医护人员中严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染的职业风险因素：亚特兰大埃默里医疗保健人员 COVID-19 预防研究（COPE）的 6 个月前瞻性分析。
Occupational risk factors for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection among healthcare personnel: A 6-month prospective analysis of the COVID-19 Prevention in Emory Healthcare Personnel (COPE) Study.
机构信息
Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
Georgia Emerging Infections Program, Decatur, Georgia.
出版信息
Infect Control Hosp Epidemiol. 2022 Nov;43(11):1664-1671. doi: 10.1017/ice.2021.518. Epub 2022 Feb 14.
OBJECTIVES
To determine the incidence of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection among healthcare personnel (HCP) and to assess occupational risks for SARS-CoV-2 infection.
DESIGN
Prospective cohort of healthcare personnel (HCP) followed for 6 months from May through December 2020.
SETTING
Large academic healthcare system including 4 hospitals and affiliated clinics in Atlanta, Georgia.
PARTICIPANTS
HCP, including those with and without direct patient-care activities, working during the coronavirus disease 2019 (COVID-19) pandemic.
METHODS
Incident SARS-CoV-2 infections were determined through serologic testing for SARS-CoV-2 IgG at enrollment, at 3 months, and at 6 months. HCP completed monthly surveys regarding occupational activities. Multivariable logistic regression was used to identify occupational factors that increased the risk of SARS-CoV-2 infection.
RESULTS
Of the 304 evaluable HCP that were seronegative at enrollment, 26 (9%) seroconverted for SARS-CoV-2 IgG by 6 months. Overall, 219 participants (73%) self-identified as White race, 119 (40%) were nurses, and 121 (40%) worked on inpatient medical-surgical floors. In a multivariable analysis, HCP who identified as Black race were more likely to seroconvert than HCP who identified as White (odds ratio, 4.5; 95% confidence interval, 1.3-14.2). Increased risk for SARS-CoV-2 infection was not identified for any occupational activity, including spending >50% of a typical shift at a patient's bedside, working in a COVID-19 unit, or performing or being present for aerosol-generating procedures (AGPs).
CONCLUSIONS
In our study cohort of HCP working in an academic healthcare system, <10% had evidence of SARS-CoV-2 infection over 6 months. No specific occupational activities were identified as increasing risk for SARS-CoV-2 infection.
目的
确定医护人员（HCP）中严重急性呼吸冠状病毒病毒 2（SARS-CoV-2）感染的发生率，并评估 SARS-CoV-2 感染的职业风险。
设计
对 2020 年 5 月至 12 月期间进行了 6 个月随访的医护人员（HCP）进行前瞻性队列研究。
地点
包括佐治亚州亚特兰大的 4 家医院和附属诊所在内的大型学术医疗保健系统。
参与者
包括有和没有直接患者护理活动的医护人员，在 2019 年冠状病毒病（COVID-19）大流行期间工作。
方法
通过在入组时、3 个月时和 6 个月时进行 SARS-CoV-2 IgG 的血清学检测来确定 SARS-CoV-2 感染的情况。HCP 每月完成一次关于职业活动的调查。采用多变量逻辑回归来确定增加 SARS-CoV-2 感染风险的职业因素。
结果
在 304 名可评估的入组时血清学阴性的 HCP 中，有 26 名（9%）在 6 个月时 SARS-CoV-2 IgG 血清转化。总体而言，219 名参与者（73%）自我认定为白人种族，119 名（40%）为护士，121 名（40%）在住院内科外科病房工作。在多变量分析中，黑人种族的 HCP 比白人种族的 HCP 更有可能血清转化（优势比，4.5；95%置信区间，1.3-14.2）。没有发现任何职业活动（包括在患者床边度过超过典型班次的 50%、在 COVID-19 病房工作或进行或在场进行气溶胶生成程序（AGPs））会增加 SARS-CoV-2 感染的风险。
结论
在我们的学术医疗保健系统中工作的医护人员研究队列中，不到 10%的人在 6 个月内有 SARS-CoV-2 感染的证据。没有发现任何特定的职业活动会增加 SARS-CoV-2 感染的风险。
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