在产生气溶胶的操作过程中，医护人员感染冠状病毒的风险：一项系统评价和荟萃分析。
The risk of coronavirus to healthcare providers during aerosol-generating procedures: A systematic review and meta-analysis.
作者信息
Bin Nafisah Sharafaldeen A, Mzahim Bandr Y, Aleid Bakhitah S, Sheerah Shahad A, Almatrafi Daliah Q, Ciottone Gregory R, AlAnazi Khalid H, Khan Anas A
机构信息
Department of Emergency, research center of King Fahd Medical City, Riyadh, Saudi Arabia.
Infection Control of the Ministry of Health, Harvard Medical School, Boston, Massachusetts, USA.
出版信息
Ann Thorac Med. 2021 Apr-Jun;16(2):165-171. doi: 10.4103/atm.ATM_497_20. Epub 2021 Apr 17.
CONTEXT
Several medical procedures are thought to increase the risk of transmission of infectious agents to health-care providers (HCPs) through an aerosol-generating mechanism.
AIMS
Given the significant influenza and coronavirus pandemics that have occurred in the 20 and 21 century, including the current severe acute respiratory syndrome coronavirus 2 global pandemic, the objective of this analysis is to assess the occurrence of disease transmission to HCPs from the performance aerosol-generating procedures (AGPs).
SETTINGS AND DESIGN
This was a systematic review and meta-analysis.
SUBJECTS AND METHODS
We performed a systematic meta-analysis looking at the odds ratio (OR) of AGP, causing infection among HCPs. We searched the following databases: MEDLINE (PubMed), ProQuest, Cochrane databases, and the Gray literature (ClinicalTrials.gov and World Health Organization International Clinical Trials Registry Platform). In addition, we conducted nondatabase search activities. The search terms used were "MERS-CoV," "COVID," and "SARS" combined with "provider" or "healthcare provider."
STATISTICAL ANALYSIS USED
RevMan meta-analysis was used for statistical analysis.
RESULTS
Following the search, we reviewed 880 studies, of which six studies were eligible. The estimated odd ratio utilizing a control group of HCPs who were exposed to AGP but did not develop the infection was 1.85 (95% confidence interval [CI]: 1.33, 2.57). The OR remained the same when we added another control group who, despite not being exposed to AGP, had developed the infection. The OR remained 1.85 (95% CI: 1.33, 2.55). However, there is an increase in the OR to 1.89 (95% CI: 1.38, 2.59) when we added HCPs who did not use adequate personal protective equipment (PPE) during the procedures to the total estimates.
CONCLUSIONS
The performance of AGP with inadequate PPE can result in an increased risk of disease transmission to HCWs.
背景
一些医疗程序被认为会通过气溶胶生成机制增加感染源传播给医护人员（HCPs）的风险。
目的
鉴于20世纪和21世纪发生的重大流感和冠状病毒大流行，包括当前的严重急性呼吸综合征冠状病毒2全球大流行，本分析的目的是评估因实施气溶胶生成程序（AGPs）导致疾病传播给医护人员的情况。
设置与设计
这是一项系统评价和荟萃分析。
研究对象与方法
我们进行了一项系统荟萃分析，观察AGP导致医护人员感染的比值比（OR）。我们检索了以下数据库：MEDLINE（PubMed）、ProQuest、Cochrane数据库和灰色文献（ClinicalTrials.gov和世界卫生组织国际临床试验注册平台）。此外，我们还进行了非数据库检索活动。使用的检索词为“中东呼吸综合征冠状病毒（MERS-CoV）”、“新冠（COVID）”和“非典（SARS）”，并与“提供者”或“医护人员”组合。
所用统计分析方法
使用RevMan荟萃分析进行统计分析。
结果
检索后，我们审查了880项研究，其中六项研究符合条件。利用未感染但接触过AGP的医护人员对照组估算的比值比为1.85（95%置信区间[CI]：1.33，2.57）。当我们加入另一个对照组时，该比值比保持不变，这个对照组尽管未接触AGP，但感染了。比值比仍为1.85（95%CI：1.33，2.55）。然而，当我们将在操作过程中未使用适当个人防护装备（PPE）的医护人员纳入总体估算时，比值比增至1.89（95%CI：1.38，2.59）。
结论
使用PPE不足进行AGP操作可能会增加疾病传播给医护人员的风险。
Zotero 插件