SARS-CoV-2 Infection in Healthcare Personnel With High-risk Occupational Exposure: Evaluation of 7-Day Exclusion From Work Policy
SARS-CoV-2 Infection in Healthcare Personnel With High-risk Occupational Exposure: Evaluation of 7-Day Exclusion From Work Policy
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DOI：
10.1093/cid/ciaa888
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发表时间：
2020-12-15
影响因子：
11.8
通讯作者：
Sipsas, Nikolaos
中科院分区：
文献类型：
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作者：
Maltezou, Helena C.;Dedoukou, Xanthi;Sipsas, Nikolaos
背景。截至 2020 年 2 月下旬，希腊一直在经历 2019 年冠状病毒病 (COVID-19) 疫情。医护人员 (HCP) 受到的影响尤为严重，约占通报病例的 10%。对于有高风险职业暴露的 HCP，建议停职 7 天。我们的目的是评估针对高风险暴露的 HCP 的 7 天工作排除政策。方法。有 COVID-19 职业暴露史的 HCP 已被通知给希腊国家公共卫生组织，无论其暴露风险类别如何。在最后一次暴露后，对暴露的 HCP 进行了 14 天的跟踪。结果。我们前瞻性研究了 3398 名职业暴露的 HCP；护理人员的暴露量最大（n = 1705；50.2%）。在 3398 名暴露的 HCP 中，1599 名 (47.1%) 被归类为低风险，765 名 (22.5%) 被归类为中度风险，1031 名 (30.4%) 被归类为高风险暴露。 66 名 HCP (1.9%) 平均在接触后 3.65 天（范围：0-17）天出现了 COVID-19。在 66 名感染 COVID-19 的 HCP 中，46 名、7 名和 13 名有高风险、中风险或低风险暴露史（分别占所有高风险、中风险和低风险暴露的 4.5%、0.9% 和 0.8%）。在高风险暴露的医护人员中，住院和缺勤更为普遍。逻辑回归分析显示，以下变量与COVID-19发病风险增加显着相关：男性、行政人员、基础疾病和高风险暴露。结论。因职业接触 COVID-19 的高风险医护人员出现严重发病、就医、住院和缺勤的可能性增加。我们的研究结果证明，对高风险暴露的 HCP 实施 7 天的工作排除政策是合理的。
Background. As of late February 2020, Greece has been experiencing the coronavirus disease 2019 (COVID-19) epidemic. Healthcare personnel (HCP) were disproportionately affected, accounting for similar to 10% of notified cases. Exclusion from work for 7 days was recommended for HCP with high-risk occupational exposure. Our aim was to evaluate the 7-day exclusion from work policy for HCP with high-risk exposure.Methods. HCP with a history of occupational exposure to COVID-19 were notified to the Hellenic National Public Health Organization, regardless of their exposure risk category. Exposed HCP were followed for 14 days after last exposure.Results. We prospectively studied 3398 occupationally exposed HCP; nursing personnel accounted for most exposures (n = 1705; 50.2%). Of the 3398 exposed HCP, 1599 (47.1%) were classified as low-risk, 765 (22.5%) as moderate-risk, and 1031 (30.4%) as high-risk exposures. Sixty-six (1.9%) HCP developed COVID-19 at a mean of 3.65 (range: 0-17) days postexposure. Of the 66 HCP with COVID-19, 46, 7, and 13 had a history of high-, moderate- or low-risk exposure (4.5%, 0.9%, and 0.8% of all high-, moderate-, and low-risk exposures, respectively). Hospitalization and absenteeism were more prevalent among HCP with high-risk exposure. A logistic regression analysis showed that the following variables were significantly associated with an increased risk for the onset of COVID-19: male, administrative personnel, underlying disease, and high-risk exposure.Conclusions. HCP with high-risk occupational exposure to COVID-19 had increased probability of serious morbidity, healthcare seeking, hospitalization, and absenteeism. Our findings justify the 7-day exclusion from work policy for HCP with high-risk exposure.