Ng Chester Yan Hao, Lim Nicole-Ann, Bao Lena X Y, Quek Amy M L, Seet Raymond C S
Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Public Health Rev. 2022 Feb 23;43:1604572. doi: 10.3389/phrs.2022.1604572. eCollection 2022.
Hospital outbreaks of SARS-CoV-2 infection are dreaded but preventable catastrophes. We review the literature to examine the pattern of SARS-CoV-2 transmission in hospitals and identify potential vulnerabilities to mitigate the risk of infection. Three electronic databases (PubMed, Embase and Scopus) were searched from inception to July 27, 2021 for publications reporting SARS-CoV-2 outbreaks in hospital. Relevant articles and grey literature reports were hand-searched. Twenty-seven articles that described 35 SARS-CoV-2 outbreaks were included. Despite epidemiological investigations, the primary case could not be identified in 37% of outbreaks. Healthcare workers accounted for 40% of primary cases (doctors 17%, followed by ancillary staff 11%). Mortality among infected patients was approximately 15%. By contrast, none of the infected HCWs died. Several concerning patterns were identified, including infections involving ancillary staff and healthcare worker infections from the community and household contacts. Continuous efforts to train-retrain and enforce correct personal protective equipment use and regular routine screening tests (especially among ancillary staff) are necessary to stem future hospital outbreaks of SARS-CoV-2.
新型冠状病毒2型（SARS-CoV-2）感染在医院爆发是可怕但可预防的灾难。我们回顾文献，以研究SARS-CoV-2在医院内的传播模式，并确定潜在的薄弱环节，以降低感染风险。检索了三个电子数据库（PubMed、Embase和Scopus），从建库至2021年7月27日，查找报告医院内SARS-CoV-2爆发的出版物。对手检相关文章和灰色文献报告进行了检索。纳入了27篇描述35起SARS-CoV-2爆发的文章。尽管进行了流行病学调查，但在37%的爆发中无法确定首例病例。医护人员占首例病例的40%（医生占17%，其次辅助人员占11%）。感染患者的死亡率约为15%。相比之下，没有感染的医护人员死亡。确定了几种令人担忧的模式，包括涉及辅助人员的感染以及医护人员来自社区和家庭接触者的感染。为阻止未来医院内SARS-CoV-2的爆发，持续努力进行培训再培训、强制正确使用个人防护装备以及定期进行常规筛查检测（尤其是辅助人员）是必要的。
