Dzinamarira Tafadzwa, Nkambule Sphamandla Josias, Hlongwa Mbuzeleni, Mhango Malizgani, Iradukunda Patrick Gad, Chitungo Itai, Dzobo Mathias, Mapingure Munyaradzi Paul, Chingombe Innocent, Mashora Moreblessing, Madziva Roda, Herrera Helena, Makanda Pelagia, Atwine James, Mbunge Elliot, Musuka Godfrey, Murewanhema Grant, Ngara Bernard
School of Health Systems & Public Health, University of Pretoria, Pretoria, 0002, South Africa.
ICAP at Columbia University, Harare, Zimbabwe.
Saf Health Work. 2022 Sep;13(3):263-268. doi: 10.1016/j.shaw.2022.04.001. Epub 2022 Apr 12.
Health care workers (HCWs) are more than ten times more likely to be infected with coronavirus infectious disease 2019 (COVID-19) than the general population, thus demonstrating the burden of COVID-19 among HCWs. Factors that expose HCWs to a differentially high-risk of COVID-19 acquisition are important to elucidate, enable appropriate public health interventions to mitigate against high risk and reduce adverse outcomes from the infection. We conducted a systematic review and meta-analysis to summarize and critically analyze the existing evidence on SARS-CoV-2 risk factors among HCWs. With no geographical limitation, we included studies, in any country, that reported (i) the PCR laboratory diagnosis of COVID-19 as an independent variable (ii) one or more COVID-19 risk factors among HCWs with risk estimates (relative risk, odds ratio, or hazard ratio) (iii) original, quantitative study design, and published in English or Mandarian. Our initial search resulted in 470 articles overall, however, only 10 studies met the inclusion criteria for this review. Out of the 10 studies included in the review, inadequate/lack of protective personal equipment, performing tracheal intubation, and gender were the most common risk factors of COVID-19. Based on the random effects adjusted pooled relative risk, HCWs who reported the use of protective personal equipment were 29% (95% CI: 16% to 41%) less likely to test positive for COVID-19. The study also revealed that HCWs who performed tracheal intubations were 34% (95% CI: 14% to 57%) more likely to test positive for COVID-19. Interestingly, this study showed that female HCWs are at 11% higher risk (RR 1.11 95% CI 1.01-1.21) of COVID-19 than their male counterparts. This article presents initial findings from a living systematic review and meta-analysis, therefore, did not yield many studies; however, it revealed a significant insight into better understanding COVID-19 risk factors among HCWs; insights important for devising preventive strategies that protect them from this infection.
CRD42020193508 available for public comments via the link below https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020193508).
医护人员感染2019冠状病毒病(COVID-19)的可能性是普通人群的十多倍,这表明了COVID-19在医护人员中的负担。阐明使医护人员面临COVID-19感染高风险的因素很重要,这样才能采取适当的公共卫生干预措施来降低高风险,并减少感染带来的不良后果。我们进行了一项系统综述和荟萃分析,以总结并批判性地分析关于医护人员中严重急性呼吸综合征冠状病毒2风险因素的现有证据。在无地域限制的情况下,我们纳入了任何国家的研究,这些研究报告了:(i)将COVID-19的聚合酶链反应实验室诊断作为自变量;(ii)医护人员中的一种或多种COVID-19风险因素及风险估计值(相对风险、比值比或风险比);(iii)原始的定量研究设计,且以英文或中文发表。我们最初的搜索总共得到470篇文章,然而,只有10项研究符合本综述的纳入标准。在本综述纳入的10项研究中,防护性个人装备不足/缺乏、进行气管插管和性别是COVID-19最常见的风险因素。基于随机效应调整后的合并相对风险,报告使用防护性个人装备的医护人员COVID-19检测呈阳性的可能性降低了29%(95%置信区间:16%至41%)。该研究还表明,进行气管插管的医护人员COVID-19检测呈阳性的可能性高34%(95%置信区间:14%至57%)。有趣的是,该研究表明,女性医护人员感染COVID-19的风险比男性医护人员高11%(相对风险1.11,95%置信区间1.01 - 1.21)。本文展示了一项实时系统综述和荟萃分析的初步结果,因此,纳入的研究不多;然而,它揭示了对更好理解医护人员中COVID-19风险因素的重要见解;这些见解对于制定保护他们免受这种感染的预防策略很重要。
PROSPERO注册号:CRD42020193508,可通过以下链接https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020193508获取公众评论。