Fatma ŞİMŞEK CEVİZ, Funda ÇOKTAŞ, Fatma SARI DOĞAN, Tuba CİMİLLİ ÖZTÜRK

Sağlık Çalışanlarında Covid-19 Hastalığına Bağlı Risk Faktörlerinin Değerlendirilmesi

Amaç: Covid-19 pandemisinin en belirgin mağdurları sağlık çalışanlarıdır. Hastanelerde artan iş yükü ve her gün bir hastalık etkenine maruz kalmak, sağlık çalışanlarının ve toplumun sağlığını tehdit etmektedir. Bu çalışma ile Covid-19 hastalarına sağlık hizmeti sunumu sırasında hastalığa maruz kalan sağlık çalışanlarının enfeksiyon açısından risk faktörlerini ve mevcut enfeksiyon kontrol önlemlerinin etkili olup olmadığını araştırmayı amaçladık. Gereç ve Yöntemler: İstanbul Fatih Sultan Mehmet Eğitim ve Araştırma Hastanesi'nde çalışan Covid-19 tanılı sağlık çalışanlarına ve enfekte olmayan sağlık çalışanlarına anket ile vaka kontrol çalışması yapılmıştır. Bulgular: Çalışmaya 127 sağlık çalışanı katıldı. Meslekte ortalama deneyim süresi vaka grubunda daha yüksek bulundu (p = 0.011). Covid-19 hastalarına yüksek riskli maruziyet sonrası profilaktik ilaç alma oranı kontrollere göre vaka grubunda anlamlı olarak daha yüksekti (p=0,001). Sonuç: Meslekte daha fazla deneyime sahip sağlık çalışanları, Covid-19 enfeksiyonu riski altında görünmektedir ve yüksek riskli korunmasız maruziyet, daha yüksek enfeksiyon oranları ile ilişkili olabilir. Covid-19 hastasıyla yüksek riskli temastan sonra üç günlük profilaktik hidroksiklorokin, hastalığı önlemede etkili değildir.

Evaluations of Risk Factors Related to Covid-19 Disease in Healthcare Professionals

Aim: The most prominent victims of the Covid-19 pandemic are healthcare workers. The increasing workload in hospitals and daily exposure to a disease factor threaten the health of healthcare professionals and the community. With this study, we aimed to investigate the risk factors in terms of infection of healthcare workers who are exposed to the disease during the health service delivery to Covid-19 patients, and whether current infection control measures are effective. Materials and Methods: A case-control study was conducted with a questionnaire for healthcare workers diagnosed with Covid-19 and non-infected healthcare workers working in a Fatih Sultan Mehmet Training and Research Hospital in Istanbul in Istanbul. Results: In the study in which 127 healthcare workers participated, the average duration of experience in the profession was found to be higher in cases compared to controls (p = 0.011). The rate of taking prophylactic drugs after high-risk exposure to Covid-19 patients was significantly higher in the case group compared to controls (p=0,001). Conclusion: Healthcare workers with more experience in the profession appear to be at greater risk of Covid-19 infection and high-risk unprotected exposure may be associated with higher infection rates. Three days of prophylactic hydroxychloroquine after high-risk contact with a Covid-19 patient is not effective in preventing the disease.

