Elfström K Miriam, Blomqvist Jonas, Nilsson Peter, Hober Sophia, Pin Elisa, Månberg Anna, Pimenoff Ville N, Arroyo Mühr Laila Sara, Lundgren Kalle Conneryd, Dillner Joakim
Karolinska University Hospital, Stockholm SE-141 86, Sweden.
Division of Affinity Proteomics, Department of Protein Science, KTH Royal Institute of Technology, SciLifeLab, Stockholm, Sweden.
Prev Med Rep. 2021 Dec;24:101518. doi: 10.1016/j.pmedr.2021.101518. Epub 2021 Aug 21.
Healthcare workers (HCWs) are a risk group for SARS-CoV-2 infection, but which healthcare work that conveys risk and to what extent such risk can be prevented is not clear. Starting on April 24th, 2020, all employees at work (n = 15,300) at the Karolinska University Hospital, Stockholm, Sweden were invited and 92% consented to participate in a SARS-CoV-2 cohort study. Complete SARS-CoV-2 serology was available for n = 12,928 employees and seroprevalences were analyzed by age, sex, profession, patient contact, and hospital department. Relative risks were estimated to examine the association between type of hospital department as a proxy for different working environment exposure and risk for seropositivity, adjusting for age, sex, sampling week, and profession. Wards that were primarily responsible for COVID-19 patients were at increased risk (adjusted OR 1.95 (95% CI 1.65-2.32) with the notable exception of the infectious diseases and intensive care units (adjusted OR 0.86 (95% CI 0.66-1.13)), that were not at increased risk despite being highly exposed. Several units with similar types of work varied greatly in seroprevalences. Among the professions examined, nurse assistants had the highest risk (adjusted OR 1.62 (95% CI 1.38-1.90)). Although healthcare workers, in particular nurse assistants, who attend to COVID-19 patients are a risk group for SARS-CoV-2 infection, several units caring for COVID-19 patients had no excess risk. Large variations in seroprevalences among similar units suggest that healthcare work-related risk of SARS-CoV-2 infection may be preventable.
医护人员是感染新冠病毒的高危群体，但哪些医疗工作存在风险以及这种风险能在多大程度上得到预防尚不清楚。从2020年4月24日起，瑞典斯德哥尔摩卡罗林斯卡大学医院邀请了所有在职员工（n = 15300），其中92%同意参与一项新冠病毒队列研究。12928名员工可获得完整的新冠病毒血清学检测结果，并按年龄、性别、职业、患者接触情况和医院科室分析血清阳性率。估计相对风险以检验作为不同工作环境暴露代理的医院科室类型与血清阳性风险之间的关联，并对年龄、性别、采样周和职业进行调整。主要负责新冠患者的病房风险增加（调整后的比值比为1.95（95%置信区间1.65 - 2.32）），但传染病科和重症监护病房是显著例外（调整后的比值比为0.86（95%置信区间0.66 - 1.13）），尽管暴露程度高但风险并未增加。几个从事类似工作的科室血清阳性率差异很大。在所检查的职业中，护士助理风险最高（调整后的比值比为1.62（95%置信区间1.38 - 1.90））。尽管护理新冠患者的医护人员，尤其是护士助理，是感染新冠病毒的高危群体，但几个护理新冠患者的科室并没有额外风险。类似科室之间血清阳性率的巨大差异表明，与医疗工作相关的新冠病毒感染风险可能是可以预防的。
