Correia Roberta Fernandes, da Costa Ana Carolina Carioca, Moore Daniella Campelo Batalha Cox, Gomes Junior Saint Clair, de Oliveira Maria Paula Carneiro, Zuma Maria Célia Chaves, Galvani Rômulo Gonçalves, Savino Wilson, Bonomo Adriana Cesar, Vasconcelos Zilton Farias Meira, Artmann Elizabeth
National Institute of Health for Women, Children and Adolescents Fernandes Figueira/Oswaldo Cruz Foundation, Rio de Janeiro 22250-020, Brazil.
Laboratory on Thymus Research, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro 21045-900, Brazil.
Lancet Reg Health Am. 2022 Mar;7:100170. doi: 10.1016/j.lana.2021.100170. Epub 2021 Dec 31.
COVID-19 has exacerbated health inequalities worldwide. Yet, such a perspective has not been investigated in specific healthcare workers and their resulting inclusion as a priority group for vaccination have been an important focus of political and social discussion. This study aimed at investigating whether SARS-CoV-2-seropositivity in healthcare workers in a public hospital in Rio de Janeiro, Brazil, was influenced by social determinants of health and the social vulnerability in subgroups of workers.
A serological survey was conducted in 1,154 healthcare workers in June and July 2020. The association between the serological test results for detection of IgG antibodies to SARS-CoV-2 and socioeconomic, occupational characteristics and transportation used by the workers to commute was assessed using the Pearson´s chi-square test and Cramer's V.
Overall, the serum prevalence for the virus in the healthcare workers was 30% (342/1141). Non-white workers (208/561) with lower income (169/396) and schooling (150/353), as well as users of the mass transportation system (157/246) showed the highest infection rates. Importantly they mostly corresponded to hospital support workers (131/324), in particular the cleaning personnel (42/70). Accordingly, income, schooling and work modality appeared as negative predictors, as ascertained by forest plot analysis.
The data clearly illustrate the inequality in SARS-CoV-2 infection in the Brazilian population, comprising even healthcare workers of the Brazilian unified health system.
新冠疫情加剧了全球范围内的健康不平等。然而，这一观点尚未在特定医护人员中得到研究，且将他们列为优先接种疫苗群体一直是政治和社会讨论的重要焦点。本研究旨在调查巴西里约热内卢一家公立医院的医护人员中，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）血清阳性是否受健康的社会决定因素以及不同亚组医护人员的社会脆弱性影响。
2020年6月和7月对1154名医护人员进行了血清学调查。采用Pearson卡方检验和Cramer's V评估SARS-CoV-2 IgG抗体检测血清学检测结果与社会经济、职业特征以及医护人员通勤所用交通方式之间的关联。
总体而言，医护人员中该病毒的血清流行率为30%（342/1141）。收入较低（169/396）、受教育程度较低（150/353）的非白人员工（208/561）以及使用公共交通系统的人员（157/246）感染率最高。重要的是，他们大多是医院辅助人员（131/324），尤其是清洁人员（42/70）。因此，通过森林图分析确定，收入、受教育程度和工作方式似乎是阴性预测因素。
数据清楚地表明了巴西人群中SARS-CoV-2感染的不平等现象，甚至在巴西统一医疗系统的医护人员中也存在。
