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比较日本奥密克戎和德尔塔变异株流行期间医护人员感染 SARS-CoV-2 的危险因素。

Comparison of risk factors for SARS-CoV-2 infection among healthcare workers during Omicron and Delta dominance periods in Japan.

机构信息

Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.

Department of Laboratory Testing, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan.

出版信息

J Hosp Infect. 2023 Apr;134:97-107. doi: 10.1016/j.jhin.2023.01.018. Epub 2023 Feb 16.

Abstract

BACKGROUND

The risk factors for coronavirus disease (COVID-19) among healthcare workers (HCWs) might have changed since the emergence of the highly immune evasive Omicron variant.

AIM

To compare the risk factors for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among HCWs during the Delta- and Omicron-predominant periods.

METHODS

Using data from repeated serosurveys among the staff of a medical research centre in Tokyo, two cohorts were established: Delta period cohort (N = 858) and Omicron period cohort (N = 652). The potential risk factors were assessed using a questionnaire. Acute/current or past SARS-CoV-2 infection was identified by polymerase chain reaction or anti-nucleocapsid antibody tests, respectively. Poisson regression was used to calculate the risk ratio (RR) of infection risk.

FINDINGS

The risk of SARS-CoV-2 infection during the early Omicron-predominant period was 3.4-fold higher than during the Delta-predominant period. Neither working in a COVID-19-related department nor having a higher degree of occupational exposure to SARS-CoV-2 was associated with an increased infection risk during both periods. During the Omicron-predominant period, infection risk was higher among those who spent ≥30 min in closed spaces, crowded spaces, and close-contact settings without wearing mask (≥3 times versus never: RR: 6.62; 95% confidence interval: 3.01-14.58), whereas no such association was found during the Delta period.

CONCLUSION

Occupational exposure to COVID-19-related work was not associated with the risk of SARS-CoV-2 infection in the Delta or Omicron period, whereas high-risk behaviours were associated with an increased infection risk during the Omicron period.

摘要

背景

自高度免疫逃避的奥密克戎变异株出现以来,医护人员(HCWs)患冠状病毒病(COVID-19)的危险因素可能已经发生了变化。

目的

比较德尔塔和奥密克戎为主的时期 HCWs 中严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)感染的危险因素。

方法

利用东京某医学研究中心工作人员重复血清学调查的数据,建立了两个队列:德尔塔期队列(N=858)和奥密克戎期队列(N=652)。使用问卷评估潜在的危险因素。通过聚合酶链反应或抗核衣壳抗体试验分别确定急性/当前或既往 SARS-CoV-2 感染。使用泊松回归计算感染风险的风险比(RR)。

结果

在奥密克戎为主的早期,SARS-CoV-2 感染的风险是德尔塔为主时期的 3.4 倍。在两个时期,从事 COVID-19 相关部门的工作或职业接触 SARS-CoV-2 的程度较高与感染风险增加无关。在奥密克戎为主的时期,在封闭空间、拥挤空间和不戴口罩的密切接触环境中花费≥30 分钟的人感染风险更高(≥3 次与从不:RR:6.62;95%置信区间:3.01-14.58),而在德尔塔期则没有这种关联。

结论

在德尔塔或奥密克戎时期,职业接触 COVID-19 相关工作与 SARS-CoV-2 感染的风险无关,而高危行为与奥密克戎时期的感染风险增加有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4529/9933573/439934d10dfe/gr1_lrg.jpg

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