Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 461
Filtrar
1.
Recenti Prog Med ; 115(7): 350-356, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39011917

RESUMO

BACKGROUND: Healthcare workers (HCWs) are at high risk of contracting Covid-19 due to their frontline roles and close interactions with infected patients. Understanding the prevalence of Covid-19 infection among HCWs and the factors contributing to it is crucial for informing mitigation strategies. However, the available data on Covid-19 infection rates among Iranian HCWs is limited. OBJECTIVE: The primary objective of this study was to compare the prevalence of Covid-19 infection among HCWs working in hospitals dedicated to Covid-19 care versus HCWs in other non-Covid-19 hospitals in Khuzestan province, Iran. Additionally, the study aimed to identify potential risk factors associated with Covid-19 transmission and symptom severity in this population. METHODS: This cohort study recruited 3,012 HCWs from 35 hospitals in Khuzestan province. Covid-19 diagnosis was made using RT-PCR testing, chest CT scans, and clinical examination. RESULTS: Overall, 96% (n=2,918) of the 3,012 HCWs were infected with Covid-19. The prevalence was significantly higher among HCWs from Covid-19 hospitals (59.83%, n=1,746) compared to those from non-Covid-19 hospitals (5.75%, n=168). The capital city of Ahvaz had the highest proportion of Covid-19 cases at 28%. CONCLUSIONS: HCWs, especially those working in hospitals dedicated to Covid-19 care, face a substantial risk of contracting the virus. The high infection rates observed may be attributed to factors like weakened immune systems, non-compliance with precautions, and delayed diagnosis. These findings underscore the critical need to strengthen infection control measures, improve access to personal protective equipment, and enhance surveillance of Covid-19 among frontline HCWs in Iran.


Assuntos
COVID-19 , Pessoal de Saúde , Humanos , Irã (Geográfico)/epidemiologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Masculino , Feminino , Adulto , Prevalência , Pessoa de Meia-Idade , Pessoal de Saúde/estatística & dados numéricos , Fatores de Risco , Estudos de Coortes , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Paciente para o Profissional/estatística & dados numéricos , Hospitais/estatística & dados numéricos , Adulto Jovem , Equipamento de Proteção Individual , SARS-CoV-2
2.
Einstein (Sao Paulo) ; 22: eAO0433, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38865569

RESUMO

Crispim et al. demonstrated the independent risk factors for acquiring COVID-19 among healthcare personnel. They also showed the importance of infection prevention training to avoid acquiring COVID-19 in this population. OBJECTIVE: To verify the rate of COVID-19 infection among healthcare personnel at high and low risk of COVID-19 infection and identify the underlying risk factors. METHODS: This cross-sectional study was conducted between December 1, 2020 and February 28, 2021. Associations were verified between the levels of risk (high or low) of occupational COVID-19 infection and participant characteristics using the World Health Organization risk assessment questionnaire and adjusted using logistic regression models in single and multiple approaches. RESULTS: Of the 486 participants, 57.4% were classified as having a high occupational risk for SARS-CoV-2 infection, with a diagnosis rate of 12.1%. The factors identified in the multivariate analysis for high occupational risk were age up to 29 years (odds ratio [OR] = 2.7, 95% confidence interval [95%CI] = 1.63-4.47), monthly family income greater than eight times the basic salary (OR= 1.8, 95%CI= 1.07-3.16), and healthcare personnel who did not participate in initial training to work in the area of patients with COVID-19 infection (OR= 2.39, 95%CI= 1.53-3.75). CONCLUSION: Encouraging training for occupational infection prevention is very important to reduce the impact of infectious diseases on healthcare personnel, especially young health professionals. COVID-19 infection among healthcare personnel has impacted the workforce in hospitals. Knowledge of the risk factors for COVID-19 infection is important for disease prevention measures. Failure to train healthcare personnel is an important risk factor for acquiring COVID-19.


