俄罗斯卫生部门患者和工作人员SARS-CoV-2的rna检测动态

Оксана Газимагомедовна Старкова, Д. С. Тихомиров, А. Ю. Крылова, И. О. Снежко, Е. Н. Овчинникова, О. А. Алешина, Т. А. Туполева, Т. В. Гапонова
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引用次数: 0

摘要

背景。COVID-19要求医疗保健管理以及肿瘤和血液患者的医疗护理发生根本性变化。对医疗机构的访问减少到最低限度,75%的医生预约被转换为远程医疗咨询。防止新冠病毒进一步传播的解决方案包括:建立观察单位,区分患者和员工流动,定期进行SARS-CoV-2 RNA检测,缩短住院时间,将COVID-19检测阳性的患者转移到改造后的新型冠状病毒感染专科医院,只提供紧急医疗治疗,并尽可能将全身化疗转为全身治疗等;的目标。评估2020年4月至2022年1月国家血液学研究中心实施疫情控制措施期间SARS-CoV-2 RNA检测动态。材料,方法。该研究基于对从国家血液学研究中心(以下简称中心)的患者和员工获得的鼻和口咽样本进行的SARS-CoV-2 RNA检测。此外,对支气管肺泡灌洗液、肺组织活检和痰液进行了SARS-CoV-2 RNA检测。本研究在中心病毒学部进行,使用Sintol试剂盒“ПЦР-РВ-2019-nCov”。 结果。该研究基于107,470项测试:58141名(54%)员工和45126名(46%)患者;35,508名(33%)男性和71,962名(67%)女性。1318例检测到SARS-CoV-2 RNA,占总检测数的1.15%。在员工/患者组中,病毒检出率为1.42% / 1.09% (p <0.001),男女组分别为1.3% / 1.2% (p = 0.154)。经SARS-CoV-2 RNA检测,肿瘤和非肿瘤血液病患者的感染率分别为1.24%和0.92% (p = 0.147)。在该中心的员工和患者中,观察到波浪状病毒检出率。感染人数最多的是2020年4月至6月(79名患者和170名员工)、2020年10月至12月(126名患者和190名员工)和2022年1月(59名患者和203名员工),这与俄罗斯的第一波、第二波和第五波COVID-19相对应。结论。对国家血液学研究中心获得的数据进行分析后发现,该中心员工和患者的SARS-CoV-2 RNA检出率呈波浪状,这与俄罗斯的总体趋势相吻合。SARS-CoV-2 RNA检出率不依赖于研究对象的性别,在肿瘤和非肿瘤血液病患者组中无显著差异。尽管血液科医院的患者更容易出现严重的感染并发症,但他们出现COVID-19实验室标志物的频率低于中心员工。
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Динамика выявления РНК вируса SARS-CoV-2 у пациентов и сотрудников ФГБУ «НМИЦ гематологии» Минздрава России в первые 2 года пандемии новой коронавирусной инфекции COVID-19
Background. COVID-19 required fundamental changes in healthcare management, also in medical care for oncological and hematological patients. Visits to healthcare organizations were minimized, 75 % of doctor appointments were converted to telemedicine consultations. The solutions aimed at preventing further spread of COVID-19 included establishing of observational units, distinguishing between patient and employee flows, regular SARS-CoV-2 RNA testing, reducing hospital stays and transferring patients with positive COVID-19 tests to the remodeled hospitals specializing in the novel coronavirus infection, as well as providing only emergency medical treatment and, as far as feasible, converting systemic chemotherapy to per os treatment, etc. Aim. To assess SARS-CoV-2 RNA detection dynamics at the National Research Center for Hematology from April 2020 to January 2022 during the implementation of epidemic control measures. Materials & Methods. The study was based on SARS-CoV-2 RNA testing of naso- and oropharyngeal samples obtained from patients and employees of the National Research Center for Hematology (hereafter referred to as Center). Besides, bronchoalveolar lavage fluid, lung tissue biopsies, and sputum were examined for SARS-CoV-2 RNA. The study was performed at the Center’s Virusology Department with the use of Sintol reagent kit “ПЦР-РВ-2019-nCov”. Results. The study was based on 107,470 tests: 58,141 (54 %) of employees and 45,126 (46 %) of patients; 35,508 (33 %) of men and 71,962 (67 %) of women. In 1318 cases SARS-CoV-2 RNA was detected which accounted for 1.15 % of total test number. In the groups of employees/patients, virus detection rate was 1.42 %/1.09 % (p < 0.001), and in male/female groups it was 1.3 %/1.2 %, respectively (p = 0.154). The rate of infection in the groups of tumor and non-tumor hematological patients, as proved by SARS-CoV-2 RNA testing, was 1.24 % and 0.92 %, respectively (p = 0.147). In employees and patients of the Center, a wave-like virus detection rate was observed. The largest number of infections was registered in April-June 2020 (79 patients and 170 employees), October-December 2020 (126 patients and 190 employees), and January 2022 (59 patients and 203 employees), which corresponded to the first, second, and fifth COVID-19 waves in Russia. Conclusion. The analysis of data obtained at the National Research Center for Hematology demonstrated a wave-like SARS-CoV-2 RNA detection rate in employees and patients of the Center, which corresponded to the general trend in Russia. The SARS-CoV-2 RNA detection rate did not depend on sex of subjects under study and was not significantly different in the groups of tumor and non-tumor hematological patients. Although the patients in hematological hospital are more exposed to the risk of severe infectious complications, they showed laboratory markers for COVID-19 less frequently than the Center employees.
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