Centro Nacional de Epidemiología, Prevención y Control de Enfermedades, Ministerio de Salud, Calle Daniel Olaechea 199 Jesús María, Lima, 15072, Peru.
Instituto de Investigaciones en Ciencias Biomédicas (INICIB), Facultad de Medicina, Universidad Ricardo Palma, Av. Alfredo Benavides 5440, Santiago de Surco, Lima, 15039, Peru.
Hum Resour Health. 2022 Dec 22;20(1):86. doi: 10.1186/s12960-022-00787-0.
Peru has some of the worst outcomes worldwide as a result of the SARS-CoV-2 pandemic; it is presumed that this has also affected healthcare workers. This study aimed to establish whether occupation and other non-occupational variables were risk factors for possible reinfection, hospitalization, and mortality from COVID-19 in cohorts of Peruvian healthcare workers infected with SARS-CoV-2.
Retrospective cohort study. Healthcare workers who presented SARS-CoV-2 infection between March 1, 2020, and August 6, 2021, were included. Occupational cohorts were reconstructed from the following sources of information: National Epidemiological Surveillance System, molecular tests (NETLAB), results of serology and antigen tests (SICOVID-19), National Registry of Health Personnel (INFORHUS), and National Information System of Deaths (SINADEF). The incidence of probable reinfection, hospitalization, and death from COVID-19 was obtained in the cohorts of technicians and health assistants, nursing staff, midwives, dentists, doctors, and other healthcare workers. We evaluated whether the occupation and other non-occupational variables were risk factors for probable reinfection, hospitalization, and death from COVID-19 using log-binomial and probit binomial models, obtaining the adjusted relative risk (RR).
90,398 healthcare workers were included in the study. Most cases were seen in technicians and health assistants (38.6%), and nursing staff (25.6%). 8.1% required hospitalization, 1.7% died from COVID-19, and 1.8% had probable reinfection. A similar incidence of probable reinfection was found in the six cohorts (1.7-1.9%). Doctors had a higher incidence of hospitalization (13.2%) and death (2.6%); however, they were also those who presented greater susceptibility linked to non-occupational variables (age and comorbidities). The multivariate analysis found that doctors (RR = 1.720; CI 95: 1.569-1.886) had a higher risk of hospitalization and that the occupation of technician and health assistant was the only one that constituted a risk factor for mortality from COVID-19 (RR = 1.256; 95% CI: 1.043-1.512).
Peruvian technicians and health assistants would have a higher risk of death from COVID-19 than other healthcare workers, while doctors have a higher incidence of death probably linked to the high frequency of non-occupational risk factors. Doctors present a higher risk of hospitalization independent of comorbidities and age; likewise, all occupations show a similar risk of probable reinfection.
秘鲁是全球因 SARS-CoV-2 大流行而出现最坏结果的国家之一;据推测,这也影响了医护人员。本研究旨在确定职业和其他非职业变量是否是感染 SARS-CoV-2 的秘鲁医护人员再次感染、住院和 COVID-19 死亡的危险因素。
回顾性队列研究。纳入 2020 年 3 月 1 日至 2021 年 8 月 6 日期间出现 SARS-CoV-2 感染的医护人员。从以下信息来源重建职业队列:国家流行病学监测系统、分子检测(NETLAB)、血清学和抗原检测结果(SICOVID-19)、国家卫生人员登记册(INFORHUS)和国家死亡信息系统(SINADEF)。在技术人员和卫生助理、护理人员、助产士、牙医、医生和其他医护人员队列中获得 COVID-19 再次感染、住院和死亡的发生率。我们使用对数二项式和概率二项式模型评估职业和其他非职业变量是否是 COVID-19 再次感染、住院和死亡的危险因素,得出调整后的相对风险(RR)。
纳入 90398 名医护人员。大多数病例发生在技术人员和卫生助理(38.6%)和护理人员(25.6%)中。8.1%需要住院治疗,1.7%死于 COVID-19,1.8%发生再次感染。六个队列的再次感染发生率相似(1.7-1.9%)。医生的住院率(13.2%)和死亡率(2.6%)较高;然而,他们也是与非职业变量(年龄和合并症)相关的易感性更高的人群。多变量分析发现,医生(RR=1.720;95%CI:1.569-1.886)住院风险更高,而技术人员和卫生助理的职业是 COVID-19 死亡的唯一危险因素(RR=1.256;95%CI:1.043-1.512)。
秘鲁的技术人员和卫生助理因 COVID-19 死亡的风险可能高于其他医护人员,而医生的死亡发生率较高可能与非职业危险因素的高频率有关。医生的住院风险较高,独立于合并症和年龄;同样,所有职业的再次感染风险相似。