Characteristics of 1573 healthcare workers who underwent nasopharyngeal swab testing for SARS-CoV-2 in Milan, Lombardy, Italy
Characteristics of 1573 healthcare workers who underwent nasopharyngeal swab testing for SARS-CoV-2 in Milan, Lombardy, Italy
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DOI：
10.1016/j.cmi.2020.06.013
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发表时间：
2020-10-01
影响因子：
14.2
通讯作者：
Gori, A.
中科院分区：
文献类型：
--
作者：
Lombardi, A.;Consonni, D.;Gori, A.
目的：对接触2019年新冠肺炎确诊病例的医护人员的管理仍是一个有争议的问题。方法：收集2020年2月24日至2020年3月31日在某大学医院接受鼻咽拭子检测SARS-CoV-2的医务人员的职业和临床特征。对于那些检测呈阳性的人和那些检测呈阳性但没有症状的人，我们检查了截至5月22日的实验室和临床数据，以计算卫生工作者随后检测为阴性所需的时间，并核实此后是否出现症状。结果：在1573名医务人员中检出阳性反应139例(8.8%)，95%可信区间为7.510.3%，有症状和无症状工人之间有显著差异(P<；0.001)。内科医生阳性率最高(61/582，10.5%)，文书、技术人员最低(5/137，3.6%)。新冠肺炎检测呈阳性的可能性随着报告症状的数量的增加而增加；对检测阳性的最强预测因素是味觉和嗅觉变化(优势比=76.9)和发烧(优势比=9.12)。从首次阳性到阴性的中位时间为27天(95%可信区间，24~30天)。结论：医务人员可以感染SARS-CoV-2，而不会出现任何症状。在有症状的卫生工作者中，指导诊断的关键症状是味觉和气味改变以及发热。在鼻咽拭子检测结果为阴性之前，需要大约4周的中位数。(C)2020年欧洲临床微生物学和传染病学会。爱思唯尔有限公司出版。保留所有权利。
Objectives: The management of healthcare workers (HCWs) exposed to confirmed cases of coronavirus disease 2019 (COVID-19) is still a matter of debate. We aimed to assess in this group the attack rate of asymptomatic carriers and the symptoms most frequently associated with infection.Methods: Occupational and clinical characteristics of HCWs who underwent nasopharyngeal swab testing for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a university hospital from 24 February 2020 to 31 March 2020 were collected. For those who tested positive and for those who tested positive but who were asymptomatic, we checked the laboratory and clinical data as of 22 May to calculate the time necessary for HCWs to then test negative and to verify whether symptoms developed thereafter. Frequencies of positive tests were compared according to selected variables using multivariable logistic regression models.Results: There were 139 positive tests (8.8%) among 1573 HCWs (95% confidence interval, 7.5-10.3), with a marked difference between symptomatic (122/503, 24.2%) and asymptomatic (17/1070, 1.6%) workers (p < 0.001). Physicians were the group with the highest frequency of positive tests (61/582, 10.5%), whereas clerical workers and technicians had the lowest frequency (5/137, 3.6%). The likelihood of testing positive for COVID-19 increased with the number of reported symptoms; the strongest predictors of test positivity were taste and smell alterations (odds ratio = 76.9) and fever (odds ratio = 9.12). The median time from first positive test to a negative test was 27 days (95% confidence interval, 24-30).Conclusions: HCWs can be infected with SARS-CoV-2 without displaying any symptoms. Among symptomatic HCWs, the key symptoms to guide diagnosis are taste and smell alterations and fever. A median of almost 4 weeks is necessary before nasopharyngeal swab test results are negative. (C) 2020 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.