Personal protective equipment protecting healthcare workers in the Chinese epicentre of COVID-19

Zhao, Yi; Liang, Wenhua; Luo, Yu; Chen, Ying; Peng, Liang; Zhong, Ran; Chen, Ailan; He, Jianxing

doi:10.1016/j.cmi.2020.07.029

Cited by 43 publications

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“…15 The lower seroprevalence observed in our study may be explained by the fact that our hospital is the reference centre for infectious diseases and bioemergencies in Northern Italy and has the largest number of ID beds in Lombardy and an active biocontainment unit in which ID and ICU staff are continuously trained to use different types of PPE. As demonstrated during the SARS outbreak and the COVID-19 epidemic in China, the appropriate use of masks, gloves, gowns and hand hygiene is effective in preventing virus transmission in clinical settings, [24][25][26][27] and so it is likely that the availability of PPE and confidence in using it, together with the early implementation of preventive measures throughout the hospital (including the use of surgical masks in COVID-free areas and by colleagues not involved in treating patients with COVID-19) played a crucial role in containing the spread of the virus. It must be acknowledged that differently from other clinical settings and territorial health facilities, our hospital did not experience severe shortage of PPE at any time of the outbreak.…”

Section: Discussionmentioning

confidence: 99%

Dynamics of the seroprevalence of SARS-CoV-2 antibodies among healthcare workers at a COVID-19 referral hospital in Milan, Italy

et al. 2021

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ObjectivesHealthcare workers (HCWs) are at high risk of developing SARS-CoV-2 infection. The aim of this single-centre prospective study was to evaluate the trend of SARS-CoV-2 seroprevalence in HCWs working at the primary referral centre for infectious diseases and bioemergencies (eg, COVID-19) in Northern Italy and investigate the factors associated with seroconversion.MethodsSix hundred and seventy-nine HCW volunteers were tested for anti-SARS-CoV-2 antibodies three times between 4 March and 27 May 2020 and completed a questionnaire covering COVID-19 exposure, symptoms and personal protective equipment (PPE) training and confidence at each time.ResultsSARS-CoV-2 seroprevalence rose from 3/679 to 26/608 (adjusted prevalence: 0.5%, 95% CI 0.1 to 1.7% and 5.4%, 95% CI 3.6 to 7.9, respectively) between the first two time points and then stabilised, in line with the curve of the COVID-19 epidemic in Milan. From the first time point, 61.6% of the HCWs had received training in the use of PPE and 17 (61.5%) of those who proved to be seropositive reported symptoms compatible with SARS-CoV-2 infection. Contacts with ill relatives or friends and self-reported symptoms were independently associated with an increased likelihood of seroconversion (p<0.0001 for both), whereas there was no significant association with professional exposure.ConclusionThe seroprevalence of SARS-CoV-2 among the HCWs at our COVID-19 referral hospital was low at the time of the peak of the epidemic. The seroconversions were mainly attributable to extrahospital contacts, probably because the hospital readily adopted effective infection control measures. The relatively high number of asymptomatic seropositive HCWs highlights the need to promptly identify and isolate potentially infectious HCWs.

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Section: Discussionmentioning

confidence: 99%

Dynamics of the seroprevalence of SARS-CoV-2 antibodies among healthcare workers at a COVID-19 referral hospital in Milan, Italy

et al. 2021

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“…After the screening of the titles and abstracts, we removed 2671 records and we added 4 more records found by the reference lists scanning. Finally, we included 14 studies [26][27][28][29][30][31][32][33][34][35][36][37][38][39] in this metaanalysis that met our inclusion criteria.…”

Section: Identification and Selection Of Studiesmentioning

confidence: 99%

“…Main characteristics of the studies included in our systematic review and metaanalysis are shown in Table 1 [26,28,[30][31][32][33]35,36,38,39], two studies were conducted in Europe [34,37], one study was conducted in South America [27], and one study included HCWs from 10 countries [29]. All studies were cross-sectional, while 13 studies [26][27][28][29][30][32][33][34][35][36][37][38][39] used a convenience sample method and one study [31] used a purposeful sampling method. Assessment of adverse events was self-reported through questionnaires in 13 studies [26][27][28][29][30][31][32][33][34][35][37][38][39], while in one study [36] a clinical diagnosis was performed.…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

