接触新冠病人的医护及家人感染的风险：全国关联队列研究 (BMJ, IF:30.223)
15 November 2020
Risk of hospital admission with coronavirus disease 2019 in healthcare workers and their households: nationwide linkage cohort study
Shah Anoop S V,Wood Rachael,Gribben Ciara et al. Risk of hospital admission with coronavirus disease 2019 in healthcare workers and their households: nationwide linkage cohort study.[J] .BMJ, 2020, 371: m3582.
To assess the risk of hospital admission for coronavirus disease 2019 (covid-19) among patient facing and non-patient facing healthcare workers and their household members.
Nationwide linkage cohort study.
Scotland, UK, 1 March to 6 June 2020.
Healthcare workers aged 18-65 years, their households, and other members of the general population.
Admission to hospital with covid-19.
The cohort comprised 158 445 healthcare workers, most of them (90 733; 57.3%) being patient facing, and 229 905 household members. Of all hospital admissions for covid-19 in the working age population (18-65 year olds), 17.2% (360/2097) were in healthcare workers or their households. After adjustment for age, sex, ethnicity, socioeconomic deprivation, and comorbidity, the risk of admission due to covid-19 in non-patient facing healthcare workers and theirhouseholds was similar to the risk in the general population (hazard ratio 0.81 (95% confidence interval 0.52 to 1.26) and 0.86 (0.49 to 1.51), respectively). In models adjusting for the same covariates, however, patient facing healthcare workers, compared with non-patient facing healthcare workers, were at higher risk (hazard ratio 3.30, 2.13 to 5.13), as were household members of patient facing healthcare workers (1.79, 1.10 to 2.91). After sub-division of patient facing healthcare workers into those who worked in "front door," intensive care, and non-intensive care aerosol generating settings and other, those in front door roles were at higher risk (hazard ratio 2.09, 1.49 to 2.94). For most patient facing healthcare workers and their households, the estimated absolute risk of hospital admission with covid-19 was less than 0.5%, but it was 1% and above in older men with comorbidity.
该队列包括158 445名保健工作者，其中大部分(90 733名;57.3%)接触新冠病人，以及229905名家庭成员。在所有因新冠住院的工作年龄人口(18-65岁)中，17.2%(360/2097)是医疗工作者或其家人。在调整年龄、性别、种族、社会经济剥夺和伴随疾病，住院的风险对没接触新冠病人的卫生保健工作者及其家人而言，因新冠入院的风险与一般人群的风险相似(风险比0.81(95%置信区间0.52至1.26)和0.86(0.49至1.51)。然而，在对相同协变量进行调整的模型中，接触新冠病人的卫生保健工作者与没接触的相比，面临更高的风险(风险比3.30、2.13至5.13)，接触新冠病人的卫生保健工作者的家庭成员也面临更高的风险(风险比1.79、1.10至2.91)。在将面对医护人员的患者划分为在“前门”、重症监护和非重症监护气溶胶产生环境和其他环境中工作的人员后，那些在前门工作的人员风险更高(危险比2.09、1.49至2.94)。对大多数接触新冠病人的医疗工作者及其家人来说，因新冠入院的估计绝对风险小于0.5%，但在有基础疾病的老年男性中，这一风险为1%以上。
Healthcare workers and their households contributed a sixth of covid-19 cases admitted to hospital. Although the absolute risk of admission was low overall, patient facing healthcare workers and their household members had threefold and twofold increased risks of admission with covid-19.