Lepak Alexander J, Buys Ashley, Stevens Linda, LeClair-Netzel Megan, Anderson Laura, Osman Fauzia, Brennan Meghan B, Bartels Christie M, Safdar Nasia
Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Infection Control Department, UW Health University Hospital, Madison, WI, USA.
Mayo Clin Proc. 2021 Sep;96(9):2312-2322. doi: 10.1016/j.mayocp.2021.06.019. Epub 2021 Jul 2.
To identify significant factors that help predict whether health care personnel (HCP) will test positive for severe acute respiratory coronavirus 2 (SARS-CoV-2).
We conducted a prospective cohort study among 7015 symptomatic HCP from March 25, 2020, through November 11, 2020. We analyzed the associations between health care role, contact history, symptoms, and a positive nasopharyngeal swab SARS-CoV-2 polymerase chain reaction test results, using univariate and multivariable modelling.
Of the symptomatic HCP, 624 (8.9%) were positive over the study period. On multivariable analysis, having a health care role other than physician or advanced practice provider, contact with family or community member with known or suspected coronavirus disease 2019 (COVID-19), and seven individual symptoms (cough, anosmia, ageusia, fever, myalgia, chills, and headache) were significantly associated with higher adjusted odds ratios for testing positive for SARS-CoV-2. For each increase in symptom number, the odds of testing positive nearly doubled (odds ratio, 1.93; 95% CI, 1.82 to 2.07, P<.001).
Symptomatic HCP have higher adjusted odds of testing positive for SARS-CoV-2 based on three distinct factors: (1) nonphysician/advanced practice provider role, (2) contact with a family or community member with suspected or known COVID-19, and (3) specific symptoms and symptom number. Differences among health care roles, which persisted after controlling for contacts, may reflect the influence of social determinants. Contacts with COVID-19-positive patients and/or HCP were not associated with higher odds of testing positive, supporting current infection control efforts. Targeted symptom and contact questionnaires may streamline symptomatic HCP testing for COVID-19.
确定有助于预测医护人员是否会出现严重急性呼吸综合征冠状病毒2（SARS-CoV-2）检测呈阳性的重要因素。
我们在2020年3月25日至2020年11月11日期间对7015名有症状的医护人员进行了一项前瞻性队列研究。我们使用单变量和多变量模型分析了医疗保健角色、接触史、症状与鼻咽拭子SARS-CoV-2聚合酶链反应检测结果呈阳性之间的关联。
在有症状的医护人员中，624人（8.9%）在研究期间检测呈阳性。多变量分析显示，担任医生或高级执业提供者以外的医疗保健角色、与已知或疑似2019冠状病毒病（COVID-19）的家庭成员或社区成员接触，以及七种个体症状（咳嗽、嗅觉丧失、味觉丧失、发热、肌痛、寒战和头痛）与SARS-CoV-2检测呈阳性的调整后比值比显著相关。症状数量每增加一个，检测呈阳性的几率几乎翻倍（比值比，1.93；95%置信区间，1.82至2.07，P<0.001）。
有症状的医护人员基于三个不同因素，SARS-CoV-2检测呈阳性的调整后几率更高：（1）非医生/高级执业提供者角色；（2）与疑似或已知COVID-19的家庭成员或社区成员接触；（3）特定症状和症状数量。在控制接触因素后，医疗保健角色之间的差异可能反映了社会决定因素的影响。与COVID-19阳性患者和/或医护人员接触与检测呈阳性的几率较高无关，这支持了当前的感染控制措施。有针对性的症状和接触调查问卷可能会简化有症状医护人员的COVID-19检测。
