South Western Sydney Nursing and Midwifery Research, Ingham Institute of Applied Medical Research, Sydney, New South Wales, Australia.
Western Sydney University, Sydney, New South Wales, Australia.
J Clin Nurs. 2022 Jun;31(11-12):1557-1569. doi: 10.1111/jocn.16009. Epub 2021 Sep 27.
This systematic review and meta-analysis reports the seroprevalence of SARS-CoV-2 antibodies among nurses.
With a growing body of literature reporting the positive serology for SARS-CoV-2 antibodies among healthcare workers, it remains unclear whether staff at the point of direct patient care are more prone to developing and transmitting the virus. Given nurses make up the majority of the global health workforce, outbreaks among these workers could severely undermine a health system's capability to manage the pandemic. We aimed to summarise and report the seroprevalence of SARS-CoV-2 antibodies among nurses globally.
Systematic review and meta-analyses.
This systematic review was developed, undertaken and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. We searched the electronic medical literature databases: MEDLINE; CINAHL; and EMBASE for studies reporting the seroprevalence of SARS-CoV-2 antibodies among nursing staff. Studies that reported nursing specific data were included in this review. Study quality was evaluated using the Joanna Briggs Institute checklist for studies reporting prevalence data. Studies were stratified according to the World Health Organisation region classifications, and results were presented using forest plots and summary prevalence and variance was estimated using a random effects model.
Our electronic search identified 1687 potential studies, of which 1148 were screened for eligibility after duplicates were removed, and 51 of the studies were included in our meta-analysis. The overall seroprevalence of SARS-CoV-2 antibodies among nurses was estimated to be 8.1% (95% CI 6.9%-9.4%) among the 60,571 participants included in the studies. Seropositivity was highest in the African region (48.2%, 95% CI 39.2%-57.3%), followed by the European region (10.3%, 95% CI 8.0%-12.5%), the Region of the Americas (8.4%, 95% CI 6.0%-10.7%), the South-East Asia region (3.0%, 95% CI 0.00%-6.5%) and the Western Pacific region (0.5%, 95% CI 0.0%-1.0%). Pooled estimates were unable to be calculated in the Eastern Mediterranean region due to insufficient studies.
The seroprevalence of SARS-CoV-2 antibodies among nurses is comparable to other healthcare workers, and possibly similar to the general population. Early adoption and adherence to personal protective equipment and social distancing measures could explain these similarities, meaning the majority of staff contracted the virus through community transmission and not in a healthcare setting.
Fear and uncertainty have been features of this pandemic, including among nurses. This meta-analysis should provide some comfort to nurses that risks are similar to community exposure when adequate PPE is available and there is an adherence to infection control measures.
本系统评价和荟萃分析报告了护士中 SARS-CoV-2 抗体的血清阳性率。
随着越来越多的文献报道医护人员中 SARS-CoV-2 抗体呈阳性，仍不清楚直接接触患者的医护人员是否更容易感染和传播病毒。鉴于护士占全球卫生劳动力的大多数，如果这些工作人员中爆发疫情，可能会严重削弱卫生系统管理大流行的能力。我们旨在总结和报告全球护士中 SARS-CoV-2 抗体的血清阳性率。
系统评价和荟萃分析。
本系统评价按照系统评价和荟萃分析的首选报告项目（PRISMA）指南进行制定、进行和报告。我们在电子医学文献数据库中搜索了报告护理人员中 SARS-CoV-2 抗体血清阳性率的研究：MEDLINE；CINAHL；和 EMBASE。纳入了报告护理特定数据的研究。使用 Joanna Briggs 研究所针对报告流行率数据的清单评估研究质量。根据世界卫生组织区域分类对研究进行分层，使用森林图呈现结果，并使用随机效应模型估计汇总流行率和方差。
我们的电子搜索确定了 1687 项潜在研究，其中 1148 项在去除重复项后进行了筛选以确定其合格性，有 51 项研究纳入了我们的荟萃分析。在纳入的 60571 名参与者中，护士中 SARS-CoV-2 抗体的总体血清阳性率估计为 8.1%（95%CI 6.9%-9.4%）。在非洲地区（48.2%，95%CI 39.2%-57.3%）血清阳性率最高，其次是欧洲地区（10.3%，95%CI 8.0%-12.5%），美洲地区（8.4%，95%CI 6.0%-10.7%），东南亚地区（3.0%，95%CI 0.00%-6.5%）和西太平洋地区（0.5%，95%CI 0.0%-1.0%）。由于研究不足，无法计算东地中海地区的汇总估计值。
护士中 SARS-CoV-2 抗体的血清阳性率与其他医护人员相当，可能与一般人群相似。早期采用和遵守个人防护设备和保持社交距离措施可以解释这些相似之处，这意味着大多数工作人员是通过社区传播而不是在医疗环境中感染病毒的。
在这场大流行中，包括护士在内，恐惧和不确定性一直是特征。这项荟萃分析应该可以让护士们感到一些安慰，即当有足够的个人防护设备且遵守感染控制措施时，风险与社区暴露相似。