Assuntos
COVID-19 , Pessoal de Saúde , Humanos , COVID-19/prevenção & controle , COVID-19/epidemiologia , Estudos Transversais , Masculino , Feminino , Adulto , Pessoal de Saúde/estatística & dados numéricos , Fatores de Risco , Pessoa de Meia-Idade , Brasil/epidemiologia , Medição de Risco , SARS-CoV-2 , Inquéritos e Questionários , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Paciente para o Profissional/estatística & dados numéricos , Fatores Etários , Doenças Profissionais/prevenção & controle , Doenças Profissionais/epidemiologia , Adulto Jovem , Exposição Ocupacional/prevenção & controle , Exposição Ocupacional/estatística & dados numéricos
4.
J Thorac Cardiovasc Surg ; 163(3): 1085-1092.e3, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-33220960

RESUMO

OBJECTIVE: The impact of coronavirus disease 2019 (COVID-19) on the postoperative course of patients after cardiac surgery is unknown. We experienced a major severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak in our cardiac surgery unit, with several patients who tested positive early after surgery. Here we describe the characteristics, postoperative course, and laboratory findings of these patients, along with the fate of the health care workers. We also discuss how we reorganize and reallocate hospital resources to resume the surgical activity without further positive patients. METHODS: After diagnosis of the first symptomatic patient, surgery was suspended. Nasopharyngeal swabs were performed in all patients and health care workers. Patients who were positive for SARS-CoV-2 were isolated and monitored throughout the in-hospital stay and followed up after discharged until death or clinical recovery. RESULTS: Twenty patients were found to be positive for SARS-CoV-2 sometime after cardiac surgery (mean age 69 ± 10.4 years; median European System for Cardiac Operative Risk Evaluation II score 3 [interquartile range, 5.1]); the median time from surgery to diagnosis was 15 days (interquartile range, 11). Among the patients, 18 had undergone cardiac surgery and 2 of them transcatheter aortic valve replacement. Overall mortality was 15%. Specific COVID-19-related symptoms were identified in 7 patients (35%). Among the 12 health care workers infected, 1 developed a bilateral mild-grade interstitial pneumonia. CONCLUSIONS: COVID-19 infection after cardiac surgery, regardless the time of the onset, is a serious condition. The systemic inflammatory state that follows extracorporeal circulation may mask the typical COVID-19 laboratory findings, making the diagnosis more difficult. A strict reorganization of the hospital resources is necessary to safely resume the cardiac surgical activity.


Assuntos
COVID-19/etiologia , Procedimentos Cirúrgicos Cardíacos , Surtos de Doenças , Complicações Pós-Operatórias , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/transmissão , Surtos de Doenças/prevenção & controle , Feminino , Seguimentos , Alocação de Recursos para a Atenção à Saúde/métodos , Alocação de Recursos para a Atenção à Saúde/organização & administração , Acessibilidade aos Serviços de Saúde/organização & administração , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Paciente para o Profissional/estatística & dados numéricos , Itália , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/prevenção & controle , Centros de Atenção Terciária
5.
PLoS Med ; 18(10): e1003816, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34637439

