Hamad Medical Corporation, Doha, Qatar.
Microbiology and Immunology Department, Faculty of Medicine, Assiut University, Assiut, Egypt.
PLoS One. 2021 Sep 30;16(9):e0257845. doi: 10.1371/journal.pone.0257845. eCollection 2021.
While many studies have reported the rate and risk of SARS-CoV-2 infection among healthcare workers (HCWs), there are scant data regarding the impact of employment type and job grades upon such risk.
We determined the rate of SARS-CoV-2 infection based on a positive nasopharyngeal swab (NPS) PCR among employees of a large national healthcare system. Antibody testing was performed on those who agreed to provide a blood sample. Using logistic regression analysis, we determined the risk of infection (PCR+) associated with demographic characteristics, job family and job grade.
We identified 35,075 staff (30,849 full-time, 4,226 outsourced) between March 1-October 31, 2020. Among full-time employees, 78.0% had a NPS (11.8% positive). Among outsourced staff, 94.4% had a NPS (31.1% positive). Antibody testing was performed on 33.9% full-time employees (13.0% reactive), and on 39.1% of the outsourced staff (47.0% reactive). PCR-positivity was higher among outsourced staff (31.0% vs. 18.3% in non-clinical and 9.0% in clinical full-time employees) and those in the low-grade vs. mid-grade and high-grade job categories. Male sex (OR 1.88), non-clinical job family (OR 1.21), low-grade job category (OR 3.71) and being an outsourced staff (OR 2.09) were associated with a higher risk of infection.
HCWs are a diverse population with varying risk of infection. Clinical staff are at a lower risk likely due to increased awareness and infection prevention measures. Risk is higher for those in the lower socioeconomic strata. Infection is more likely to occur in non-healthcare setting than within the healthcare facilities.
虽然许多研究报告了医护人员（HCWs）中 SARS-CoV-2 感染的发生率和风险，但关于就业类型和工作等级对这种风险的影响的数据很少。
我们根据大型国家医疗保健系统中员工的鼻咽拭子（NPS）PCR 阳性结果，确定了 SARS-CoV-2 感染的发生率。同意提供血样的人进行抗体检测。使用逻辑回归分析，我们确定了与人口统计学特征、工作类别和工作等级相关的感染风险（PCR+）。
我们在 2020 年 3 月 1 日至 10 月 31 日期间确定了 35075 名员工（30849 名全职，4226 名外包）。在全职员工中，78.0%的人进行了 NPS（11.8%阳性）。在外包员工中，94.4%的人进行了 NPS（31.1%阳性）。对 33.9%的全职员工（13.0%反应性）和 39.1%的外包员工（47.0%反应性）进行了抗体检测。外包员工的 PCR 阳性率较高（31.0%，而非临床全职员工为 18.3%，临床全职员工为 9.0%），以及低等级与中等级和高等级工作类别相比。男性（OR 1.88）、非临床工作类别（OR 1.21）、低等级工作类别（OR 3.71）和外包员工（OR 2.09）与感染风险增加相关。
HCWs 是一个多样化的人群，感染风险不同。临床工作人员的风险较低，可能是因为他们有更高的意识和感染预防措施。社会经济地位较低的人风险较高。感染更可能发生在非医疗保健环境中，而不是在医疗保健设施内。
