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西班牙教学医院医护人员的 SARS-CoV-2 血清流行率的医院内调查。

Hospital-Wide SARS-CoV-2 seroprevalence in health care workers in a Spanish teaching hospital.

机构信息

Occupational Health Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain.

Infectious Diseases and Research Unit, Hospital Universitario Fundación Alcorcón, Madrid, Spain.

出版信息

Enferm Infecc Microbiol Clin (Engl Ed). 2022 Jun-Jul;40(6):302-309. doi: 10.1016/j.eimce.2020.11.025.

Abstract

INTRODUCTION

Hospital-wide SARS-CoV-2 seroprevalence is rarely explored and can identify areas of unexpected risk. We determined the seroprevalence against SARS-CoV-2 in all health care workers (HCW) at a hospital.

METHODS

Cross-sectional study (14-27/04/2020). We determined SARS-CoV-2 IgG by ELISA in all HCW including external workers of a teaching hospital in Madrid. They were classified by professional category, working area, and risk for SARS-CoV-2 exposure.

RESULTS

Among 2919 HCW, 2590 (88,7%) were evaluated. The mean age was 43.8 years (SD 11.1), and 73.9% were females. Globally, 818 (31.6%) workers were IgG positive with no differences for age, sex or previous diseases. Of these, 48.5% did not report previous symptoms. Seropositivity was more frequent in high- (33.1%) and medium- (33.8%) than in low-risk areas (25.8%, p=0.007), but not for hospitalization areas attending COVID-19 and non-COVID-19 patients (35.5 vs 38.3% p>0.05). HWC with a previous SARS-CoV2 PCR-positive test were IgG seropositive in 90.8%. By multivariate logistic regression analysis seropositivity was significantly associated with being physicians (OR 2.37, CI95% 1.61-3.49), nurses (OR 1.67, CI95% 1.14-2.46), nurse assistants (OR 1.84, CI95% 1.24-2.73), HCW working at COVID-19 hospitalization areas (OR 1.71, CI95% 1.22-2.40), non-COVID-19 hospitalization areas (OR 1.88, CI95% 1.30-2.73), and at the Emergency Room (OR 1.51, CI95% 1.01-2.27).

CONCLUSIONS

Seroprevalence uncovered a high rate of infection previously unnoticed among HCW. Patients not suspected of having COVID-19 as well as asymptomatic HCW may be a relevant source for nosocomial SARS-CoV-2 transmission.

摘要

介绍

医院范围内的 SARS-CoV-2 血清流行率很少被研究,它可以确定意想不到的风险区域。我们确定了一家马德里教学医院所有医护人员(HCW)的 SARS-CoV-2 血清流行率。

方法

横断面研究(2020 年 4 月 14 日至 27 日)。我们通过酶联免疫吸附试验(ELISA)测定了所有 HCW 的 SARS-CoV-2 IgG,包括马德里一所教学医院的外部工作人员。根据职业类别、工作区域和 SARS-CoV-2 暴露风险对他们进行了分类。

结果

在 2919 名 HCW 中,评估了 2590 名(88.7%)。平均年龄为 43.8 岁(标准差 11.1),73.9%为女性。总体而言,818 名(31.6%)工人 IgG 呈阳性,年龄、性别或既往疾病无差异。其中,48.5%未报告有既往症状。高(33.1%)和中(33.8%)风险区域的血清阳性率高于低(25.8%,p=0.007),但 COVID-19 和非 COVID-19 患者就诊的住院区域则无差异(35.5% vs 38.3%,p>0.05)。以前 SARS-CoV2 PCR 阳性检测结果的 HCW 的 IgG 血清阳性率为 90.8%。通过多变量逻辑回归分析,血清阳性与医生(OR 2.37,95%CI95%1.61-3.49)、护士(OR 1.67,95%CI95%1.14-2.46)、护士助理(OR 1.84,95%CI95%1.24-2.73)、COVID-19 住院区(OR 1.71,95%CI95%1.22-2.40)、非 COVID-19 住院区(OR 1.88,95%CI95%1.30-2.73)和急诊科(OR 1.51,95%CI95%1.01-2.27)的 HCW 显著相关。

结论

血清流行率揭示了 HCW 中先前未被发现的高感染率。未被怀疑患有 COVID-19 的患者以及无症状的 HCW 可能是医院内 SARS-CoV-2 传播的一个相关来源。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6522/9168001/3f58dd36a44b/gr1_lrg.jpg

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