RESUMO

BACKGROUND: Nosocomial spread of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has been widely reported, but the transmission pathways among patients and healthcare workers (HCWs) are unclear. Identifying the risk factors and drivers for these nosocomial transmissions is critical for infection prevention and control interventions. The main aim of our study was to quantify the relative importance of different transmission pathways of SARS-CoV-2 in the hospital setting. METHODS AND FINDINGS: This is an observational cohort study using data from 4 teaching hospitals in Oxfordshire, United Kingdom, from January to October 2020. Associations between infectious SARS-CoV-2 individuals and infection risk were quantified using logistic, generalised additive and linear mixed models. Cases were classified as community- or hospital-acquired using likely incubation periods of 3 to 7 days. Of 66,184 patients who were hospitalised during the study period, 920 had a positive SARS-CoV-2 PCR test within the same period (1.4%). The mean age was 67.9 (±20.7) years, 49.2% were females, and 68.5% were from the white ethnic group. Out of these, 571 patients had their first positive PCR tests while hospitalised (62.1%), and 97 of these occurred at least 7 days after admission (10.5%). Among the 5,596 HCWs, 615 (11.0%) tested positive during the study period using PCR or serological tests. The mean age was 39.5 (±11.1) years, 78.9% were females, and 49.8% were nurses. For susceptible patients, 1 day in the same ward with another patient with hospital-acquired SARS-CoV-2 was associated with an additional 7.5 infections per 1,000 susceptible patients (95% credible interval (CrI) 5.5 to 9.5/1,000 susceptible patients/day) per day. Exposure to an infectious patient with community-acquired Coronavirus Disease 2019 (COVID-19) or to an infectious HCW was associated with substantially lower infection risks (2.0/1,000 susceptible patients/day, 95% CrI 1.6 to 2.2). As for HCW infections, exposure to an infectious patient with hospital-acquired SARS-CoV-2 or to an infectious HCW were both associated with an additional 0.8 infection per 1,000 susceptible HCWs per day (95% CrI 0.3 to 1.6 and 0.6 to 1.0, respectively). Exposure to an infectious patient with community-acquired SARS-CoV-2 was associated with less than half this risk (0.2/1,000 susceptible HCWs/day, 95% CrI 0.2 to 0.2). These assumptions were tested in sensitivity analysis, which showed broadly similar results. The main limitations were that the symptom onset dates and HCW absence days were not available. CONCLUSIONS: In this study, we observed that exposure to patients with hospital-acquired SARS-CoV-2 is associated with a substantial infection risk to both HCWs and other hospitalised patients. Infection control measures to limit nosocomial transmission must be optimised to protect both staff and patients from SARS-CoV-2 infection.


Assuntos
COVID-19 , Infecções Comunitárias Adquiridas , Infecção Hospitalar/epidemiologia , Pessoal de Saúde , Hospitais , Transmissão de Doença Infecciosa do Paciente para o Profissional , Transmissão de Doença Infecciosa do Profissional para o Paciente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/transmissão , Estudos de Coortes , Feminino , Hospitalização , Hospitais/estatística & dados numéricos , Humanos , Controle de Infecções , Transmissão de Doença Infecciosa do Paciente para o Profissional/estatística & dados numéricos , Transmissão de Doença Infecciosa do Profissional para o Paciente/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros , Fatores de Risco , SARS-CoV-2 , Reino Unido/epidemiologia
6.
Pan Afr Med J ; 39: 138, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34527154

RESUMO

INTRODUCTION: hepatitis B virus (HBV) is one of the commonest causes of acute and chronic liver diseases worldwide. HBV can be transmitted by exposure to infected blood and human secretions through sharp injuries and splashes. Health workers are among the most high-risk groups because they regularly interact with patients. A seroprevalence survey conducted in Uganda in 2014 found a higher prevalence of HBV in Gulu Municipality compared to the rest of Uganda. METHODS: a cross-sectional study was conducted among health workers in Gulu Regional Hospital. A stratified random sampling was used. Knowledge ratings and Likert scale were used to score knowledge, attitudes and risks of HBV infections in a qualitative assessment. Ethical approval was obtained and SPSS was used for data analysis. A p-value less than 0.05 was considered significant. RESULTS: one hundred and twenty-six (126) respondents participated; 65 (51.6%) were male, 80 (63.5%) were aged 20-29 years, 74 (58.7%) were not married, 86 (68.3%) had a work experience of 0-9 years, 64 (50.8%) had good knowledge, 90(71.4%) had positive attitude, 114 (90.5%) had high to very high pre-exposure risks, and 75 (59.5%) had moderate to high exposure and post-exposure risks. There was no significant difference in knowledge (X 2= 13.895; p = 0.178) and work experience (X 2= 21.196; p = 0.097) among the health workers. CONCLUSION: there is a high pre-exposure, exposure and post-exposure risks of HBV infection among health workers in Gulu Hospital. There is need to augment awareness on HBV infection and design strategies to strengthen and implement infection control measures including HBV vaccination among health workers.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/estatística & dados numéricos , Hepatite B/epidemiologia , Exposição Ocupacional/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , Hepatite B/transmissão , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Paciente para o Profissional/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/prevenção & controle , Prevalência , Estudos Soroepidemiológicos , Inquéritos e Questionários , Uganda/epidemiologia , Adulto Jovem
9.
Curr Opin Infect Dis ; 34(4): 372-383, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34227581

