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德国高风险和低风险地区放射科工作人员职业性 COVID-19 感染风险:“第一波”中的经验教训。

Risk to Radiology Staff for Occupational COVID-19 Infection in a High-Risk and a Low-Risk Region in Germany: Lessons from the "First Wave".

机构信息

Department of Radiology and Neuroradiology, Hospital Weiden, Germany.

Department of Hematology and Oncology, Brandenburg Medical School Theodor Fontane, Brandenburg a. d. Havel, Germany.

出版信息

Rofo. 2021 May;193(5):537-543. doi: 10.1055/a-1393-6668. Epub 2021 Mar 10.

Abstract

PURPOSE

The recent COVID-19 pandemic has resulted in an increasing overload of the medical system. Healthcare workers (HCW) in radiology departments are exposed to a high infection risk similar to HCWs in the ICU or dedicated COVID wards. The goal of our paper is to evaluate the prevalence of IgG antibody against SARS-CoV-2 among radiology HCWs in two different hospitals and regions in Germany with a low and high COVID-19 prevalence and to compare it to the prevalence in other clinical personnel. Additionally, we assessed the number of radiological procedures performed in patients with a positive PCR test (C+) followed by a short review of the risk for nosocomial infections of radiology HCWs.

MATERIALS AND METHODS

During the first COVID-19 wave between March and July 2020, we evaluated a region with one of the highest COVID-19 rates (776-1570/100 000) in Germany (Hospital A). Additionally, we assessed Hospital B in a region with a low prevalence (65/100 000). We tested the serum prevalence of SARS-CoV-2 IgG antibodies among the whole staff with a subgroup analysis for radiology in both hospitals. We calculated the total number of different radiological procedures performed in C+ patients.

RESULTS

In Hospital A 594 PCR-proven C+ patients were treated resulting in 2723 radiological procedures. 24 % (n = 6) of the radiology technicians and 13.35 (n = 2) of radiologists had a positive IgG test. The rates were similar to positive rates in HCWs in COVID-19 wards and ICUs within the hospital. The most frequently performed procedures in C+ patients were chest X-rays (3.17/patient) and CT examinations (1.15/patient). In Hospital B 50 C+ patients were treated, resulting in 64 radiological procedures. None of the HCWs tested IgG positive. The most frequently performed examinations were also chest X-rays (1.04/patient) and CT (0.2/patient).

CONCLUSION

HCWs in radiology have a high occupational infection risk similar to that of HCWs in ICUs and dedicated COVID wards.

KEY POINTS

· The risk of acquiring COVID-19 increases with the amount of contact with infected individuals.. · The occupational risk of a SARS-CoV-2 infection for radiology staff is similar to that of nurses and physicians in COVID wards.. · Hygiene concepts and medical resources have to be adapted for further COVID outbreaks.. · Reporting of an occupational disease can be considered in the case of seropositive staff..

CITATION FORMAT

· Finkenzeller T, Lenhart S, Reinwald M et al. Risk to Radiology Staff for Occupational COVID-19 Infection in a High-Risk and a Low-Risk Region in Germany: Lessons from the "First Wave". Fortschr Röntgenstr 2021; 193: 537 - 543.

摘要

目的

最近的 COVID-19 大流行导致医疗系统负担过重。放射科的医护人员(HCW)面临着与 ICU 或专门的 COVID 病房的 HCW 类似的高感染风险。我们论文的目的是评估德国两个不同地区和医院中放射科 HCW 中针对 SARS-CoV-2 的 IgG 抗体的流行率,这两个地区的 COVID-19 流行率较低和较高,并将其与其他临床人员的流行率进行比较。此外,我们评估了对 PCR 检测呈阳性(C+)的患者进行的放射学检查数量,随后对放射科 HCW 发生医院感染的风险进行了简短回顾。

材料和方法

在 2020 年 3 月至 7 月的第一波 COVID-19 期间,我们评估了德国 COVID-19 发病率最高的地区之一(每 10 万人口 776-1570 例)(医院 A)。此外,我们还评估了发病率较低的医院 B(每 10 万人口 65 例)。我们用亚组分析对这两个医院的所有工作人员进行了血清 SARS-CoV-2 IgG 抗体流行率检测。我们计算了 C+患者中不同放射学检查的总数。

结果

在医院 A,有 594 例经 PCR 证实的 C+患者接受了治疗,共进行了 2723 次放射学检查。24%(n=6)的放射技术人员和 13.35%(n=2)的放射科医生 IgG 检测呈阳性。这些比率与医院内 COVID-19 病房和 ICU 的 HCW 阳性率相似。C+患者中最常进行的检查是胸部 X 光检查(3.17/例)和 CT 检查(1.15/例)。在医院 B,有 50 例 C+患者接受了治疗,共进行了 64 次放射学检查。没有一名 HCW 的 IgG 检测呈阳性。最常进行的检查也是胸部 X 光检查(1.04/例)和 CT(0.2/例)。

结论

放射科的 HCW 面临着与 ICU 和专门的 COVID 病房的 HCW 相似的高职业感染风险。

关键要点

· 与受感染个体接触的次数越多,感染 COVID-19 的风险就越大。

· 放射科工作人员感染 SARS-CoV-2 的职业风险与 COVID 病房的护士和医生相似。

· 需要为进一步的 COVID 爆发调整卫生概念和医疗资源。

· 对于血清阳性的工作人员,可以考虑报告职业病。

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