瑞士一家大学医院员工的严重急性呼吸综合征冠状病毒2（SARS-CoV-2）血清转化与职业暴露：一项大型纵向队列研究。
Severe acute respiratory coronavirus virus 2 (SARS-CoV-2) seroconversion and occupational exposure of employees at a Swiss university hospital: A large longitudinal cohort study.
作者信息
Martischang Romain, Iten Anne, Arm Isabelle, Abbas Mohamed, Meyer Benjamin, Yerly Sabine, Eckerle Isabella, Pralong Jacques, Sauser Julien, Suard Jean-Claude, Kaiser Laurent, Pittet Didier, Harbarth Stephan
机构信息
Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
Division of Laboratory Medicine, Department of Diagnostics, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
出版信息
Infect Control Hosp Epidemiol. 2022 Mar;43(3):326-333. doi: 10.1017/ice.2021.117. Epub 2021 Mar 19.
BACKGROUND
The dynamics of coronavirus disease 2019 (COVID-19) seroconversion of hospital employees are understudied. We measured the proportion of seroconverted employees and evaluated risk factors for seroconversion during the first pandemic wave.
METHODS
In this prospective cohort study, we recruited Geneva University Hospitals employees and sampled them 3 times, every 3 weeks from March 30 to June 12, 2020. We measured the proportion of seroconverted employees and determined prevalence ratios of risk factors for seroconversion using multivariate mixed-effects Poisson regression models.
RESULTS
Overall, 3,421 participants (29% of all employees) were included, with 92% follow-up. The proportion of seroconverted employees increased from 4.4% (95% confidence interval [CI], 3.7%-5.1%) at baseline to 8.5% [(95% CI, 7.6%-9.5%) at the last visit. The proportions of seroconverted employees working in COVID-19 geriatrics and rehabilitation (G&R) wards (32.3%) and non-COVID-19 G&R wards (12.3%) were higher compared to office workers (4.9%) at the last visit. Only nursing assistants had a significantly higher risk of seroconversion compared to office workers (11.7% vs 4.9%; P = .006). Significant risk factors for seroconversion included the use of public transportation (adjusted prevalence ratio, 1.59; 95% CI, 1.25-2.03), known community exposure to severe acute respiratory coronavirus virus 2 (2.80; 95% CI, 2.22-3.54), working in a ward with a nosocomial COVID outbreak (2.93; 95% CI, 2.27-3.79), and working in a COVID-19 G&R ward (3.47; 95% CI, 2.45-4.91) or a non-COVID-19 G&R ward (1.96; 95% CI, 1.46-2.63). We observed an association between reported use of respirators and lower risk of seroconversion (0.73; 95% CI, 0.55-0.96).
CONCLUSION
Additional preventive measures should be implemented to protect employees in G&R wards. Randomized trials on the protective effect of respirators are urgently needed.
背景
2019冠状病毒病（COVID-19）医院员工血清转化的动态情况研究不足。我们测量了血清转化员工的比例，并评估了疫情第一波期间血清转化的风险因素。
方法
在这项前瞻性队列研究中，我们招募了日内瓦大学医院的员工，并在2020年3月30日至6月12日期间，每3周对他们进行3次采样。我们测量了血清转化员工的比例，并使用多变量混合效应泊松回归模型确定血清转化风险因素的患病率比值。
结果
总体而言，纳入了3421名参与者（占所有员工的29%），随访率为92%。血清转化员工的比例从基线时的4.4%（95%置信区间[CI]，3.7%-5.1%）增加到最后一次访视时的8.5%（95%CI，7.6%-9.5%）。在最后一次访视时，在COVID-19老年病和康复（G&R）病房工作的血清转化员工比例（32.3%）和非COVID-19 G&R病房工作的血清转化员工比例（12.3%）高于办公室工作人员（4.9%）。与办公室工作人员相比，只有护理助理血清转化风险显著更高（11.7%对4.9%；P = 0.006）。血清转化的显著风险因素包括使用公共交通工具（调整后的患病率比值，1.59；95%CI，1.25-2.03）、已知在社区接触严重急性呼吸综合征冠状病毒2（2.80；95%CI，2.22-3.54）、在有医院内COVID爆发的病房工作（2.93；95%CI），2.27-3.79），以及在COVID-19 G&R病房（3.47；95%CI，2.45-4.91）或非COVID-19 G&R病房（1.96；95%CI，1.46-2.63）工作。我们观察到报告使用呼吸器与较低的血清转化风险之间存在关联（0.73；95%CI，0.55-0.96）。
结论
应采取额外的预防措施来保护G&R病房的员工。迫切需要对呼吸器的保护效果进行随机试验。
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