RESUMO

PURPOSE OF REVIEW: An estimated four to 11% of reported coronavirus disease 2019 (COVID-19) cases occurs in healthcare personnel (HCP). HCP are at high risk of acquiring and transmitting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) given their close contact with individuals with recognized and unrecognized COVID-19. We summarize the literature to date describing the epidemiology, identifying risk factors associated with COVID-19, and analyzing clinical characteristics and outcomes of SARS-CoV-2 infection in HCP. RECENT FINDINGS: The prevalence of SARS-CoV-2 antibodies among HCP ranges from 0.7 to 45%. Although there is heterogeneity in the seroprevalence rate reported in the literature, HCP may be at increased risk of SARS-CoV-2 infection from exposure to patients with COVID-19. The literature supports that this can be minimized with adequate personal protective equipment (PPE) supply, proper hand hygiene, appropriate PPE use, and other infection prevention measures. In addition, infections in HCP are commonly acquired in the community as well as in nonclinical care settings including break rooms or work rooms. SUMMARY: While much focus has been on minimizing patient-to-HCP transmission of SARS-CoV-2, additional efforts are needed to prevent exposures in nonclinical care settings and in the community.


Assuntos
COVID-19/epidemiologia , COVID-19/transmissão , Pessoal de Saúde , Transmissão de Doença Infecciosa do Paciente para o Profissional/estatística & dados numéricos , Exposição Ocupacional , SARS-CoV-2 , COVID-19/prevenção & controle , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Exposição Ocupacional/efeitos adversos , Pandemias , Vigilância em Saúde Pública , Fatores de Risco , Estudos Soroepidemiológicos
10.
Behav Neurol ; 2021: 6655103, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34257741

RESUMO

This study is aimed at assessing differences in basic attentional functioning between substantial and minimal work-related exposure to COVID-19 patients in professionals working in a tertiary referral hospital in Rio de Janeiro, Brazil. Therefore, hospital employees performed a Continuous Visual Attention Test. This test consisted of a 90-second Go/No-Go task with 72 (80%) targets and 18 (20%) nontargets. For each participant, reaction time and intraindividual variability of reaction times of all correct target responses, as well as the number of omission and commission errors, were evaluated. Participants were divided into 2 groups based on their exposure to COVID-19 patients (substantial versus minimal exposure). The substantial exposure group consisted of participants with 24 hours/week or more direct contact with COVID-19 patients. This cut-off was based on the clear division between professionals working and not working with COVID-19 patients and considered that 12-hour and 24-hour daily shifts are common for hospital employees in Brazil. A MANCOVA was performed to examine between-group differences, using age, sleep quality, sex, education level, previous COVID-19 infection, and profession as covariates. Of 124 participants, 80 had substantial exposure and 44 had minimal exposure to COVID-19. The overall MANCOVA reached statistical significance (P = 0.048). Post hoc ANCOVA analysis showed that the substantial exposure group had a statistically significantly higher intraindividual variability of reaction time of all correct target responses (P = 0.017, Cohen's δ = -0.55). This result remained after removing those with a previous COVID-19 infection (P = 0.010, Cohen's δ = -0.64) and after matching groups for sample size (P = 0.004, Cohen's δ = -0.81). No other variables reached statistical significance. Concluding, hospital professionals with a substantial level of exposure to patients with COVID-19 show a significant attention decrement and, thus, may be at a higher risk of accidental SARS-CoV-2 infection.


Assuntos
Atenção , COVID-19/terapia , COVID-19/transmissão , Pessoal de Saúde/psicologia , Transmissão de Doença Infecciosa do Paciente para o Profissional , Centros de Atenção Terciária , Adulto , Brasil/epidemiologia , COVID-19/epidemiologia , Feminino , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Paciente para o Profissional/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Tempo de Reação , SARS-CoV-2 , Tolerância ao Trabalho Programado , Adulto Jovem
13.
Medicine (Baltimore) ; 100(25): e26433, 2021 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-34160433

