COVID-19 ile enfekte sağlık çalışanlarında hastaneye yatış riskinin değerlendirilmesi

Öz

Amaç: Bu çalışmada Çanakkale Onsekiz Mart Üniversitesi Hastanesinde yatırılarak takip edilen COVID-19 enfeksiyonu tanısı doğrulanmış sağlık çalışanlarının klinik, laboratuar ve aşılanma verilerinin incelenmesi, breakthrough enfeksiyon oranlarının tespit edilmesi, literatürle karşılaştırılarak hastane ve yoğun bakım yatış risk parametrelerinin ortaya konması amaçlanmıştır. Yöntem: Bu retrospektif çalışmaya 6 Nisan 2020 - 1 Ocak 2023 tarihleri arasında Çanakkale Onsekiz Mart Üniversitesi Hastanesinde yatırılarak takip edilen gerçek-zamanlı polimeraz zincir reaksiyonu (RT-PCR) ile SARS CoV-2 viral nükleik asit testi pozitif olan COVID-19 enfekte sağlık çalışanları dahil edildi. Çalışmaya dahil edilen 12 olgunun demografik, klinik kayıtları ve dosyaları hastane bilgi yönetim sisteminden retrospektif olarak tarandı, aşılanma verileri hastane enfeksiyon kontrol hemşirelerinin tuttuğu sürveyans kayıtlarından alındı. Bulgular: Pandeminin başından itibaren çalışmanın yapıldığı otuziki aylık süreçte COVID-19 enfeksiyonu tanısı alan 760 sağlık çalışanından, 10’u(1.3%) serviste, ikisi (0.2%) yoğun bakımda yatırılarak takip edilmişti. Hastaların yaş ortalamalarının 39.1 yıl olduğu, serviste yatan hastaların ortalama yaşının 40.6±8.9 yıl olduğu, dokuzunun(%90) kadın iken, yoğun bakımda yatan iki hastanın yaş ortalamasının 36.0±2.8 yıl olup cinsiyetlerinin erkek(%100) olduğu izlendi. Yatan hastaların 8’inin(%66.6) ek hastalığı yoktu. Obezite, hipertansiyon, diyabet, astım hastalarda görülen komorbit hastalıklar arasındaydı. Hastaların kan gruplarına bakıldığında on iki hastadan 5’i (%41.6) B Rh+’ti. Yatan 12 hastanın 8'i aşılanmamıştı (%66.6). Sonuç: Çalışmamızda literatürden farklı olarak COVID-19 enfekte sağlık çalışanlarında daha düşük bir oranda servis ve yoğun bakım yatışı(1.3%, 0.2%) izlenmiş olup mortalite gerçekleşmemişti.Yoğun bakımdaki ağırlık kriterleri olarak lenfopeni, LDH, ferritin, beyaz küre yüksekliği tespit edilmiştir. Yatan hastaların ayaktanlara oranınının yıllara göre dağılımına bakıldığında aşılamanın hastaneye yatışı azalttığı görülmüştür.

Anahtar Kelimeler

• SARS-CoV-2
• COVID-19 enfekte sağlık çalışanları
• Breakthrough enfeksiyon
• Aşı

Destekleyen Kurum

çanakkale 18 mart üniversitesi

Evaluation of the risk of hospitalization in health care workers ınfected with COVID-19 university hospital experience

Öz

Objectives: In this study, it was aimed to determine the rates of hospitalized COVID-19 infected healthcare workers(HCW’s) at Canakkale Onsekiz Mart University Hospital, to examine clinical, laboratory, breakthrough infection rate and vaccination data, and to reveal hospital and intensive care risk parameters by comparing them with the literature. Methods: In this retrospective study, COVID-19 infected HCW’s, whose diagnosis confirmed by real-time polymerase chain reaction and hospitalized at Canakkale Onsekiz Mart University Hospital between April 6, year 2020, and January 1, year 2023, were included. Demographic and clinical data were retrospectively scanned from the hospital information management system and vaccination data were obtained from the surveillance records. Results: During the study period, 10 (1.3%) of the 760 HCW’s diagnosed with COVID-19 infection were followed up in the ward and two (0.2%) in the intensive care unit. The mean age of all patients was 39.1, hospitalized patients in the ward was 40.6±8.9; hospitalized in the intensive care unit(ICU) was 36.0±2.8 years. Eight of the hospitalized patients (66.6%) did not have any additional disease. Obesity, hypertension, diabetes, and asthma were among the comorbid diseases seen in the patients. 5 (41.6%) of the twelve patient’s blood group was B Rh+. Eight of 12 hospitalized patients were not vaccinated (66.6%). Conclusion: In our study, a lower rate of hospitalization in the service and ICU (1.3%, 0.2%) was observed in HCW’s, and mortality did not occured. Lymphopenia, LDH, ferritin, and high white blood cell count were determined as weight criteria in the intensive care unit. Considering the distribution of the ratio of inpatients to outpatients by years, it was seen that vaccination reduced hospitalizations.

