Risk Factors Associated With SARS-CoV-2 Seropositivity Among US Health Care Personnel.
Risk Factors Associated With SARS-CoV-2 Seropositivity Among US Health Care Personnel.
复制标题
DOI：
10.1001/jamanetworkopen.2021.1283
复制
发表时间：
2021-03-01
影响因子：
13.8
通讯作者：
Harris AD
中科院分区：
文献类型：
--
作者：
Jacob JT;Baker JM;Fridkin SK;Lopman BA;Steinberg JP;Christenson RH;King B;Leekha S;O'Hara LM;Rock P;Schrank GM;Hayden MK;Hota B;Lin MY;Stein BD;Caturegli P;Milstone AM;Rock C;Voskertchian A;Reddy SC;Harris AD
在工作场所内外的医护人员中，哪些危险因素与严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)血清阳性有关？在这项对美国3个州的24个SARS-CoV-2 HCP进行的横断面研究中，与已知患有2019年冠状病毒病(新冠肺炎)的个人在工作场所以外接触是与 -CoV-2血清阳性相关的最强风险因素，同时生活在新冠肺炎发病率较高的邮政编码。评估的工作场所因素中没有一项与血清阳性有关。在这项研究中，与SARS-CoV-2感染相关的危险因素大多在工作场所以外，这表明目前的卫生保健感染预防策略在防止工作场所患者向HCP传播方面是有效的。这项横断面研究评估了卫生保健人员中与严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)血清阳性相关的危险因素。在卫生保健人员中感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的风险尚不清楚。根据社区暴露而非卫生保健暴露与血清阳性相关的先验假设，评估与SARS-CoV-2血清阳性相关的危险因素。这项横断面研究是在美国3个州的4个大型医疗保健系统的志愿者HCP中进行的。网站共享已确定的数据集，包括以前收集的血清学结果、关于血清学时社区和工作场所暴露的问卷结果，以及HCP的3位住宅邮政编码前缀。特定于站点的响应被映射到公共元数据集。居民每周冠状病毒病2019年(新冠肺炎)累计发病率根据州新冠肺炎病例和人口普查数据计算。模型变量包括人口统计学(年龄、种族、性别、民族)、社区(已知的新冠肺炎联系人、按3位邮政编码前缀的新冠肺炎累积发病率)和卫生保健(工作场所、工作角色、新冠肺炎患者接触者)因素。主要结果是SARS-CoV-2血清阳性。用随机截距的混合效应Logistic回归模型估计血清阳性的危险因素，以说明按地点聚集的情况。在24例 -749HCP中，年龄<50岁者17例(69.6%)，女性19例(78.2%)，白人15例(61.2%)，有工作场所接触史的新冠肺炎患者12例(12例 -413例(50.2%))。许多医务人员在住院场所工作(8893人(35.9%))和护士(7830人(31.6%))。在血清学检测前一周，社区中新冠肺炎每10,000人中的累积发病率从8.2%到275.6；20 072HCP(81.1%)报告社区中没有新冠肺炎接触者。血清阳性率为4.4%(95%可信区间，4.1%-4.6%；1080个HCP)。在多因素分析中，社区新冠肺炎接触者和社区新冠肺炎累计发病率与血清阳性率有关(社区接触者：校正优势比[AOR]，3.5；95%CI，2.9~4.1；社区累积发病率：AOR，1.8；95%CI，1.3~2.6)。没有评估的工作场所因素与血清阳性相关，包括护士的工作角色(AOR，1.1；95%CI，0.9-1.3)，在急诊科工作(AOR，1.0；95%CI，0.8-1.3)，或与新冠肺炎患者的工作场所接触(AOR，1.1；95%CI，0.9-1.3)。在这项对美国3个州的HCP的横断面研究中，社区暴露与SARS-CoV-2血清阳性有关，但工作场所因素，包括工作场所角色、环境或与已知新冠肺炎患者的接触，没有关联。这些发现让人放心，目前在不同卫生保健环境中的感染预防措施在防止SARS-CoV-2从患者传播到HCP方面是有效的。
What risk factors are associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seropositivity among health care personnel (HCP) inside and outside the workplace? In this cross-sectional study of 24 749 HCP in 3 US states, contact with an individual with known coronavirus disease 2019 (COVID-19) exposure outside the workplace was the strongest risk factor associated with SARS-CoV-2 seropositivity, along with living in a zip code with higher COVID-19 incidence. None of the assessed workplace factors were associated with seropositivity. In this study, most risk factors associated with SARS-CoV-2 infection among HCP were outside the workplace, suggesting that current infection prevention strategies in health care are effective in preventing patient-to-HCP transmission in the workplace. This cross-sectional study evaluates the risk factors associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seropositivity among health care personnel. Risks for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among health care personnel (HCP) are unclear. To evaluate the risk factors associated with SARS-CoV-2 seropositivity among HCP with the a priori hypothesis that community exposure but not health care exposure was associated with seropositivity. This cross-sectional study was conducted among volunteer HCP at 4 large health care systems in 3 US states. Sites shared