RESUMO

ABSTRACT: The subclinical severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rate in hospitals during the pandemic remains unclear. To evaluate the effectiveness of our hospital's current nosocomial infection control measures, we conducted a serological survey of anti-SARS-CoV-2 antibodies (immunoglobulin [Ig] G) among the staff of our hospital, which is treating coronavirus disease 2019 (COVID-19) patients.The study design was cross-sectional. We measured anti-SARS-CoV-2 IgG in the participants using a laboratory-based quantitative test (Abbott immunoassay), which has a sensitivity and specificity of 100% and 99.6%, respectively. To investigate the factors associated with seropositivity, we also obtained some information from the participants with an anonymous questionnaire. We invited 1133 staff members in our hospital, and 925 (82%) participated. The mean age of the participants was 40.0 ±â€Š11.8 years, and most were women (80.0%). According to job title, there were 149 medical doctors or dentists (16.0%), 489 nurses (52.9%), 140 medical technologists (14.2%), 49 healthcare providers (5.3%), and 98 administrative staff (10.5%). The overall prevalence of seropositivity for anti-SARS-CoV-2 IgG was 0.43% (4/925), which was similar to the control seroprevalence of 0.54% (16/2970) in the general population in Osaka during the same period according to a government survey conducted with the same assay. Seropositive rates did not significantly differ according to job title, exposure to suspected or confirmed COVID-19 patients, or any other investigated factors.The subclinical SARS-CoV-2 infection rate in our hospital was not higher than that in the general population under our nosocomial infection control measures.


Assuntos
Anticorpos Antivirais/sangue , Infecções Assintomáticas/epidemiologia , COVID-19/epidemiologia , Pessoal de Saúde/estatística & dados numéricos , Estudos Soroepidemiológicos , Adulto , COVID-19/sangue , COVID-19/imunologia , COVID-19/transmissão , Estudos Transversais , Feminino , Hospitais Urbanos/organização & administração , Hospitais Urbanos/normas , Hospitais Urbanos/estatística & dados numéricos , Humanos , Imunoglobulina G/sangue , Controle de Infecções/organização & administração , Controle de Infecções/normas , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Paciente para o Profissional/estatística & dados numéricos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias/estatística & dados numéricos , Prevalência , Fatores de Risco , SARS-CoV-2/imunologia , Inquéritos e Questionários/estatística & dados numéricos
14.
JMIR Public Health Surveill ; 7(6): e27189, 2021 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-34003761

RESUMO

BACKGROUND: During the COVID-19 pandemic, swab tests proved to be effective in containing the infection and served as a means for early diagnosis and contact tracing. However, little evidence exists regarding the correct timing for the execution of the swab test, especially for asymptomatic individuals and health care workers. OBJECTIVE: The objective of this study was to analyze changes in the positive findings over time in individual SARS-CoV-2 swab tests during a health surveillance program. METHODS: The study was conducted with 2071 health care workers at the University Hospital of Verona, with a known date of close contact with a patient with COVID-19, between February 29 and April 17, 2020. The health care workers underwent a health surveillance program with repeated swab tests to track their virological status. A generalized additive mixed model was used to investigate how the probability of a positive test result changes over time since the last known date of close contact, in an overall sample of individuals who tested positive for COVID-19 and in a subset of individuals with an initial negative swab test finding before being proven positive, to assess different surveillance time intervals. RESULTS: Among the 2071 health care workers in this study, 191 (9.2%) tested positive for COVID-19, and 103 (54%) were asymptomatic with no differences based on sex or age. Among 49 (25.7%) cases, the initial swab test yielded negative findings after close contact with a patient with COVID-19. Sex, age, symptoms, and the time of sampling were not different between individuals with an initial negative swab test finding and those who initially tested positive after close contact. In the overall sample, the estimated probability of testing positive was 0.74 on day 1 after close contact, which increased to 0.77 between days 5 and 8. In the 3 different scenarios for scheduled repeated testing intervals (3, 5, and 7 days) in the subgroup of individuals with an initially negative swab test finding, the probability peaked on the sixth, ninth and tenth, and 13th and 14th days, respectively. CONCLUSIONS: Swab tests can initially yield false-negative outcomes. The probability of testing positive increases from day 1, peaking between days 5 and 8 after close contact with a patient with COVID-19. Early testing, especially in this final time window, is recommended together with a health surveillance program scheduled in close intervals.


