Basso Paolo, Negro Corrado, Cegolon Luca, Larese Filon Francesca
Department of Medical, Surgical & Health Sciences, University of Trieste, 34129 Trieste, Italy.
Clinical Unit of Occupational Medicine, University of Trieste, 34129 Trieste, Italy.
Viruses. 2022 Feb 7;14(2):336. doi: 10.3390/v14020336.
Healthcare workers (HCWs) are particularly exposed to biological risk, including SARS-CoV-2 infection. In order to contrast the current pandemic and alleviate the burden of the disease on the healthcare system, a mass vaccination campaign against COVID-19 has been launched worldwide. To evaluate the impact of COVID-19 vaccination in HCWs exposed to SARS-CoV-2, to describe the clinical presentation of COVID-19 in infected HCWs, and to investigate clinical and occupational risk factors for breakthrough infection. Retrospective cohort study. The cohort of HCWs of Trieste Hospitals were followed up from 1 March 2020, to 30 November 2021 (21 months). All HCWs were periodically screened for SARS-CoV-2 infection by real-time PCR (RT-PCR) analysis. Clinical data were obtained through routine medical surveillance records. Risk factors for SARS-CoV-2 infection were investigated by univariable as well as multivariable logistic regression analysis. Among 4394 HCWs routinely screened for SARS-CoV-2 by PCR on nasopharyngeal swab, a total of 800 incident cases were identified during the entire study period (1 March 2020 to 30 November 2021). Five hundred and sixty-four cases occurred before, and 236 after the start of the vaccination campaign against COVID-19, of whom 155 received a complete vaccination scheme before SARS-CoV-2 infection. Breakthrough infection was featured by mild or no symptoms and was significantly associated with the male sex, BMI > 25, and diabetes mellitus. Some categories of HCWs (physicians and nurse aids/auxiliary personnel) were at a higher risk of breakthrough infection. Fully vaccinated HCWs were less likely to acquire symptomatic as well as asymptomatic SARS-CoV-2 infection. Risk factors for SARS-CoV-2 infection after a full COVID-19 vaccination scheme included the male gender, diabetes mellitus, and overweight. HCWs with higher exposure to COVID-19 patients were at higher risk of breakthrough infection.
医护人员尤其容易面临生物风险，包括感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）。为了应对当前的疫情并减轻疾病对医疗系统的负担，全球已开展了针对2019冠状病毒病（COVID-19）的大规模疫苗接种运动。评估COVID-19疫苗接种对接触SARS-CoV-2的医护人员的影响，描述感染SARS-CoV-2的医护人员中COVID-19的临床表现，并调查突破性感染的临床和职业风险因素。回顾性队列研究。的里雅斯特医院的医护人员队列从2020年3月1日至2021年11月30日（21个月）进行随访。所有医护人员均通过实时荧光定量聚合酶链反应（RT-PCR）分析定期筛查SARS-CoV-2感染情况。临床数据通过常规医疗监测记录获得。通过单变量和多变量逻辑回归分析调查SARS-CoV-2感染的风险因素。在4394名通过鼻咽拭子PCR常规筛查SARS-CoV-2的医护人员中，在整个研究期间（2020年3月1日至2021年11月30日）共确定了800例新发病例。564例发生在COVID-19疫苗接种运动开始之前，236例发生在之后，其中155例在感染SARS-CoV-2之前接受了完整的疫苗接种方案。突破性感染的特点是症状轻微或无症状，并且与男性、体重指数>25以及糖尿病显著相关。某些类别的医护人员（医生和护士助理/辅助人员）发生突破性感染的风险较高。完全接种疫苗的医护人员感染有症状和无症状SARS-CoV-2的可能性较小。完整的COVID-19疫苗接种方案后感染SARS-CoV-2的风险因素包括男性、糖尿病和超重。接触COVID-19患者较多的医护人员发生突破性感染的风险较高。
