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医护人员及其家庭成员因Covid-19入院的风险分析
作者:小柯机器人 发布时间:2020/11/4 15:35:59

英国爱丁堡大学David A McAllister团队研究了医护人员及其家庭成员因Covid-19入院的风险。2020年10月28日,该研究发表在《英国医学杂志》上。

为了评估直接接触患者和非直接接触患者的医护人员及其家庭成员因Covid-19入院的风险,2020年3月1日至6月6日,研究组在英国苏格兰进行了一项全国联动队列研究,招募年龄在18-65岁之间的医疗保健工作者、其家庭成员以及其他普通人群。主要结局指标为因covid-19而入院。

该队列包括158445名医护人员,其中57.3%直接接触患者,以及他们的229905名家庭成员。在所有因covid-19住院治疗的工作年龄人口(18-65岁)中,17.2%为医疗保健工作者或其家庭成员。

在对年龄、性别、种族、社会经济贫困和合并症进行校正后,非直接接触患者的医护人员及其家庭成员因covid-19入院的风险与普通人群相似,风险比分别为0.81和0.86。但在针对相同协变量进行校正的模型中,与非直接接触患者的医护人员相比,直接接触患者的医护人员因covid-19入院的风险较高,风险比为3.30,其家庭成员的风险也较高,风险比为1.79。

将直接接触患者的医护人员细分为从事“一线”、“重症监护室”和“非重症监护”气溶胶暴露等工作人员后,“一线”角色人员的风险较高,风险比为2.09。对于大多数直接接触患者的医护人员及其家属,covid-19入院的估计绝对风险低于0.5%,但有合并症的老年男性则为1%或更高。

结果表明,在covid-19住院病例中,医护人员及其家属占六分之一。尽管总体上绝对入院风险较低,但直接接触患者的医护人员及其家属的covid-19入院风险分别增加了三倍和两倍。

附:英文原文

Title: Risk of hospital admission with coronavirus disease 2019 in healthcare workers and their households: nationwide linkage cohort study

Author: Anoop S V Shah, Rachael Wood, Ciara Gribben, David Caldwell, Jennifer Bishop, Amanda Weir, Sharon Kennedy, Martin Reid, Alison Smith-Palmer, David Goldberg, Jim McMenamin, Colin Fischbacher, Chris Robertson, Sharon Hutchinson, Paul McKeigue, Helen Colhoun, David A McAllister

Issue&Volume: 2020/10/28

Abstract:

Objective To assess the risk of hospital admission for coronavirus disease 2019 (covid-19) among patient facing and non-patient facing healthcare workers and their household members.

Design Nationwide linkage cohort study.

Setting Scotland, UK, 1 March to 6 June 2020.

Participants Healthcare workers aged 18-65 years, their households, and other members of the general population.

Main outcome measure Admission to hospital with covid-19.

Results The cohort comprised 158445 healthcare workers, most of them (90733; 57.3%) being patient facing, and 229905 household members. Of all hospital admissions for covid-19 in the working age population (18-65 year olds), 17.2% (360/2097) were in healthcare workers or their households. After adjustment for age, sex, ethnicity, socioeconomic deprivation, and comorbidity, the risk of admission due to covid-19 in non-patient facing healthcare workers and their households was similar to the risk in the general population (hazard ratio 0.81 (95% confidence interval 0.52 to 1.26) and 0.86 (0.49 to 1.51), respectively). In models adjusting for the same covariates, however, patient facing healthcare workers, compared with non-patient facing healthcare workers, were at higher risk (hazard ratio 3.30, 2.13 to 5.13), as were household members of patient facing healthcare workers (1.79, 1.10 to 2.91). After sub-division of patient facing healthcare workers into those who worked in “front door,” intensive care, and non-intensive care aerosol generating settings and other, those in front door roles were at higher risk (hazard ratio 2.09, 1.49 to 2.94). For most patient facing healthcare workers and their households, the estimated absolute risk of hospital admission with covid-19 was less than 0.5%, but it was 1% and above in older men with comorbidity.

Conclusions Healthcare workers and their households contributed a sixth of covid-19 cases admitted to hospital. Although the absolute risk of admission was low overall, patient facing healthcare workers and their household members had threefold and twofold increased risks of admission with covid-19.

DOI: 10.1136/bmj.m3582

Source: https://www.bmj.com/content/371/bmj.m3582

期刊信息

BMJ-British Medical Journal:《英国医学杂志》,创刊于1840年。隶属于BMJ出版集团,最新IF:27.604
官方网址:http://www.bmj.com/
投稿链接:https://mc.manuscriptcentral.com/bmj