在 COVID-19 大流行第一波期间，加拿大魁北克省感染 SARS-CoV-2 的医护人员的院内转归。
In-hospital outcomes of SARS-CoV-2-infected health care workers in the COVID-19 pandemic first wave, Quebec, Canada.
机构信息
Division of Infectious Diseases, McGill University, Montréal, Quebec, Canada.
Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montréal, Quebec, Canada.
出版信息
PLoS One. 2022 Aug 24;17(8):e0272953. doi: 10.1371/journal.pone.0272953. eCollection 2022.
BACKGROUND
Health care workers (HCW), particularly immigrants and ethnic minorities are at increased risk for SARS-CoV-2 infection. Outcomes during a COVID-19 associated hospitalization are not well described among HCW. We aimed to describe the characteristics of HCW admitted with COVID-19 including immigrant status and ethnicity and the associated risk factors for Intensive Care unit (ICU) admission and death.
METHODS
Adults with laboratory-confirmed community-acquired COVID-19 hospitalized from March 1 to June 30, 2020, at four tertiary-care hospitals in Montréal, Canada were included. Demographics, comorbidities, occupation, immigration status, country of birth, ethnicity, workplace exposures, and hospital outcomes (ICU admission and death) were obtained through a chart review and phone survey. A Fine and Gray competing risk proportional hazards model was used to estimate the risk of ICU admission among HCW stratified by immigrant status and region of birth.
RESULTS
Among 1104 included persons, 150 (14%) were HCW, with a phone survey participation rate of 68%. HCWs were younger (50 vs 64 years; p<0.001), more likely to be female (61% vs 41%; p<0.001), migrants (68% vs 55%; p<0.01), non-White (65% vs 41%; p<0.001) and healthier (mean Charlson Comorbidity Index of 0.3 vs 1.2; p<0.001) compared to non-HCW. They were as likely to be admitted to the ICU (28% vs 31%; p = 0.40) but were less likely to die (4% vs. 17%; p<0.001). Immigrant HCW accounted for 68% of all HCW cases and, compared to Canadian HCW, were more likely to be personal support workers (PSW) (54% vs. 33%, p<0.01), to be Black (58% vs 4%) and to work in a Residential Care Facility (RCF) (59% vs 33%; p = 0.05). Most HCW believed that they were exposed at work, 55% did not always have access to personal protective equipment (PPE) and 40% did not receive COVID-19-specific Infection Control (IPAC) training.
CONCLUSION
Immigrant HCW were particularly exposed to COVID-19 infection in the first wave of the pandemic in Quebec. Despite being young and healthy, one third of all HCW required ICU admission, highlighting the importance of preventing workplace transmission through strong infection prevention and control measures, including high COVID-19 vaccination coverage.
背景
卫生保健工作者（HCW），尤其是移民和少数族裔，感染 SARS-CoV-2 的风险增加。COVID-19 相关住院期间 HCW 的结局尚不清楚。我们旨在描述 COVID-19 住院的 HCW 的特征，包括移民身份和种族，并描述与 ICU 入院和死亡相关的危险因素。
方法
纳入 2020 年 3 月 1 日至 6 月 30 日在加拿大蒙特利尔四家三级保健医院住院的经实验室确诊的社区获得性 COVID-19 成年患者。通过病历回顾和电话调查获得人口统计学、合并症、职业、移民身份、出生地、族裔、工作场所暴露和医院结局（ICU 入院和死亡）。使用 Fine 和 Gray 竞争风险比例风险模型估计按移民身份和出生地分层的 HCW 中 ICU 入院的风险。
结果
在纳入的 1104 名患者中，有 150 名（14%）为 HCW，电话调查参与率为 68%。HCW 更年轻（50 岁 vs. 64 岁；p<0.001），更可能为女性（61% vs. 41%；p<0.001）、移民（68% vs. 55%；p<0.01）、非白人（65% vs. 41%；p<0.001）和健康状况更好（平均 Charlson 合并症指数为 0.3 分 vs. 1.2 分；p<0.001）。他们 ICU 入院的可能性相似（28% vs. 31%；p = 0.40），但死亡率较低（4% vs. 17%；p<0.001）。移民 HCW 占所有 HCW 病例的 68%，与加拿大 HCW 相比，他们更有可能是个人支持工作者（PSW）（54% vs. 33%，p<0.01）、更可能是黑人（58% vs. 4%）和在长期护理机构（RCF）工作（59% vs. 33%；p = 0.05）。大多数 HCW 认为他们在工作中接触到了 COVID-19，55%的人并非总是能获得个人防护设备（PPE），40%的人未接受 COVID-19 特异性感染控制（IPC）培训。
结论
在魁北克省 COVID-19 大流行的第一波中，移民 HCW 特别容易感染 COVID-19。尽管年轻且健康，但三分之一的 HCW 需要 ICU 入院，这突出了通过强化感染预防和控制措施预防工作场所传播的重要性，包括高 COVID-19 疫苗接种率。
Zotero 插件