Sharma Sarit, Gupta Vikas, Bawa Ashvind, Kumar Ajay, Pooni Puneet Aulakh, Gautam Parshotam Lal, Chaudhary Ashwani Kumar, Chhina Rajoo Singh
Department of Community Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
Department of Rheumatology and Immunology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
Indian J Community Med. 2023 Jan-Feb;48(1):155-160. doi: 10.4103/ijcm.ijcm_1523_21. Epub 2022 Dec 8.
Healthcare workers (HCWs) are at higher risk of getting infected with COVID-19 infection due to their close proximity to COVID-19-positive patients. We studied the risk stratification and positivity rate in HCWs at risk of getting COVID-19 infection as well as the possible factors responsible for their being at risk of COVID-19 infection during the study period.
This prospective study was conducted after approval by the institutional ethics committee. The data regarding demographic variables, risk stratification, COVID-19 (reverse-transcription polymerase chain reaction) report, and possible sources of exposure for HCWs were recorded in a proforma by personal/telephonic interviews as well as from hospital records from March 2020 to June 2021. The data generated were entered into Microsoft Excel software and analyzed using percentages, proportions, and Chi-square tests for qualitative variables.
COVID-19 infection's positivity rate was 19.5% among high-risk and 0.6% among low-risk HCW contacts. HCWs working in non-COVID-19 areas (67.9%) were more at risk than those working in COVID-19 areas (32.1%). In contrast, the COVID-19 positivity rate was significantly higher among high-risk contact HCWs from COVID-19 areas (34.2%) than in non-COVID-19 areas (12.6%). The maximum COVID-19 positivity rate was seen in high-risk contacts with body fluid exposure (21%), performing aerosol-generating procedures (20%), and close exposure in operation theaters (18%).
Risk stratification is an important tool to contain infection among HCWs who had unprotected close contact with a COVID-19-positive case. With appropriate contact tracing, we were able to avoid over- and under-quarantine, save many man-hours as well as contain the spread of infection. HCWs should not only wear appropriate personal protective equipment (PPE) during work hours but should also practice mask-wearing and social distancing while they are in the community.
医护人员由于与新冠病毒检测呈阳性的患者密切接触,感染新冠病毒的风险更高。我们研究了有感染新冠病毒风险的医护人员的风险分层和阳性率,以及在研究期间导致他们有感染新冠病毒风险的可能因素。
本前瞻性研究在获得机构伦理委员会批准后进行。通过个人/电话访谈以及从2020年3月至2021年6月的医院记录中,将医护人员的人口统计学变量、风险分层、新冠病毒(逆转录聚合酶链反应)报告以及可能的暴露源数据记录在一份表格中。生成的数据录入微软Excel软件,并使用百分比、比例和卡方检验对定性变量进行分析。
高风险医护人员接触者中新冠病毒感染的阳性率为19.5%,低风险医护人员接触者中为0.6%。在非新冠病区工作的医护人员(67.9%)比在新冠病区工作的医护人员(32.1%)面临的风险更高。相比之下,来自新冠病区的高风险接触医护人员中的新冠病毒阳性率(34.2%)显著高于非新冠病区(12.6%)。在有体液暴露的高风险接触者(21%)、进行产生气溶胶操作的人员(20%)以及手术室密切接触者(18%)中,新冠病毒阳性率最高。
风险分层是控制与新冠病毒检测呈阳性病例有未受保护密切接触的医护人员感染的重要工具。通过适当的接触者追踪,我们能够避免过度隔离和隔离不足,节省大量工时并控制感染传播。医护人员不仅在工作时间应佩戴适当的个人防护装备(PPE),在社区中时也应佩戴口罩并保持社交距离。