武汉同济医院医务人员2019新型冠状病毒感染相关因素的病例对照研究

目的了解医务人员感染2019新型冠状病毒(2019-nCoV)的疾病情况及相关因素的影响。方法回顾2020年2月9日之前发病且经咽拭子核酸检测2019-nCoV感染的同济医院在职医务人员,选取2020年1月15日-2020年2月8日发病的医务人员为感染组,以年龄和工作科室危险性作为配对因素、选取相同数量未感染的同济医院在职医务人员为未感染组。通过电子病历系统查询和电话访问的形式回顾两组人群的人口学资料、临床特征及药物服用情况,进而行数据分析。结果本次研究共纳入同济医院在职医务人员158例,感染组和未感染组各79例,其中男62例,女96例。高危科室医务人员感染率约为6.26%,而非高危科室医务人员感染率约为0.98%,两组感染率差异具有统计学意义(P<0.05)。感染组中26例(32.91%)预防性口服了抗病毒药物,未感染组中46例(58.22%),差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,口服抗病毒药物对医务人员感染COVID-19的影响有统计学意义(P<0.05)。感染者中重症肺炎4例,患者平均年龄51.8岁, 75例非重症患者平均年龄38.2岁,年龄差异存在统计学意义(P<0.05)。结论高危科室医务人员相对于非高危科室更易感染2019-nCoV,建议强化预防措施;预防性口服抗病毒药物是医务人员感染2019-nCoV的保护性因素,为高危人群预防用药的选择提供了依据;高龄患者具有重症肺炎易患性。

A case-control study on 2019-nCoV infection-related factors among medical staff in Wuhan Tongji Hospital

OBJECTIVE To investigate the infection status and relevant factors of novel coronavirus(2019-nCoV) among medical staff. METHODS In-service medial staff of Tongji Hospital who had onset of disease and had been detected the 2019-nCoV infection through a throat swab nucleic acid test before Feb. 9, 2020 were retrospectively analyzed. Medical staff with onset from Jan. 15, 2020 to Feb. 8, 2020 were selected as the infection group, and the same number of uninfected medical staff in Tongji Hospital were selected as the uninfected group based on age and the risk of work department as mathcing factors. The demographics, clinical characteristics and medications were reviewed through electronic medical record system queries and telephone interviews and analyzed between the two groups. RESULTS A total of 158 medical staff of Wuhan Tongji Hospital were included in this study, 79 cases in the infected group and 79 cases in the uninfected group, including 62 males and 96 females. The infection rate of medical staff in high-risk departments was about 6.26%, while that of medical staff in non high-risk departments was about 0.98%. The difference between the two groups was statistically significant(P<0.05). Twenty-six patients(32.91%) in the infection group were given took antiviral drugs in prophylaxis, 46 patients(58.22%) in the uninfected group, the difference was statistically significant(P<0.05). Multivariate logistic regression analysis showed that the effect of oral antiviral drugs on covid-19 infection of mecial staff was significant(P<0.05). There were 4 cases of severe pneumonia in infected patients, with the average age of 51.8 years old, and the average age of 75 non-severe patients was 38.2 years old. There was a significant difference in age(P<0.05). CONCLUSION Compared with non high risk departments, medical staff in high-risk departments are more susceptible to infection with 2019-nCov, and it is recommended to strengthen preventive measures. Prophylactic oral antiviral drugs are the protective factors for medical staff to be infected 2019-nCov, and provides a basis for the selection of preventive medication for high-risk groups.The elderly patients are susceptible to severe pneumonia.