Anahtar Kelimeler

• SARS-CoV-2
• Breakthrough infection
• Vaccine
• COVID-19 infected health care workers

Kaynakça

1. 1. https://www.covid19.saglik.gov.tr/TR-66935/genel-koronavirus-tablosu.html
2. 2. https://www.ttb.org.tr/userfiles/files/covid19-rapor.pdf
3. 3. Dakroub F, Fakhredine S, Yassine M, et al. A retros-pective analysis of 902 hospitalized COVID-19 patients in Lebanon: clinical epidemiology and risk factors. J Clin Virol Plus. 2021;1(4):100048.
4. 4. Xiang G, Xie L, Chen Z et al. Clinical risk factors for mortality of hospitalized patients with COVID-19: systematic review and meta-analysis. Ann Palliat Med. 2021 Mar;10(3):2723-2735. doi: 10.21037/apm-20-1278.
5. 5. Sobral MFF, Roazzi A, da Penha Sobral AIG, et al. A retrospective cohort study of 238,000 COVID-19 hospitalizations and deaths in Brazil. Sci Rep. 2022;12(1):3629.
6. 6. Kambhampati AK, O'Halloran AC, Whitaker M, et al; COVID-NET Surveillance Team. COVID-19-Associated Hospitalizations Among Health Care Personnel - COVID-NET, 13 States, March 1-May 31, 2020. MMWR 2020 Oct 30;69(43):1576-1583.
7. 7. Hughes MM, Groenewold MR, Lessem SE, et al. Update: Characteristics of health care personnel with COVID-19—United States, February 12–July 16, 2020. MMWR 2020; 69: 1364–8.
8. 8. Ferland L, Carvalho C, Gomes Dias J, et al. Risk of hospitalization and death for healthcare workers with COVID-19 in nine European countries, January 2020-January 2021. J Hosp Infect. 2022 Jan;119:170-174.

9. 9. Go´mez-Ochoa SJ, 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. Am J Epidemiol 2021;190:161e75.
10. 10. Bandyopadhyay S, Baticulon RE, Kadhum M, et al. Infection and mortality of healthcare workers worldwide from COVID-19: a systematic review. BMJ Glob Health. 2020 Dec;5(12):e003097. doi: 10.1136/bmjgh-2020-003097.
11. 11. Yang JY, Parkins MD, Canakis A et al. Outcomes of COVID-19 Among Hospitalized Health Care Workers in North America: JAMA Network Open. 2021;4(1):e2035699.
12. 12. Díez-Manglano J, Solís-Marquínez MN, Álvarez García A, et al; SEMI-COVID-19 Network. Healthcare workers hospitalized due to COVID-19 have no higher risk of death than general population. Data from the Spanish SEMI-COVID-19 Registry. PLoS One. 2021 Feb 19;16(2):e0247422.
13. 13. Ratshikhopha E, Muvhali M, Naicker N, et al. Disease Severity and Comorbidities among Healthcare Worker COVID-19 Admissions in South Africa: A Retrospective Analysis. Int J Environ Res Public Health. 2022 May;19(9):5519 14. Khairy Y, Naghibi D, Moosavi A, et al. Prevalence of hypertension and associated risks in hospitalized patients with COVID-19: a meta-analysis of meta-analyses with 1468 studies and 1,281,510 patients. Syst Rev. 2022 Nov 17;11(1):242.
14. 15. Lai X, Wang M, Qin C, et al. Coronavirus disease 2019 (COVID-19) infection among healthcare workers and implications for prevention measures in a tertiary hospital in Wuhan, China. JAMA Network Open 2020; 3: e209666
15. 16. Nienhaus A, Hod R. COVID-19 among health workers in Germany and Malaysia. Int J Environ Res Public Health 2020; 17: 4881.
16. 17. Pourali F, Afshari M, Alizadeh-Navaei R, et al. Relationship between blood group and risk of infection and death in COVID-19: a live meta-analysis. New Microbes New Infect. 2020 Sep;37:100743. Epub 2020 Aug 11.
17. 18. Ho FK, Petermann-Rocha F, Gray SR, et al. Is older age associated with COVID-19 mortality in the absence of other risk factors? General population cohort study of 470,034 participants. PLoS ONE 2020; 15: e0241824.
18. 19. Zheng Z, Peng F, Hu B, et al. Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis. J Infect 2020; 81: e16–25.
19. 20. Yang J, Zheng Y, Gou X, et al. Prevalence of comorbidities and its effects in coronavirus disease 2019 patients: A systematic review and meta-analysis. Int J Infect Dis 2020; 94:91–5.
20. 21. Chandan S, Khan SR, Deliwala S, et al. Postvaccina-tion SARS-CoV-2 infection among healthcare workers: A systematic review and meta-analysis. J Med Virol. 2022 Apr;94(4):1428-1441.
21. 22. Keehner J, Horton LE, Pfeffer MA, et al. SARS-CoV-2 infection after vaccination in healthcare workers in California. N Engl J Med 2021;384: 1774–1775.
22. 23. Hacisuleyman E, Hale C, Saito Y, et al. Vaccine bre-akthrough infections with SARS-CoV-2 variants. N. Engl. J. Med 2021;384:2212-2218.
23. 24. Agrawal, U., Katikireddi, S.V., McCowan, et al, 2021. COVID-19 hospital admissions and deaths after BNT162b2 and ChAdOx1 nCoV-19 vaccinations in 2⋅57 million people in Scotland (EAVE II): a prospective cohort study. Lancet Respiratory Med. 9 (12), 1439–1449.
24. 25. Sabnis R , Patil A, Shete N, et al. Break-through COVID-19 infection rate with Indian strain in Single-center Healthcare Workers – A real world data. medRxiv 2021.07.02.21258881.
25. 26. Taquet M, Dercon Q, Harrison PJ. Six-month sequelae of post-vaccination SARS-CoV-2 infection: A retrospective cohort study of 10,024 breakthrough infections. Brain Behav Immun. 2022 Jul;103:154-162.
26. 27. Siegrist, C.-A., Aspinall, R., 2009. B-cell responses to vaccination at the extremes of age. Nat. Rev. Immunol. 9 (3), 185–194.
27. 28. Bahl A, Johnson S, Maine G, et al. Vaccination reduces need for emergency care in breakthrough COVID-19 infections: A multicenter cohort study. Lancet Reg Health Am. 2021 Dec;4:100065.