Assuntos
Teste de Ácido Nucleico para COVID-19/estatística & dados numéricos , COVID-19/diagnóstico , Pessoal de Saúde/estatística & dados numéricos , Adulto , COVID-19/epidemiologia , COVID-19/transmissão , Busca de Comunicante/métodos , Reações Falso-Negativas , Feminino , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/estatística & dados numéricos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , SARS-CoV-2 , Fatores de Tempo
15.
J Patient Saf ; 17(4): 323-330, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-33994534

RESUMO

BACKGROUND: Although recommendations to prevent COVID-19 healthcare-associated infections (HAIs) have been proposed, data on their effectivity are currently limited. OBJECTIVE: The aim was to evaluate the effectivity of a program of control and prevention of COVID-19 in an academic general hospital in Spain. METHODS: We captured the number of COVID-19 cases and the type of contact that occurred in hospitalized patients and healthcare personnel (HCP). To evaluate the impact of the continuous use of a surgical mask among HCP, the number of patients with COVID-19 HAIs and accumulated incidence of HCP with COVID-19 was compared between the preintervention and intervention periods. RESULTS: Two hundred fifty-two patients with COVID-19 have been admitted to the hospital. Seven of them had an HAI origin (6 in the preintervention period and 1 in the intervention period). One hundred forty-two HCP were infected with SARS-CoV-2. Of them, 22 (15.5%) were attributed to healthcare (2 in the emergency department and none in the critical care departments), and 120 (84.5%) were attributed to social relations in the workplace or during their non-work-related personal interactions. The accumulated incidence during the preintervention period was 22.3 for every 1000 HCP and 8.2 for every 1000 HCP during the intervention period. The relative risk was 0.37 (95% confidence interval, 0.25 to 0.55) and the attributable risk was -0.014 (95% confidence interval, -0.020 to -0.009). CONCLUSIONS: A program of control and prevention of HAIs complemented with the recommendation for the continuous use of a surgical mask in the workplace and social environments of HCP effectively decreased the risk of COVID-19 HAIs in admitted patients and HCP.


Assuntos
Centros Médicos Acadêmicos , COVID-19/prevenção & controle , Infecção Hospitalar/prevenção & controle , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Adulto , COVID-19/epidemiologia , COVID-19/transmissão , Infecção Hospitalar/epidemiologia , Feminino , Humanos , Incidência , Transmissão de Doença Infecciosa do Paciente para o Profissional/estatística & dados numéricos , Masculino , Máscaras/estatística & dados numéricos , Pessoa de Meia-Idade , Recursos Humanos em Hospital/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde , Medição de Risco/estatística & dados numéricos , SARS-CoV-2/isolamento & purificação , Espanha/epidemiologia
16.
Phys Ther ; 101(8)2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-33970270

RESUMO

OBJECTIVES: The purpose of this study was to explore the prevalence, personal- and work-related exposures, and signs and symptoms among physical therapists during the first wave of coronavirus disease 2019 (COVID-19) in Italy. METHODS: This cross-sectional, survey-based study collected demographic and exposure data from physical therapists from April to May 2020. All physical therapists working in inpatient and outpatient care in Italy were eligible. A self-administered questionnaire was distributed among all eligible physical therapists to collect (1) demographic characteristics, (2-3) personal- and work-related exposures, and (4) signs and symptoms of COVID-19. Factors associated with a COVID-19-positive nasopharyngeal swab (NPS) were explored through logistic regression models and multivariate methods. RESULTS: A total of 15,566 respondents completed the survey, with a response rate of 43.3%, achieving high statistical precision (99% CI, 1% type I error). Among physical therapists who received NPS testing, 13.1% (95% CI = 12.1-14.1%) had a positive result, with a peak reached in March 2020 (36%). The top 5 symptoms were fatigue and tiredness (69.1%), loss of smell (64.5%), aches and pains (60.8%), loss of taste (58.3%), and headache (51.1%). No symptoms were reported by 8.9%. Working in a health care institution (odds ratio [OR] = 12.0; 95% CI = 7.8-18.4), being reallocated to a different unit (OR = 1.9; 95% CI = 1.3-2.7), and changing job tasks (OR = 1.6; 95% CI = 1.2-2.3) increased the risk of being COVID-19 positive. In therapists with a confirmed diagnosis of COVID-19, comorbidities were associated with male sex and age older than 51 years. CONCLUSION: During the first wave in Italy, almost 1 out of 7 physical therapists tested positive on the COVID-19 NPS test. Considering personal- and work-related exposures, health care organizations should adopt prevention measures and adequate preparedness to prevent high rate of infections during future pandemics. IMPACT: This is the largest investigation about the spread of and main risk factors for COVID-19 in the physical therapy field.


