Use of personal protective equipment against coronavirus disease 2019 by healthcare professionals in Wuhan, China: cross sectional study
Use of personal protective equipment against coronavirus disease 2019 by healthcare professionals in Wuhan, China: cross sectional study
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DOI：
10.1136/bmj.m2195
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发表时间：
2020-06-10
影响因子：
105.7
通讯作者：
Xiao, Hai-Peng
中科院分区：
文献类型：
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作者：
Liu, Min;Cheng, Shou-Zhen;Xiao, Hai-Peng
目的探讨新型冠状病毒病（covid-19）一线医护人员佩戴适当个人防护装备的防护效果。设计横断面研究。中国武汉有四家医院。参与者：从2020年1月24日至4月7日，由中山大学附属医院和南方医科大学南方医院派遣到武汉的420名医护人员（116名医生和304名护士），为期6-8周。为这些研究参与者提供了适当的个人防护装备，以便为covid-19住院患者提供医疗保健，并参与了气溶胶产生程序。招募77名无COVID-19暴露史的医护人员和80名COVID-19康复患者来验证抗体检测的准确性。主要观察指标covid -19相关症状（发烧、咳嗽和呼吸困难）和严重急性呼吸综合征冠状病毒2 （SARS-CoV-2）感染的证据，定义为鼻咽拭子中病毒特异性核酸检测阳性，或血清样本中IgM或IgG抗体检测阳性。结果研究对象的平均年龄为35.8岁，女性占68.1%（286/420）。这些研究参与者每周平均工作5.4天，每班工作4-6小时；他们在重症监护室平均每周工作16.2小时。所有420名研究参与者都与covid-19患者直接接触，并进行了至少一次气溶胶产生程序。在武汉部署期间，没有研究参与者报告与covid-19相关的症状。当参与者回家时，他们对SARS-CoV-2特异性核酸和IgM或IgG抗体的检测均为阴性（95%置信区间为0.0至0.7%）。在获得安全有效的疫苗之前，卫生保健专业人员仍然容易感染covid-19。尽管暴露的风险很高，但研究参与者得到了适当的保护，没有感染或产生针对SARS-CoV-2的保护性免疫。卫生保健系统必须优先采购和分发个人防护装备，并为卫生保健专业人员提供充分的使用培训。
OBJECTIVETo examine the protective effects of appropriate personal protective equipment for frontline healthcare professionals who provided care for patients with coronavirus disease 2019 (covid-19).DESIGNCross sectional study.SETTINGFour hospitals in Wuhan, China.PARTICIPANTS420 healthcare professionals (116 doctors and 304 nurses) who were deployed to Wuhan by two affiliated hospitals of Sun Yat-sen University and Nanfang Hospital of Southern Medical University for 6-8 weeks from 24 January to 7 April 2020. These study participants were provided with appropriate personal protective equipment to deliver healthcare to patients admitted to hospital with covid-19 and were involved in aerosol generating procedures. 77 healthcare professionals with no exposure history to covid-19 and 80 patients who had recovered from covid-19 were recruited to verify the accuracy of antibody testing.MAIN OUTCOME MEASURESCovid-19 related symptoms (fever, cough, and dyspnoea) and evidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, defined as a positive test for virus specific nucleic acids in nasopharyngeal swabs, or a positive test for IgM or IgG antibodies in the serum samples.RESULTSThe average age of study participants was 35.8 years and 68.1% (286/420) were women. These study participants worked 4-6 hour shifts for an average of 5.4 days a week; they worked an average of 16.2 hours each week in intensive care units. All 420 study participants had direct contact with patients with covid-19 and performed at least one aerosol generating procedure. During the deployment period in Wuhan, none of the study participants reported covid-19 related symptoms. When the participants returned home, they all tested negative for SARS-CoV-2 specific nucleic acids and IgM or IgG antibodies (95% confidence interval 0.0 to 0.7%).CONCLUSIONBefore a safe and effective vaccine becomes available, healthcare professionals remain susceptible to covid-19. Despite being at high risk of exposure, study participants were appropriately protected and did not contract infection or develop protective immunity against SARS-CoV-2. Healthcare systems must give priority to the procurement and distribution of personal protective equipment, and provide adequate training to healthcare professionals in its use.