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WHO. World Health Organization, World Health Organization-Coronavirus Disease (Covid 19) Outbreak : Rights, Roles, and Responsibilities of Health Workers, Including Key Considerations for Occupational Safety. World Health Organization (WHO). 2019;(December):1-3.
Chan JFW, Yuan S, Kok KH, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. The Lancet. 2020;395(10223):514-523. doi:10.1016/S0140-6736(20)30154-9.
Kluytmans M, Buiting A, Pas S, et al. SARS-CoV-2 infection in 86 healthcare workers in two Dutch hospitals in March 2020. medRxiv. Published online 2020. doi:10.1101/2020.03.23.20041913.
Cassini A, Bergeri I, Kerkhove M Van, et al. Assessment of risk factors for coronavirus disease 2019 (COVID-19) in health workers: protocol for a case-control study. World Health Organization. 2020;2019(May):1-53. https://www.who.int/publications/i/item/assessment-of-risk-factors-for-coronavirus-disease-2019-(covid-19)-in-health-workers-protocol-for-a-case-control-study
Chou R, Dana T, Buckley DI, et al. Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers: A Living Rapid Review. Annals of internal medicine. 2020;173(2):120-136. doi:10.7326/M20-1632.
Lai X, Wang M, Qin C, et al. Coronavirus Disease 2019 (COVID-2019) Infection Among Health Care Workers and Implications for Prevention Measures in a Tertiary Hospital in Wuhan, China. JAMA network open. 2020;3(5). doi:10.1001/jamanetworkopen.2020.9666.
CDC. Characteristics of Health Care Personnel with COVID-19 - United States, February 12– April 9, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(15):477-481.
Jin YH, Huang Q, Wang YY, et al. Perceived infection transmission routes, infection control practices, psychosocial changes, and management of COVID-19 infected healthcare workers in a tertiary acute care hospital in Wuhan: A cross-sectional survey. Military Medical Research. 2020;7(1):24. doi:10.1186/s40779-020-00254-8.
Nguyen LH, Drew DA, Graham MS, et al. Risk of COVID-19 among front-line health-care workers and the general community: a prospective cohort study. The Lancet Public Health. 2020;5(9):e475-e483. doi:10.1016/S2468-2667(20)30164-X.
Chatterjee P, Anand T, Singh KJ, et al. Healthcare workers & SARS-CoV-2 infection in India: A case-control investigation in the time of COVID-19. Published online 2020. doi:10.4103/ijmr.IJMR_2234_20.
Ran L, Chen X, Wang Y, et al. Risk Factors of Healthcare Workers With Coronavirus Disease 2019: A Retrospective Cohort Study in a Designated Hospital of Wuhan in China. Clinical Infectious Diseases ®. 2020;71(16):2218-2239. doi:10.1093/cid/ciaa287.
Zheng C, Hafezi-Bakhtiari N, Cooper V, et al. Characteristics and transmission dynamics of COVID-19 in healthcare workers at a London teaching hospital. Journal of Hospital Infection. 2020;106(2):325-329. doi:10.1016/j.jhin.2020.07.025.
Gómez-Ochoa SA, Franco OH, Rojas LZ, et al. COVID-19 in Health-Care Workers: A Living Systematic Review and Meta-Analysis of Prevalence, Risk Factors, Clinical Characteristics, and Outcomes. American Journal of Epidemiology. Published online September 1, 2020. doi:10.1093/aje/kwaa191
Nienhaus A, Hod R. COVID-19 among Health Workers in Germany and Malaysia. International Journal of Environmental Research and Public Health Article. doi:10.3390/ijerph17134881.
Zhang M, Zhou M, Tang F, et al. Knowledge, attitude, and practice regarding COVID-19 among healthcare workers in Henan, China. Journal of Hospital Infection. 2020;105(2):183187. doi:10.1016/j.jhin.2020.04.012.
MacIntyre CR, Chughtai AA. A rapid systematic review of the efficacy of face masks and respirators against coronaviruses and other respiratory transmissible viruses for the community, healthcare workers, and sick patients. International Journal of Nursing Studies. 2020;108:103629. doi:10.1016/j.ijnurstu.2020.103629.
Lan FY, Filler R, Mathew S, Buley J, Iliaki E, Bruno-Murtha LA, Osgood R, Christophi CA, Fernandez-Montero A, Kales SN. COVID-19 symptoms predictive of healthcare workers' SARS-CoV-2 PCR results. PLoS One. 2020 Jun 26;15(6):e0235460. doi: 10.1371/journal.pone.0235460.
Magnavita N, Tripepi G, Di Prinzio RR. Symptoms in Health Care Workers during the COVID-19 Epidemic. A Cross-Sectional Survey. Int J Environ Res Public Health. 2020 Jul 20;17(14):5218. doi: 10.3390/ijerph17145218.
T.C. Sağlık Bakanlığı. COVID-19 temaslı takibi, salgın yönetimi, evde hasta izlemi ve filyasyon. 25 Kasım 2020. Published 2020. https://covid19.saglik.gov.tr/Eklenti/39471/0/covid19rehberitemaslitakibievdehastaizlemivefily asyonpdf.pdf.