Assuntos
COVID-19/epidemiologia , COVID-19/transmissão , Transmissão de Doença Infecciosa do Paciente para o Profissional/estatística & dados numéricos , Exposição Ocupacional/estatística & dados numéricos , Fisioterapeutas , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Prevalência , Fatores de Risco , SARS-CoV-2 , Inquéritos e Questionários , Adulto Jovem
17.
Ann R Coll Surg Engl ; 103(5): 354-359, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33682443

RESUMO

INTRODUCTION: The initial intercollegiate surgical guidance from the UK during the COVID-19 pandemic resulted in significant changes to practice. Avoidance of laparoscopy was recommended, to reduce aerosol generation and risk of virus transmission. Evidence on the safety profile of laparoscopy during the pandemic is lacking. This study compares patient outcomes and risk to staff from laparoscopic and open gastrointestinal operations during the COVID-19 pandemic. METHODS: Single-centre retrospective study of gastrointestinal operations performed during the peak of the COVID-19 pandemic. Demographic, comorbidity, perioperative and survival data were collected from electronic medical records and supplemented with patient symptoms reported at telephone follow up. Outcomes assessed were: patient mortality, illness among staff, patient COVID-19 rates, length of hospital stay and postdischarge symptomatology. RESULTS: A total of 73 patients with median age of 56 years were included; 55 (75%) and 18 (25%) underwent laparoscopic and open surgery, respectively. All-cause mortality was 5% (4/73), was related to COVID-19 in all cases, with no mortality after laparoscopic surgery. A total of 14 staff members developed COVID-19 symptoms within 2 weeks, with no significant difference between laparoscopic and open surgery (10 vs 4; p=0.331). Median length of stay was shorter in the laparoscopic versus the open group (4.5 vs 9.9 days; p=0.011), and postdischarge symptomatology across 15 symptoms was similar between groups (p=0.135-0.814). CONCLUSIONS: With appropriate protective measures, laparoscopic surgery is safe for patients and staff during the COVID-19 pandemic. The laparoscopic approach maintains an advantage of shorter length of hospital stay compared with open surgery.


Assuntos
COVID-19/epidemiologia , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Gastroenteropatias/cirurgia , Transmissão de Doença Infecciosa do Paciente para o Profissional/estatística & dados numéricos , Laparoscopia/métodos , Complicações Pós-Operatórias/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Causas de Morte , Criança , Conversão para Cirurgia Aberta/estatística & dados numéricos , Procedimentos Cirúrgicos Eletivos , Emergências , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Laparotomia/métodos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Mortalidade , Duração da Cirurgia , Estudos Retrospectivos , Risco , SARS-CoV-2 , Resultado do Tratamento , Reino Unido , Adulto Jovem
18.
Crit Care Med ; 49(7): 1159-1168, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-33749225

