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Abstract：
UNASSIGNED: The COVID-19 pandemic has exposed healthcare workers (HCWs) to serious risk of infection. The aims of our study were to investigate the epidemiological characteristics and risk factors of SARS-CoV-2 infection among HCWs, and evaluate the vaccine effectiveness (VE) during the Omicron pandemic in Shanghai, China.
UNASSIGNED: Active surveillance of COVID-19 was performed among HCWs who worked in Shanghai General Hospital from December 2022 to January 2023. A case-control study was conducted by questionnaire survey to analyse the infection-related risk factors. A retrospective cohort study was explored to evaluate VE against primary infection.
UNASSIGNED: During the Omicron outbreak, 2,008 of 2,460 (81.6%) HCWs were infected with SARS-CoV-2. The infection rate was higher in women, younger age groups, nurses and medical technicians. Among the 1,742 participants in the questionnaire, 1,463 (84.0%) were tested positive, and 95.1% of them developed symptoms. Most of the infections (53.0%) were acquired outside the hospital. The risk factors associated with higher odds of infection were working in the emergency department (aOR 3.77, 95% CI 1.69-8.38) and medical examination area (aOR 2.47, 95% CI 1.10-5.51). The protective factors associated with lower odds of infection were previous infection with SARS-CoV-2 (aOR 0.01, 95% CI 0-0.07) and receiving four doses of vaccines (aOR 0.40, 95% CI 0.17-0.97). For frontline HCWs, those who had oral-nasal exposure to coworkers were more likely to be infected (aOR 1.74, 95% CI 1.21-2.51). In VE analysis, the risk of primary infection was lower in HCWs who received the emergency heterologous booster (the fourth dose) during the epidemic (aHR 0.25, 95% CI 0.15-0.40), resulting in an adjusted-VE of 75.1%.
UNASSIGNED: In response to future pandemic, it is important for public health policies to aim at protecting HCWs through risk-differentiated infection control measures, strengthening personal protection and recommending vaccination to vulnerable individuals before the arrival of Omicron wave.
UNASSIGNED: Active surveillance of COVID-19 was performed among HCWs who worked in Shanghai General Hospital from December 2022 to January 2023. A case-control study was conducted by questionnaire survey to analyse the infection-related risk factors. A retrospective cohort study was explored to evaluate VE against primary infection.
UNASSIGNED: During the Omicron outbreak, 2,008 of 2,460 (81.6%) HCWs were infected with SARS-CoV-2. The infection rate was higher in women, younger age groups, nurses and medical technicians. Among the 1,742 participants in the questionnaire, 1,463 (84.0%) were tested positive, and 95.1% of them developed symptoms. Most of the infections (53.0%) were acquired outside the hospital. The risk factors associated with higher odds of infection were working in the emergency department (aOR 3.77, 95% CI 1.69-8.38) and medical examination area (aOR 2.47, 95% CI 1.10-5.51). The protective factors associated with lower odds of infection were previous infection with SARS-CoV-2 (aOR 0.01, 95% CI 0-0.07) and receiving four doses of vaccines (aOR 0.40, 95% CI 0.17-0.97). For frontline HCWs, those who had oral-nasal exposure to coworkers were more likely to be infected (aOR 1.74, 95% CI 1.21-2.51). In VE analysis, the risk of primary infection was lower in HCWs who received the emergency heterologous booster (the fourth dose) during the epidemic (aHR 0.25, 95% CI 0.15-0.40), resulting in an adjusted-VE of 75.1%.
UNASSIGNED: In response to future pandemic, it is important for public health policies to aim at protecting HCWs through risk-differentiated infection control measures, strengthening personal protection and recommending vaccination to vulnerable individuals before the arrival of Omicron wave.
摘要：
■COVID-19大流行使医护人员（HCWs）面临严重的感染风险。我们的研究目的是调查SARS-CoV-2感染的流行病学特征和危险因素，并评估上海Omicron大流行期间的疫苗有效性（VE），中国。
■2022年12月至2023年1月在上海市总医院工作的医护人员中对COVID-19进行了主动监测。采用问卷调查法进行病例对照研究,分析感染相关危险因素。进行了一项回顾性队列研究，以评估VE对原发感染的影响。
■在Omicron爆发期间，2,460例(81.6%)HCWs中有2,008例感染了SARS-CoV-2。女性感染率较高，年轻的年龄组，护士和医疗技术人员。在问卷的1742名参与者中，1,463（84.0%）检测呈阳性，其中95.1%出现症状。大多数感染（53.0％）是在医院外获得的。与较高感染几率相关的危险因素在急诊科（aOR3.77，95％CI1.69-8.38）和医学检查领域（aOR2.47，95％CI1.10-5.51）。与较低感染几率相关的保护因素是既往感染SARS-CoV-2（aOR0.01，95％CI0-0.07）和接受四剂疫苗（aOR0.40，95％CI0.17-0.97）。对于前线HCW，经口鼻接触同事的患者更有可能受到感染(aOR1.74,95%CI1.21~2.51).在VE分析中，在流行期间接受紧急异源加强剂（第四剂）的HCWs的原发感染风险较低（aHR0.25，95％CI0.15-0.40），导致调整后的VE为75.1%。
■为了应对未来的大流行，对于公共卫生政策而言，重要的是通过风险区分感染控制措施来保护HWs，加强个人保护，并在Omicron波到来之前向易受伤害的个人推荐疫苗接种。
■2022年12月至2023年1月在上海市总医院工作的医护人员中对COVID-19进行了主动监测。采用问卷调查法进行病例对照研究,分析感染相关危险因素。进行了一项回顾性队列研究，以评估VE对原发感染的影响。
■在Omicron爆发期间，2,460例(81.6%)HCWs中有2,008例感染了SARS-CoV-2。女性感染率较高，年轻的年龄组，护士和医疗技术人员。在问卷的1742名参与者中，1,463（84.0%）检测呈阳性，其中95.1%出现症状。大多数感染（53.0％）是在医院外获得的。与较高感染几率相关的危险因素在急诊科（aOR3.77，95％CI1.69-8.38）和医学检查领域（aOR2.47，95％CI1.10-5.51）。与较低感染几率相关的保护因素是既往感染SARS-CoV-2（aOR0.01，95％CI0-0.07）和接受四剂疫苗（aOR0.40，95％CI0.17-0.97）。对于前线HCW，经口鼻接触同事的患者更有可能受到感染(aOR1.74,95%CI1.21~2.51).在VE分析中，在流行期间接受紧急异源加强剂（第四剂）的HCWs的原发感染风险较低（aHR0.25，95％CI0.15-0.40），导致调整后的VE为75.1%。
■为了应对未来的大流行，对于公共卫生政策而言，重要的是通过风险区分感染控制措施来保护HWs，加强个人保护，并在Omicron波到来之前向易受伤害的个人推荐疫苗接种。