deidentified data sets, including previously collected serology results, questionnaire results on community and workplace exposures at the time of serology, and 3-digit residential zip code prefix of HCP. Site-specific responses were mapped to a common metadata set. Residential weekly coronavirus disease 2019 (COVID-19) cumulative incidence was calculated from state-based COVID-19 case and census data. Model variables included demographic (age, race, sex, ethnicity), community (known COVID-19 contact, COVID-19 cumulative incidence by 3-digit zip code prefix), and health care (workplace, job role, COVID-19 patient contact) factors. The main outcome was SARS-CoV-2 seropositivity. Risk factors for seropositivity were estimated using a mixed-effects logistic regression model with a random intercept to account for clustering by site. Among 24 749 HCP, most were younger than 50 years (17 233 [69.6%]), were women (19 361 [78.2%]), were White individuals (15 157 [61.2%]), and reported workplace contact with patients with COVID-19 (12 413 [50.2%]). Many HCP worked in the inpatient setting (8893 [35.9%]) and were nurses (7830 [31.6%]). Cumulative incidence of COVID-19 per 10 000 in the community up to 1 week prior to serology testing ranged from 8.2 to 275.6; 20 072 HCP (81.1%) reported no COVID-19 contact in the community. Seropositivity was 4.4% (95% CI, 4.1%-4.6%; 1080 HCP) overall. In multivariable analysis, community COVID-19 contact and community COVID-19 cumulative incidence were associated with seropositivity (community contact: adjusted odds ratio [aOR], 3.5; 95% CI, 2.9-4.1; community cumulative incidence: aOR, 1.8; 95% CI, 1.3-2.6). No assessed workplace factors were associated with seropositivity, including nurse job role (aOR, 1.1; 95% CI, 0.9-1.3), working in the emergency department (aOR, 1.0; 95% CI, 0.8-1.3), or workplace contact with patients with COVID-19 (aOR, 1.1; 95% CI, 0.9-1.3). In this cross-sectional study of US HCP in 3 states, community exposures were associated with seropositivity to SARS-CoV-2, but workplace factors, including workplace role, environment, or contact with patients with known COVID-19, were not. These findings provide reassurance that current infection prevention practices in diverse health care settings are effective in preventing transmission of SARS-CoV-2 from patients to HCP.
登录
查看更多内容
DOI：
10.15585/mmwr.mm6943e3
发表时间：
2020-10-30
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
Kambhampati AK;O'Halloran AC;Whitaker M;Magill SS;Chea N;Chai SJ;Daily Kirley P;Herlihy RK;Kawasaki B;Meek J;Yousey-Hindes K;Anderson EJ;Openo KP;Monroe ML;Ryan PA;Kim S;Reeg L;Como-Sabetti K;Danila R;Davis SS;Torres S;Barney G;Spina NL;Bennett NM;Felsen CB;Billing LM;Shiltz J;Sutton M;West N;Schaffner W;Talbot HK;Chatelain R;Hill M;Brammer L;Fry AM;Hall AJ;Wortham JM;Garg S;Kim L;COVID-NET Surveillance Team
通讯作者：
COVID-NET Surveillance Team
影响因子：
13.8
作者：
Muñoz-Price LS;Nattinger AB;Rivera F;Hanson R;Gmehlin CG;Perez A;Singh S;Buchan BW;Ledeboer NA;Pezzin LE
通讯作者：
Pezzin LE
影响因子：
4.5
作者：
Hunter, Benton R.;Dbeibo, Lana;Weaver, Lindsay
通讯作者：
Weaver, Lindsay
影响因子：
11.8
作者：
Bajema, Kristina L.;Dahlgren, F. Scott;Havers, Fiona P.
通讯作者：
Havers, Fiona P.
影响因子：
33.9
作者：
Self, Wesley H.;Tenforde, Mark W.;Patel, Manish M.
通讯作者：
Patel, Manish M.