“…All studies were cross-sectional, while 13 studies [26][27][28][29][30][32][33][34][35][36][37][38][39] used a convenience sample method and one study [31] used a purposeful sampling method. Assessment of adverse events was self-reported through questionnaires in 13 studies [26][27][28][29][30][31][32][33][34][35][37][38][39], while in one study [36] a clinical diagnosis was performed. All studies were published in journals and seven studies [26,28,29,31,32,38,39] reported response rate.…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

“…Assessment of adverse events was self-reported through questionnaires in 13 studies [26][27][28][29][30][31][32][33][34][35][37][38][39], while in one study [36] a clinical diagnosis was performed. All studies were published in journals and seven studies [26,28,29,31,32,38,39] reported response rate.…”

Section: Characteristics Of the Studiesmentioning

confidence: 99%

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Impact of personal protective equipment use on health care workers’ physical health during the COVID-19 pandemic: a systematic review and meta-analysis

Galanis

Vraka

Fragkou

et al. 2021

Preprint

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Background: During the COVID-19 pandemic, health care workers (HCWs) caring for patients with coronavirus disease 2019 (COVID-19) in high-risk clinical settings have been obliged to wear personal protective equipment (PPE). Aim: To assess the impact of PPE use on HCWs physical health during the COVID-19 pandemic. Also, we examined factors related to a greater risk of adverse events among HCWs due to PPE use. Methods: We applied the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and the Cochrane criteria for this systematic review and meta-analysis. We searched PubMed, Medline, Scopus, ProQuest, CINAHL, and pre-print services (medRxiv) from January 1, 2020 to December 27, 2020. Findings: Our review included 14 studies with 11,746 HCWs from 16 countries. The estimated overall prevalence of adverse events among HCWs was 78% (95% CI: 66.7-87.5%) with a range from 42.8% to 95.1% among studies. The prevalence of adverse events was higher for the studies with poor quality compared to those with moderate quality (83.5% vs. 67.1%), while increased sample size was related to decreased prevalence (p<0.001). The most frequent adverse events were headache (55.9%), dry skin (54.4%), dyspnoea (53.4%), pressure injuries (40.4%), itching (39.8%), hyperhidrosis (38.5%), and dermatitis (31.0%). Among others, the following factors were related to the risk of adverse events among HCWs due to PPE use: female gender, younger age, obesity, diabetes mellitus, smoking pre-existing headache, longer duration of shifts wearing PPE, increased consecutive days with PPE, and increased exposure to confirmed or suspected COVID-19 patients. Conclusion: The frequency of adverse events amongst HCWs due to PPE use is very high. Further studies should be conducted since the limitations of this review do not allow us to infer conclusive results especially in case of risk factors for the occurrence of adverse events. Healthcare facilities should take the necessary precautions and change the working conditions during the COVID-19 pandemic to prevent adverse events associated with PPE use and minimize harm to HCWs.

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Impact of personal protective equipment use on health care workers’ physical health during the COVID-19 pandemic: A systematic review and meta-analysis

Galanis

Vraka

Fragkou

et al. 2021

American Journal of Infection Control

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Personal protective equipment protecting healthcare workers in the Chinese epicentre of COVID-19

Cited by 43 publications

References 0 publications

Dynamics of the seroprevalence of SARS-CoV-2 antibodies among healthcare workers at a COVID-19 referral hospital in Milan, Italy

Dynamics of the seroprevalence of SARS-CoV-2 antibodies among healthcare workers at a COVID-19 referral hospital in Milan, Italy

Impact of personal protective equipment use on health care workers’ physical health during the COVID-19 pandemic: a systematic review and meta-analysis

Impact of personal protective equipment use on health care workers’ physical health during the COVID-19 pandemic: A systematic review and meta-analysis

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