Access to personal protective equipment in exposed healthcare workers and COVID-19 illness, severity, symptoms and duration: a population-based case-control study in six countries.
Access to personal protective equipment in exposed healthcare workers and COVID-19 illness, severity, symptoms and duration: a population-based case-control study in six countries.
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DOI：
10.1136/bmjgh-2020-004611
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发表时间：
2021-01
影响因子：
8.1
通讯作者：
Seidelmann SB
中科院分区：
文献类型：
--
作者：
Kim H;Hegde S;LaFiura C;Raghavan M;Sun N;Cheng S;Rebholz CM;Seidelmann SB
尽管个人防护装备在新冠肺炎大流行中得到了广泛应用，但关于其影响的研究令人惊讶地少之又少。评估新冠肺炎与高危医护人员接触个人防护用品的风险、严重性和持续时间。从2020年7月17日至9月25日，在6个国家(英国、德国、法国、意大利、西班牙和美国)的Survey Healthcare Globus网络中注册为提供者的高危医生和护士是根据经常与新冠肺炎患者密切接触的成人医学专业确定的。接触人群填写了一份详细的问卷，内容包括人口统计、医疗、社会和生活方式等因素。新冠肺炎病例定义为有新冠肺炎症状(发热、咳嗽、乏力、味觉或嗅觉减退)和无症状新冠肺炎试验阳性病例。接触医务人员2 884人(医生94%，护士或医师助理6%)，报告新冠肺炎病5 14例，无症状新冠肺炎试验阳性5 4例。新冠肺炎风险与工作场所内外密切接触新冠肺炎病例、工作班次和每周工作时间显著相关。与每次就诊时获得新的口罩、长袍、手套和面罩相比，有限的个人防护措施与报告新冠肺炎症状的风险增加2.2倍至22倍相关(p<；0.0001)，这一模式在所有六个国家都是一致的。此外，接触PPE的机会有限与症状持续时间超过2周以及存在中到重度症状有关，如呼吸困难、胸部X光异常、低氧饱和度、呼吸窘迫和急性肺损伤。在六个国家中，获得个人防护用品的机会较少与报告新冠肺炎疾病的风险增加以及第一线卫生工作者的病程更长和更严重密切相关。
Despite the widespread implementation of personal protective equipment (PPE) in the COVID-19 pandemic, there are surprisingly few studies of its impact. To assess the risk, severity and duration of COVID-19 in relation to access to PPE in at-risk healthcare workers (HCWs). From 17 July to 25 September 2020, at-risk physicians and nurses registered as a provider in the Survey Healthcare Globus network in six countries (the UK, Germany, France, Italy, Spain and USA) were identified based on adult medical specialties with frequent and close contact with patients with COVID-19. Exposed HCWs completed a detailed questionnaire including demographics, medical, social and lifestyle factors. COVID-19 cases were defined as COVID-19 symptoms (fever, cough, fatigue, loss of taste or smell) and asymptomatic COVID-19 test positive cases. Among 2884 exposed HCWs (94% medical doctors and 6% nurses or physician assistants), there were 514 reports of COVID-19 illness and 54 asymptomatic COVID-19 test positive cases. COVID-19 risk was significantly associated with close contact with COVID-19 cases both inside and outside the workplace, number of work shifts and hours worked per week. Limited access to PPE compared with access to a fresh mask, gown and gloves and face shield with each patient encounter was associated with a 2.2-fold to 22-fold increased risk of reporting COVID-19 symptoms (p<0.0001), a pattern consistent across all six countries. Further, limited access to PPE was associated with symptom duration greater than 2 weeks and the presence of moderate to severe symptoms such as difficulty breathing, abnormal chest X-ray, low oxygen saturations, respiratory distress and acute lung injury. In six countries, less access to PPE was strongly associated with both increased risk of reporting COVID-19 illness as well as more prolonged and severe disease course in frontline HCWs.
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影响因子：
4.4
作者：
Norton, Emma Jane;Georgiou, Ioannis;Saunders, Kate E. A.
通讯作者：
Saunders, Kate E. A.
影响因子：
39.2
作者：
Bundgaard, Henning;Bundgaard, Johan Skov;Iversen, Kasper
通讯作者：
Iversen, Kasper
DOI：
10.1056/nejmp2026913
发表时间：
2020-10-29
期刊：
The New England journal of medicine
影响因子：
--
作者：
Gandhi M;Rutherford GW
通讯作者：
Rutherford GW
DOI：
10.1101/2020.04.29.20084111
发表时间：
2020-09-01
期刊：
The Lancet. Public health
影响因子：
--
作者：
Nguyen, Long H;Drew, David A;Chan, Andrew T
通讯作者：
Chan, Andrew T
影响因子：
82.9
作者：
Leung NHL;Chu DKW;Shiu EYC;Chan KH;McDevitt JJ;Hau BJP;Yen HL;Li Y;Ip DKM;Peiris JSM;Seto WH;Leung GM;Milton DK;Cowling BJ
通讯作者：
Cowling BJ