CoV-2-positivity was detected in 11/51 (22%) health care workers in COVID-19-units, 10/220 (5%) in non-COVID-19-units and 11/192 (6%) University employees ( = .001, Fischer's exact). In health care workers, SARS-CoV-2-positivity was associated with work in a designated COVID-19-unit (OR 5.7 (95CI 2.1-16)) and caring for COVID-19-patients during the majority of shifts (OR 5.4 (95CI 2.0-15)). In all participants, SARS-CoV-2-positivity was associated with a confirmed COVID-19 case (OR 10 (95CI 2.0-45)) in the household.

CONCLUSION

Our study confirmed previous findings of elevated risk of acquiring SARS-CoV-2 in health care workers in COVID-19-units, despite exclusion of units with known outbreaks. Interestingly, health care workers in non-COVID-19-units had similar risk as University employees. Further measures to improve the safety of health care workers might be needed.KEY POINTSPrevious findings of elevated risk of contracting SARS-CoV-2 in health care workers with COVID-19 patient contact was confirmed, despite exclusion of wards with known SARS-CoV-2 outbreaks. Further measures to improve the safety of health care workers might be needed.

摘要

背景

在医护人员中,严重急性呼吸综合征冠状病毒2(SARS-CoV-2)已被证明是一种职业健康风险,常与医护人员之间的传播有关。然而,关于传播动态的信息不足,无法阐明该群体感染SARS-CoV-2的确切风险因素。

方法

在这项横断面研究中,我们调查了关于潜在暴露情况的问卷答案与SARS-CoV-2阳性之间的关联。纳入了瑞典马尔默和隆德的斯科讷大学医院9个科室中接触和未接触新冠患者的医护人员,以及瑞典隆德大学的大学员工。为限制医护人员之间传播的影响,排除了已知有疫情爆发的科室。SARS-CoV-2阳性病例定义为之前PCR检测呈阳性或血清中抗SARS-CoV-2 IgG阳性。

结果

在新冠科室的51名医护人员中,11人(22%)检测出SARS-CoV-2阳性;在非新冠科室的220名医护人员中,10人(5%)检测出阳性;在大学员工中,192人中有11人(6%)检测出阳性(P = 0.001,费舍尔精确检验)。在医护人员中,SARS-CoV-2阳性与在指定的新冠科室工作(比值比5.7(95%置信区间2.1 - 16))以及在大多数班次护理新冠患者有关(比值比5.4(95%置信区间2.0 - 15))。在所有参与者中,SARS-CoV-2阳性与家庭中确诊的新冠病例有关(比值比10(95%置信区间2.0 - 45))。

结论

我们的研究证实了之前的发现,即尽管排除了已知有疫情爆发的科室,但新冠科室的医护人员感染SARS-CoV-2的风险升高。有趣的是,非新冠科室的医护人员与大学员工的风险相似。可能需要采取进一步措施来提高医护人员的安全性。关键点尽管排除了已知有SARS-CoV-2疫情爆发的病房,但之前关于接触新冠患者的医护人员感染SARS-CoV-2风险升高的发现得到了证实。可能需要采取进一步措施来提高医护人员的安全性。

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