Nosocomial infections among patients with COVID-19, SARS and MERS: a rapid review and meta-analysis.

4区医学 Annals of translational medicine Pub Date : 2020-05-01 DOI:10.21037/atm-20-3324

Qi Zhou, Yelei Gao, Xingmei Wang, Rui Liu, Peipei Du, Xiaoqing Wang, Xianzhuo Zhang, Shuya Lu, Zijun Wang, Qianling Shi, Weiguo Li, Yanfang Ma, Xufei Luo, Toshio Fukuoka, Hyeong Sik Ahn, Myeong Soo Lee, Enmei Liu, Yaolong Chen, Zhengxiu Luo, Kehu Yang

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Abstract

Background: COVID-19, a disease caused by SARS-CoV-2 coronavirus, has now spread to most countries and regions of the world. As patients potentially infected by SARS-CoV-2 need to visit hospitals, the incidence of nosocomial infection can be expected to be high. Therefore, a comprehensive and objective understanding of nosocomial infection is needed to guide the prevention and control of the epidemic.

Methods: We searched major international and Chinese databases: Medicine, Web of Science, Embase, Cochrane, CBM (China Biology Medicine disc), CNKI (China National Knowledge Infrastructure) and Wanfang database for case series or case reports on nosocomial infections of COVID-19, SARS (severe acute respiratory syndromes) and MERS (Middle East respiratory syndrome) from their inception to March 31st, 2020. We conducted a meta-analysis of the proportion of nosocomial infection patients in the diagnosed patients, occupational distribution of nosocomial infection medical staff.

Results: We included 40 studies. Among the confirmed patients, the proportions of nosocomial infections with early outbreaks of COVID-19, SARS, and MERS were 44.0%, 36.0%, and 56.0%, respectively. Of the confirmed patients, the medical staff and other hospital-acquired infections accounted for 33.0% and 2.0% of COVID-19 cases, 37.0% and 24.0% of SARS cases, and 19.0% and 36.0% of MERS cases, respectively. Nurses and doctors were the most affected among the infected medical staff. The mean numbers of secondary cases caused by one index patient were 29.3 and 6.3 for SARS and MERS, respectively.

Conclusions: The proportion of nosocomial infection in patients with COVID-19 was 44% in the early outbreak. Patients attending hospitals should take personal protection. Medical staff should be awareness of the disease to protect themselves and the patients.

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COVID-19、SARS 和 MERS 患者的医院内感染：快速回顾和荟萃分析。

背景：COVID-19 是一种由 SARS-CoV-2 冠状病毒引起的疾病，现已蔓延到世界上大多数国家和地区。由于可能感染 SARS-CoV-2 的病人需要到医院就诊，预计院内感染的发生率会很高。因此，需要对医院内感染有一个全面客观的了解，以指导疫情的预防和控制：方法：我们检索了主要的国际和国内数据库：方法：我们检索了国际和国内主要数据库：Medicine、Web of Science、Embase、Cochrane、CBM（中国生物医学文献数据库）、CNKI（中国国家知识基础设施）和万方数据库，检索了从开始到 2020 年 3 月 31 日有关 COVID-19、SARS（严重急性呼吸系统综合征）和 MERS（中东呼吸综合征）病原微生物感染的系列病例或病例报告。我们对确诊患者中鼻源性感染患者的比例、鼻源性感染医务人员的职业分布进行了荟萃分析：我们纳入了 40 项研究。在确诊患者中，COVID-19、SARS 和 MERS 早期爆发的非医院感染比例分别为 44.0%、36.0% 和 56.0%。在确诊患者中，医务人员和其他医院感染分别占 COVID-19 病例的 33.0% 和 2.0%，SARS 病例的 37.0% 和 24.0%，MERS 病例的 19.0% 和 36.0%。在受感染的医务人员中，护士和医生受影响最大。由一名感染者引发的继发病例的平均数量在 SARS 和 MERS 中分别为 29.3 例和 6.3 例：结论：在疫情爆发初期，COVID-19 患者的院内感染比例为 44%。在医院就诊的患者应做好个人防护。医务人员应提高对该疾病的认识，以保护自己和病人。

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Annals of translational medicine Multiple-

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769

期刊介绍： The Annals of Translational Medicine (Ann Transl Med; ATM; Print ISSN 2305-5839; Online ISSN 2305-5847) is an international, peer-reviewed Open Access journal featuring original and observational investigations in the broad fields of laboratory, clinical, and public health research, aiming to provide practical up-to-date information in significant research from all subspecialties of medicine and to broaden the readers’ vision and horizon from bench to bed and bed to bench. It is published quarterly (April 2013- Dec. 2013), monthly (Jan. 2014 - Feb. 2015), biweekly (March 2015-) and openly distributed worldwide. Annals of Translational Medicine is indexed in PubMed in Sept 2014 and in SCIE in 2018. Specific areas of interest include, but not limited to, multimodality therapy, epidemiology, biomarkers, imaging, biology, pathology, and technical advances related to medicine. Submissions describing preclinical research with potential for application to human disease, and studies describing research obtained from preliminary human experimentation with potential to further the understanding of biological mechanism underlying disease are encouraged. Also warmly welcome are studies describing public health research pertinent to clinic, disease diagnosis and prevention, or healthcare policy.  With a focus on interdisciplinary academic cooperation, ATM aims to expedite the translation of scientific discovery into new or improved standards of management and health outcomes practice.