Dávila-Conn Vanessa, Soto-Nava Maribel, Caro-Vega Yanink N, Paz-Juárez Héctor E, García-Esparza Pedro, Tapia-Trejo Daniela, Pérez-García Marissa, Belaunzarán-Zamudio Pablo F, Reyes-Terán Gustavo, Sierra-Madero Juan G, Galindo-Fraga Arturo, Ávila-Ríos Santiago
Centre for Research in Infectious Diseases, National Institute of Respiratory Diseases, Mexico City, Mexico.
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
PLoS One. 2022 Mar 17;17(3):e0264964. doi: 10.1371/journal.pone.0264964. eCollection 2022.
We performed a longitudinal SARS-CoV-2 seroepidemiological study in healthcare personnel of the two largest tertiary COVID-19 referral hospitals in Mexico City.
All healthcare personnel, including staff physicians, physicians in training, nurses, laboratory technicians, researchers, students, housekeeping, maintenance, security, and administrative staff were invited to voluntarily participate, after written informed consent. Participants answered a computer-assisted self-administered interview and donated blood samples for antibody testing every three weeks from October 2020 to June 2021.
A total of 883 participants (out of 3639 registered employees) contributed with at least one blood sample. The median age was 36 years (interquartile range: 28-46) and 70% were women. The most common occupations were nurse (28%), physician (24%), and administrative staff (22%). Two hundred and ninety participants (32.8%) had a positive-test result in any of the visits, yielding an overall adjusted prevalence of 33.5% for the whole study-period. Two hundred and thirty-five positive tests were identified at the baseline visit (prevalent cases), the remaining 55 positive tests were incident cases. Prevalent cases showed associations with both occupational (institution 2 vs. 1: adjusted odds ratio [aOR] = 2.24, 95% confidence interval [CI]: 1.54-3.25; laboratory technician vs. physician: aOR = 4.38, 95% CI: 1.75-10.93) and community (municipality of residence Xochimilco vs. Tlalpan: aOR = 2.03, 95% CI: 1.09-3.79) risk-factors. The incidence rate was 3.0 cases per 100 person-months. Incident cases were associated with community-acquired risk, due to contact with suspect/confirmed COVID-19 cases (HR = 2.45, 95% CI: 1.21-5.00).
We observed that between October 2020 and June 2021, healthcare workers of the two largest tertiary COVID-19 referral centers in Mexico City had similar level of exposure to SARS-CoV-2 than the general population. Most variables associated with exposure in this setting pointed toward community rather than occupational risk. Our observations are consistent with successful occupational medicine programs for SARS-CoV-2 infection control in the participating institutions but suggest the need to strengthen mitigation strategies in the community.
我们在墨西哥城两家最大的三级 COVID-19 转诊医院的医护人员中开展了一项纵向 SARS-CoV-2 血清流行病学研究。
在获得书面知情同意后,邀请所有医护人员自愿参与,包括在职医生、实习医生、护士、实验室技术人员、研究人员、学生、家政人员、维修人员、安保人员和行政人员。参与者回答了计算机辅助的自填式问卷,并在 2020 年 10 月至 2021 年 6 月期间每三周捐献血样进行抗体检测。
共有 883 名参与者(在 3639 名注册员工中)至少捐献了一份血样。中位年龄为 36 岁(四分位间距:28 - 46 岁),70%为女性。最常见的职业是护士(28%)、医生(24%)和行政人员(22%)。290 名参与者(32.8%)在任何一次检测中结果呈阳性,整个研究期间的总体校正患病率为 33.5%。在基线检测时确定了 235 例阳性检测结果(现患病例),其余 55 例阳性检测结果为新发病例。现患病例与职业因素(机构 2 与机构 1 相比:校正比值比[aOR]=2.24,95%置信区间[CI]:1.54 - 3.25;实验室技术人员与医生相比:aOR = 4.38,95%CI:1.75 - 10.93)和社区因素(居住社区 Xochimilco 与 Tlalpan 相比:aOR = 2.03,95%CI:1.09 - 3.79)风险因素均相关。发病率为每 100 人月 3.0 例。新发病例与社区获得性风险相关,原因是接触疑似/确诊的 COVID-19 病例(风险比[HR]=2.45,95%CI:1.21 - 5.00)。
我们观察到,在 2020 年 10 月至 2021 年 6 月期间,墨西哥城两家最大的三级 COVID-19 转诊中心医护人员接触 SARS-CoV-2 的水平与普通人群相似。在此环境中,大多数与接触相关的变量指向社区而非职业风险。我们的观察结果与参与机构中成功的 SARS-CoV-2 感染控制职业医学项目一致,但表明需要加强社区的缓解策略。