RESUMO

OBJECTIVES: To assess the risk of coronavirus transmission to healthcare workers performing aerosol-generating procedures and the potential benefits of personal protective equipment during these procedures. DATA SOURCES: MEDLINE, EMBASE, and Cochrane CENTRAL were searched using a combination of related MeSH terms and keywords. STUDY SELECTION: Cohort studies and case controls investigating common anesthetic and critical care aerosol-generating procedures and transmission of severe acute respiratory syndrome coronavirus 1, Middle East respiratory syndrome coronavirus, and severe acute respiratory syndrome coronavirus 2 to healthcare workers were included for quantitative analysis. DATA EXTRACTION: Qualitative and quantitative data on the transmission of severe acute respiratory syndrome coronavirus 1, severe acute respiratory syndrome coronavirus 2, and Middle East respiratory syndrome coronavirus to healthcare workers via aerosol-generating procedures in anesthesia and critical care were collected independently. The Risk Of Bias In Non-randomized Studies - of Interventions tool was used to assess the risk of bias of included studies. DATA SYNTHESIS: Seventeen studies out of 2,676 yielded records were included for meta-analyses. Endotracheal intubation (odds ratio, 6.69, 95% CI, 3.81-11.72; p < 0.001), noninvasive ventilation (odds ratio, 3.65; 95% CI, 1.86-7.19; p < 0.001), and administration of nebulized medications (odds ratio, 10.03; 95% CI, 1.98-50.69; p = 0.005) were found to increase the odds of healthcare workers contracting severe acute respiratory syndrome coronavirus 1 or severe acute respiratory syndrome coronavirus 2. The use of N95 masks (odds ratio, 0.11; 95% CI, 0.03-0.39; p < 0.001), gowns (odds ratio, 0.59; 95% CI, 0.48-0.73; p < 0.001), and gloves (odds ratio, 0.39; 95% CI, 0.29-0.53; p < 0.001) were found to be significantly protective of healthcare workers from contracting severe acute respiratory syndrome coronavirus 1 or severe acute respiratory syndrome coronavirus 2. CONCLUSIONS: Specific aerosol-generating procedures are high risk for the transmission of severe acute respiratory syndrome coronavirus 1 and severe acute respiratory syndrome coronavirus 2 from patients to healthcare workers. Personal protective equipment reduce the odds of contracting severe acute respiratory syndrome coronavirus 1 and severe acute respiratory syndrome coronavirus 2.


Assuntos
Aerossóis , Infecções por Coronavirus/transmissão , Cuidados Críticos , Transmissão de Doença Infecciosa do Paciente para o Profissional/estatística & dados numéricos , Coronavírus da Síndrome Respiratória do Oriente Médio , SARS-CoV-2 , Coronavírus Relacionado à Síndrome Respiratória Aguda Grave , Humanos , Estudos Observacionais como Assunto , Razão de Chances , Equipamento de Proteção Individual , Fatores de Proteção , Fatores de Risco
19.
Surgeon ; 19(5): e304-e309, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33722466

RESUMO

BACKGROUND: Staff and patient safety are of paramount importance while performing a surgical tracheostomy (ST) during the corona virus disease (COVID-19) pandemic. The aim was to assess the incidence of COVID-19 infection among the healthcare personnel (HCP) performing ST on COVID-19 patients. METHODS: One hundred and twenty-two HCP participating in 71 ST procedures performed at our institution between 26th March 2020 and 27th May 2020 were identified. A COVID-19 health questionnaire was distributed among staff with their consent. Data related to the presence of COVID-19 symptoms (new onset continuous cough, fever, loss of taste and/or loss of smell) among HCP involved in ST as well as patient related data were collected. RESULTS: Of the HCP who responded, eleven (15%,11/72) reported key COVID-19 symptoms and went into self-isolation. Ten members from this group underwent a COVID-19 swab test and three tested positive. Only one HCP attended hospital for symptomatic treatment, none required hospitalisation. Sixty percent (43/72) of the responders had a COVID-19 antibody test with a positive rate of 18.6% (8/43). Among the patients undergoing a ST, 67% (37/55) required a direct intensive care unit (ICU) admission; the mean age was 58 years (29-78) with a male preponderance (65.5%). The median time from intubation to ST was 15 days (range 5-33,IQR = 9). The overall mortality was 11% (6/55). CONCLUSIONS: ST can be carried out safely with strict adherence to both, personnel protective equipment and ST protocols which are vital to mitigate the potential transmission of COVID-19 to the HCP.


Assuntos
COVID-19/epidemiologia , Transmissão de Doença Infecciosa do Paciente para o Profissional/estatística & dados numéricos , Traqueostomia/efeitos adversos , Adulto , Idoso , COVID-19/diagnóstico , COVID-19/transmissão , Feminino , Hospitalização , Humanos , Incidência , Controle de Infecções , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medição de Risco , Inquéritos e Questionários
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...