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葡萄牙市政工作人员中 SARS-CoV-2 的血清流行率和流行病学决定因素评估。

Seroprevalence of SARS-CoV-2 and assessment of epidemiologic determinants in Portuguese municipal workers.

机构信息

University of Porto, Porto, Portugal (Faculty of Medicine).

University of Porto, Porto, Portugal (MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine).

出版信息

Int J Occup Med Environ Health. 2022 Jun 8;35(3):297-307. doi: 10.13075/ijomeh.1896.01878. Epub 2022 Feb 7.

Abstract

OBJECTIVES

To assess the seroprevalence of SARS-CoV-2 antibodies in municipal employees of Northern Portugal during the first pandemic wave (May-June 2020) and its association with potentially related risk factors for infection.

MATERIAL AND METHODS

The authors assessed municipal employees of 2 cities in Northern Portugal, in whom serological tests to SARS-CoV-2 and an epidemiological survey were applied. The authors assessed the proportion of individuals presenting IgM and/or IgG antibodies to SARS-CoV-2, and evaluated the association between having positive serological test results, epidemiologic variables and clinical presentations. Reported symptoms were evaluated on their sensitivity, specificity, and predictive values.

RESULTS

The authors assessed 1696 employees, of whom 22.0% were firefighters, 10.4% were police officers, 10.3% were maintenance workers, and 8.1% were administrative assistants. The seroprevalence of SARS-CoV-2 infection was 2.9% (95% CI: 2.1-3.7%). Administrative assistants comprised the professional group with highest seroprevalence of SARS-CoV-2 (OR = 1.9 in the comparison with other occupational groups, 95% CI: 0.8-4.3, p = 0.126). The seroprevalence of SARS-CoV-2 infection among those who were in direct contact with COVID-19 patients in their professional activity was 3.9%, compared to 2.7% among those who were not in direct contact with such patients (OR = 1.5, 95% CI: 0.8-2.8, p = 0.222). The highest risk of infection was associated with the presence of a confirmed SARS-CoV-2 infection in the household (OR = 17.4, 95% CI: 8.3-36.8, p < 0.001). Living with a healthcare professional was not associated with a higher risk of infection (OR = 1.0, 95% CI: 0.4-2.5, p = 0.934). Anosmia/ dysgeusia was the symptom with the highest positive predictive value (52.2%, 95% CI: 31.8-72.6, p < 0.001) and specificity (99.3%, 95% CI: 98.9-99.7, p < 0.001), while cough was the most prevalent symptom among SARS-CoV-2 seropositive participants (36%).

CONCLUSIONS

The authors observed a SARS-CoV-2 seroprevalence of 2.9% among assessed municipal employees. Anosmia/dysgeusia was the COVID-19 symptom which displayed the highest positive predictive value and specificity. Int J Occup Med Environ Health. 2022;35(3):297-307.

摘要

目的

评估葡萄牙北部市政员工在第一波大流行期间(2020 年 5 月至 6 月)的 SARS-CoV-2 抗体血清阳性率及其与潜在感染相关危险因素的关系。

材料和方法

作者评估了葡萄牙北部 2 个城市的市政员工,对其进行了 SARS-CoV-2 的血清学检测和流行病学调查。作者评估了个体呈现 SARS-CoV-2 免疫球蛋白 M(IgM)和/或免疫球蛋白 G(IgG)抗体的比例,并评估了阳性血清学检测结果与流行病学变量和临床表现之间的关系。报告的症状的敏感性、特异性和预测值进行了评估。

结果

作者评估了 1696 名员工,其中 22.0%为消防员,10.4%为警察,10.3%为维修工人,8.1%为行政助理。SARS-CoV-2 感染的血清阳性率为 2.9%(95%置信区间:2.1-3.7%)。行政助理是 SARS-CoV-2 血清阳性率最高的职业群体(与其他职业群体相比,优势比[OR]为 1.9,95%置信区间:0.8-4.3,p=0.126)。在职业活动中与 COVID-19 患者有直接接触的员工中,SARS-CoV-2 感染的血清阳性率为 3.9%,而与这些患者没有直接接触的员工中,SARS-CoV-2 感染的血清阳性率为 2.7%(OR=1.5,95%置信区间:0.8-2.8,p=0.222)。感染的最高风险与家庭中确诊的 SARS-CoV-2 感染有关(OR=17.4,95%置信区间:8.3-36.8,p<0.001)。与卫生保健专业人员同住并不与更高的感染风险相关(OR=1.0,95%置信区间:0.4-2.5,p=0.934)。嗅觉/味觉丧失是阳性预测值最高(52.2%,95%置信区间:31.8-72.6,p<0.001)和特异性最高(99.3%,95%置信区间:98.9-99.7,p<0.001)的 COVID-19 症状,而咳嗽是 SARS-CoV-2 血清阳性参与者中最常见的症状(36%)。

结论

作者观察到评估的市政员工中 SARS-CoV-2 血清阳性率为 2.9%。嗅觉/味觉丧失是 COVID-19 症状中阳性预测值和特异性最高的症状。国际职业医学与环境卫生杂志。2022;35(3):297-307。

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