مقاله انگلیسی اولین موج COVID-19 در کارکنان بیمارستان مراقبت های عالی
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ABSTRACT
Introduction:
Understanding how hospital staff members (HSMs), including healthcare workers, acquired severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the first wave can guide the control measures in the current second wave in Europe.
Methods:
From March 5 to May 10, 2020, the Raymond-Poincaré Hospital held a weekday consultation for HSMs for PCR testing. HSMs were requested to complete a questionnaire on their potential exposure to SARS-CoV-2.
Results:
Of 200 HSMs screened, 70 tested positive for SARS-CoV-2. Ninety-nine HSMs completed the questionnaire of whom 28 tested positive for SARS-CoV-2. In the multivariable analysis, age of 44 years (aOR = 5.2, 95% CI [1.4–22.5]) and not systematically using a facemask when caring for a patient (aOR = 13.9, 95% CI [1.8–293.0]) were significantly associated with SARS-CoV-2 infection. Working in a COVID19-dedicated ward (aOR = 0.7, 95% CI [0.2–3.2]) was not significantly associated with infection. Community-related exposure in and outside the hospital, hospital meetings without facemasks (aOR = 21.3, 95% CI [4.5–143.9]) and private gatherings (aOR = 10, 95% CI [1.3–91.0]) were significantly associated with infection.
Conclusions:
Our results support the effectiveness of barrier precautions and highlight in-hospital infections not related to patient care and infections related to exposure in the community. Protecting HSMs against COVID-19 is crucial in fighting the second wave of the epidemic. © 2021 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-ncnd/4.0/).
Introduction
Healthcare workers (HCWs) are deemed to be at high risk of exposure to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with a potential risk of transmission to vulnerable patients (Keeley et al., 2020, Galmiche et al., 2020). In Japan, Furuse et al. have shown that 30% of clusters identified in reported Coronavirus Disease 2019 (COVID-19) cases are linked to healthcare facilities (Furuse et al., 2020). Hospitals have initiated infection control measures to protect HCWs, ensure workforce availability, and decrease in-hospital transmission risk. The Assistance Publique–Hôpitaux de Paris (AP-HP) university hospitals group is the largest public hospital system in Europe with 39 centres and 100,000 employees serving 8.3 million patients through a 20 000-bed capacity. In France, when the first patients infected with SARS-CoV-2 arrived from China and Italy in February 2020, AP-HP decided to prioritise testing COVID-19 for individuals suffering from unknown and severe pneumonia and organise a screening consultation for symptomatic HCWs. It was estimated that approximately 500 HCWs had been already infected at the AP-HP before the first lockdown in mid-March 2020. Along with standard precautions, droplet precautions for routine care and using personal protective equipment (PPE) such as wearing a medical mask, medical glasses or a face shield and overcoat, were implemented (Société française d’Hygiène Hospitalière, 2020).