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在纽约市一家医院中,按工作职能和工作地点划分的医护人员中 SARS-CoV-2 血清流行率。

SARS-CoV-2 Seroprevalence Among Healthcare Workers by Job Function and Work Location in a New York Inner-City Hospital.

机构信息

Division of Pediatric Infectious Disease, Department of Pediatrics, BronxCare Health System, Bronx, NY.

Department of Family Medicine, Bronx-Care Health System Bronx, NY.

出版信息

J Hosp Med. 2021 May;16(5):282-289. doi: 10.12788/jhm.3627.

Abstract

OBJECTIVE

To describe the seroprevalence and risk for SARS-CoV-2 among healthcare workers (HCWs) by job function and work location following the pandemic's first wave in New York City (NYC).

METHODS

A cross-sectional study conducted between May 18 and June 26, 2020, during which HCWs at a large inner-city teaching hospital in NYC received voluntary antibody testing. The main outcome was presence of SARS-CoV-2 antibodies indicating previous infection. Seroprevalence and adjusted odds ratios (aORs) for seropositivity by type and location of work were calculated using logistic regression analyses.

RESULTS

Of 2,749 HCWs tested, 831 tested positive, yielding a crude seroprevalence of 30.2% (95% CI, 29%-32%). Seroprevalence ranged from 11.1% for pharmacy staff to 44.0% for nonclinical HCWs comprised of patient transporters and housekeeping and security staff, with 37.5% for nurses and 20.9% for administrative staff. Compared to administrative staff, aORs (95% CIs) for seropositivity were 2.54 (1.64-3.94) for nurses; 2.51 (1.42-4.43) for nonclinical HCWs; between 1.70 and 1.83 for allied HCWs such as patient care technicians, social workers, registration clerks and therapists; and 0.80 (0.50-1.29) for physicians. Compared to office locations, aORs for the emergency department and inpatient units were 2.27 (1.53-3.37) and 1.48 (1.14-1.92), respectively.

CONCLUSION

One-third of hospital-based HCWs were seropositive for SARS-CoV-2 by the end of the first wave in NYC. Seroprevalence differed by job function and work location, with the highest estimated risk for nurses and the emergency department, respectively. These findings support current nationwide policy prioritizing HCWs for receipt of newly authorized COVID-19 vaccines.

摘要

目的

描述纽约市(NYC)大流行第一波后,按工作职能和工作地点划分的医护人员(HCWs)的 SARS-CoV-2 血清流行率和感染风险。

方法

这是一项在 2020 年 5 月 18 日至 6 月 26 日进行的横断面研究,期间 NYC 一家大型市内教学医院的 HCWs 接受了自愿抗体检测。主要结局是存在 SARS-CoV-2 抗体,表明曾有过感染。使用逻辑回归分析计算按工作类型和地点划分的血清阳性率和血清阳性的调整优势比(aOR)。

结果

在 2749 名接受检测的 HCWs 中,831 名呈阳性,粗血清流行率为 30.2%(95%CI,29%-32%)。药房工作人员的血清流行率最低为 11.1%,非临床 HCWs(包括患者转运工、保洁员和安保人员)最高为 44.0%,护士为 37.5%,行政人员为 20.9%。与行政人员相比,护士(95%CI,1.64-3.94)、非临床 HCWs(95%CI,1.42-4.43)、辅助 HCWs(如患者护理技术员、社会工作者、注册文员和治疗师)的 aORs 介于 1.70-1.83 之间,医生的 aORs 为 0.80(0.50-1.29)。与办公地点相比,急诊科和住院病房的 aORs 分别为 2.27(1.53-3.37)和 1.48(1.14-1.92)。

结论

在 NYC 大流行第一波结束时,三分之一的医院 HCWs 对 SARS-CoV-2 呈血清阳性。血清流行率因工作职能和工作地点而异,护士和急诊科的风险估计最高。这些发现支持当前全国范围内优先为 HCWs 接种新授权的 COVID-19 疫苗的政策。

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