Clinical characteristics and predictors of the duration of SARS-CoV-2 viral shedding in 140 healthcare workers
Clinical characteristics and predictors of the duration of SARS-CoV-2 viral shedding in 140 healthcare workers
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DOI：
10.1111/joim.13160
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发表时间：
2020-09-21
影响因子：
11.1
通讯作者：
Chen, Z.
中科院分区：
文献类型：
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作者：
Liu, W.;Liu, Y.;Chen, Z.
背景。已经报道了 COVID-19 患者的流行病学和临床特征，但没有一个针对医务人员，而且病毒排出持续时间的预测因素也很少有报道。迫切需要帮助医护人员预防 2019 年冠状病毒病 (COVID-19) 并快速康复。方法。我们在武汉招募了 140 名患有 COVID-19 的医务人员。收集流行病学、人口统计学、临床、实验室、放射学、治疗和临床结果数据，并通过多元线性回归分析探索病毒排出持续时间的预测因素。结果。感染COVID-19的医务人员临床症状较轻，实验室指标异常的频率较低。医护人员全部治愈出院，其中女性96人（68.6%），有基础疾病39人（27.9%），中位年龄36.0岁，住院期间感染104人（74.3%）。病毒脱落的中位持续时间为 25.0 天 (IQR:20.0-30.0)。多变量线性回归分析显示，病毒排出持续时间的缩短与接受重组人干扰素α（rIFN-α）治疗相关，而病毒排出持续时间的延长与糖皮质激素治疗的使用、从首次出现症状到入院的持续时间以及胸部计算机断层扫描（CT）证据的改善相关。此外，入院时淋巴细胞低于1.1 x 10(9)/L的受感染医护人员的病毒排毒时间延长。结论。及时接受医疗干预的医务人员表现出较轻的临床特征。糖皮质激素治疗和淋巴细胞低于 1.1 x 109/L 与病毒脱落时间延长有关。早期入院和 rIFN-α 治疗有助于缩短病毒排出的持续时间。
Background. Epidemiological and clinical features of patients with COVID-19 have been reported, but none of them focused on medical staff, and few predictors of the duration of viral shedding have been reported. It is urgent to help healthcare workers prevent and recover quickly from the coronavirus disease 2019 (COVID-19).Methods. We enrolled 140 medical workers with COVID-19 in Wuhan. Epidemiological, demographic, clinical, laboratory, radiological, treatment and clinical outcome data were collected, and predictors of the duration of viral shedding were explored through multivariable linear regression analysis.Results. The medical staff with COVID-19 presented mild clinical symptoms and showed a low frequency of abnormal laboratory indicators. All the medical staff were cured and discharged, of whom 96 (68.6%) were female, 39 (27.9%) had underlying diseases, the median age was 36.0 years, and 104 (74.3%) were infected whilst working in hospital. The median duration of viral shedding was 25.0 days (IQR:20.0-30.0). Multivariable linear regression analysis showed reducing viral shedding duration was associated with receiving recombinant human interferon alpha (rIFN-alpha) treatment, whilst the prolonged duration of viral shedding correlated with the use of glucocorticoid treatment, the durations from the first symptom to hospital admission and the improvement in chest computed tomography (CT) evidence. Moreover, infected healthcare workers with lymphocytes less than 1.1 x 10(9)/L on admission had prolonged viral shedding.Conclusion. Medical staff with timely medical interventions shows milder clinical features. Glucocorticoid treatment and lymphocytes less than 1.1 x 109/L are associated with prolonged viral shedding. Early admission and rIFN-alpha treatment help shorten the duration of viral shedding.