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美国六个地点创伤患者中的新冠病毒血清流行率及药物使用情况

SARS-CoV-2 Seroprevalence and Drug Use in Trauma Patients from Six Sites in the United States.

作者信息

Ngo Tran B, Karkanitsa Maria, Adusei Kenneth M, Graham Lindsey A, Ricotta Emily E, Darrah Jenna R, Blomberg Richard D, Spathies Jacquelyn, Pauly Kyle J, Klumpp-Thomas Carleen, Travers Jameson, Mehalko Jennifer, Drew Matthew, Hall Matthew D, Memoli Matthew J, Esposito Dominic, Kozar Rosemary A, Griggs Christopher, Cunningham Kyle W, Schulman Carl I, Crandall Marie, Neavyn Mark, Dorfman Jon D, Lai Jeffrey T, Whitehill Jennifer M, Babu Kavita M, Mohr Nicholas M, Van Heukelom Jon, Fell James C, Rooke Whit, Kalish Heather, Thomas F Dennis, Sadtler Kaitlyn

机构信息

Section on Immuno-Engineering. National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda MD 20894.

Dunlap and Associates, Inc., Stamford CT 06906.

出版信息

medRxiv. 2021 Aug 11:2021.08.10.21261849. doi: 10.1101/2021.08.10.21261849.

Abstract

In comparison to the general patient population, trauma patients show higher level detections of bloodborne infectious diseases, such as Hepatitis and Human Immunodeficiency Virus. In comparison to bloodborne pathogens, the prevalence of respiratory infections such as SARS-CoV-2 and how that relates with other variables, such as drug usage and trauma type, is currently unknown in trauma populations. Here, we evaluated SARS-CoV-2 seropositivity and antibody isotype profile in 2,542 trauma patients from six Level-1 trauma centers between April and October of 2020 during the first wave of the COVID-19 pandemic. We found that the seroprevalence in trauma victims 18-44 years old (9.79%, 95% confidence interval/CI: 8.33 - 11.47) was much higher in comparison to older patients (45-69 years old: 6.03%, 4.59-5.88; 70+ years old: 4.33%, 2.54 - 7.20). Black/African American (9.54%, 7.77 - 11.65) and Hispanic/Latino patients (14.95%, 11.80 - 18.75) also had higher seroprevalence in comparison, respectively, to White (5.72%, 4.62 - 7.05) and Non-Latino patients (6.55%, 5.57 - 7.69). More than half (55.54%) of those tested for drug toxicology had at least one drug present in their system. Those that tested positive for narcotics or sedatives had a significant negative correlation with seropositivity, while those on anti-depressants trended positive. These findings represent an important consideration for both the patients and first responders that treat trauma patients facing potential risk of respiratory infectious diseases like SARS-CoV-2.

摘要

与普通患者群体相比,创伤患者血液传播感染性疾病(如肝炎和人类免疫缺陷病毒)的检测水平更高。与血液传播病原体相比,创伤人群中诸如严重急性呼吸综合征冠状病毒2(SARS-CoV-2)等呼吸道感染的患病率以及其与其他变量(如药物使用和创伤类型)之间的关系目前尚不清楚。在此,我们评估了2020年4月至10月新冠疫情第一波期间来自六个一级创伤中心的2542名创伤患者的SARS-CoV-2血清阳性率和抗体亚型谱。我们发现,18至44岁创伤受害者的血清阳性率(9.79%,95%置信区间/CI:8.33 - 11.47)相比老年患者(45至69岁:6.03%,4.59 - 5.88;70岁及以上:4.33%,2.54 - 7.20)要高得多。黑人/非裔美国人(9.54%,7.77 - 11.65)和西班牙裔/拉丁裔患者(14.95%,11.80 - 18.75)的血清阳性率相比也分别高于白人(5.72%,4.62 - 7.05)和非拉丁裔患者(6.55%,5.57 - 7.69)。接受药物毒理学检测的患者中,超过一半(55.54%)体内至少有一种药物。那些麻醉药或镇静剂检测呈阳性的患者与血清阳性率呈显著负相关,而服用抗抑郁药的患者则呈正相关趋势。这些发现对于治疗面临SARS-CoV-2等呼吸道传染病潜在风险的创伤患者的患者和急救人员而言是重要的考虑因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31bd/8366813/3824b07100ce/nihpp-2021.08.10.21261849v1-f0001.jpg

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