COVID-19 暴露医护人员的风险分类和结局：来自泰国一家三级保健中心的队列研究。

Risk categorization and outcomes among healthcare workers exposed to COVID-19: A cohort study from a Thai tertiary-care center.

机构信息

Division of Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand.

Infection Control Department, Thammasat University Hospital, Pathumthani, Thailand.

出版信息

J Microbiol Immunol Infect. 2023 Jun;56(3):537-546. doi: 10.1016/j.jmii.2023.01.011. Epub 2023 Jan 20.

DOI:10.1016/j.jmii.2023.01.011

PMID:36725439

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9852258/

Abstract

BACKGROUND

A risk categorization tool for healthcare workers (HCWs) exposed to COVID-19 is crucial for preventing COVID-19 transmission and requires validation and modification according to local context.

METHODS

From January to December 2021, a prospective cohort study was conducted among Thai HCWs to evaluate the performance of the specifically-created risk categorization tool, which classified HCWs into low-risk (LR), intermediate-risk (IR), and high-risk (HR) groups based on types of activities, duration of exposure, and protective methods used during exposure. Subsequent measures were determined for the HCWs based on the risk categories.

RESULTS

1891 HCWs were included; 52%, 25% and 23% were LR, IR, and HR, respectively. COVID-19 was diagnosed in 1.3%, 5.1% and 27.3% of LR, IR and HR HCWs, respectively (P <0.001). Independent factors associated with COVID-19 were household or community exposure [adjusted odds ratio (aOR), 1588.68; P <0.001), being HR (aOR, 11.94; P <0.001), working at outpatient departments (aOR, 2.54; P <0.001), and no history of COVID-19 vaccination (aOR, 2.05; P = 0.01). The monthly rates of COVID-19 among LR, IR, and HR HCWs significantly decreased after the incremental rate of full vaccination. In-hospital transmission between HCWs occurred in 8% and was mainly due to eating at the same table.

CONCLUSION

The study risk categorization tool can differentiate risks of COVID-19 among the HCWs. Prevention of COVID-19 should be focused on HCWs with the identified risk factors and behaviors associated with COVID-19 development and encouraging receipt of full vaccination.

摘要

背景

针对接触过 COVID-19 的医护人员 (HCWs) 的风险分类工具对于预防 COVID-19 传播至关重要，并且需要根据当地情况进行验证和修改。

方法

2021 年 1 月至 12 月，对泰国 HCWs 进行了一项前瞻性队列研究，以评估专门创建的风险分类工具的性能，该工具根据活动类型、暴露持续时间和暴露期间使用的保护方法，将 HCWs 分为低风险 (LR)、中风险 (IR) 和高风险 (HR) 组。随后根据风险类别为 HCWs 确定后续措施。

结果

共纳入 1891 名 HCWs；LR、IR 和 HR 的比例分别为 52%、25%和 23%。LR、IR 和 HR HCWs 中分别有 1.3%、5.1%和 27.3%被诊断为 COVID-19（P<0.001）。与 COVID-19 相关的独立因素包括家庭或社区暴露[校正优势比(aOR)，1588.68；P<0.001)，高风险 (aOR，11.94；P<0.001)，在门诊部门工作(aOR，2.54；P<0.001)，以及没有 COVID-19 疫苗接种史(aOR，2.05；P=0.01)。在完全接种疫苗的增量率后，LR、IR 和 HR HCWs 中 COVID-19 的月发生率显著下降。HCWs 之间发生的院内传播占 8%，主要是由于同桌就餐。