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The risk of coronavirus to healthcare providers during aerosol-generating procedures: A systematic review and meta-analysis
Annals of Thoracic Medicine ( IF 2.3 ) Pub Date : 2021-04-01 , DOI: 10.4103/atm.atm_497_20 SharafaldeenA Bin Nafisah , BandrY Mzahim , BakhitahS Aleid , ShahadA Sheerah , DaliahQ Almatrafi , GregoryR Ciottone , KhalidH AlAnazi , AnasA Khan
CONTEXT: Several medical procedures are thought to increase the risk of transmission of infectious agents to health-care providers (HCPs) through an aerosol-generating mechanism.
AIMS: Given the significant influenza and coronavirus pandemics that have occurred in the 20th and 21st century, including the current severe acute respiratory syndrome coronavirus 2 global pandemic, the objective of this analysis is to assess the occurrence of disease transmission to HCPs from the performance aerosol-generating procedures (AGPs).
SETTINGS AND DESIGN: This was a systematic review and meta-analysis
SUBJECTS AND METHODS: We performed a systematic meta-analysis looking at the odds ratio (OR) of AGP, causing infection among HCPs. We searched the following databases: MEDLINE (PubMed), ProQuest, Cochrane databases, and the Gray literature (ClinicalTrials.gov and World Health Organization International Clinical Trials Registry Platform). In addition, we conducted nondatabase search activities. The search terms used were “MERS-CoV,” “COVID,” and “SARS” combined with “provider” or “healthcare provider.”
STATISTICAL ANALYSIS USED: RevMan meta-analysis was used for statistical analysis.
RESULTS: Following the search, we reviewed 880 studies, of which six studies were eligible. The estimated odd ratio utilizing a control group of HCPs who were exposed to AGP but did not develop the infection was 1.85 (95% confidence interval [CI]: 1.33, 2.57). The OR remained the same when we added another control group who, despite not being exposed to AGP, had developed the infection. The OR remained 1.85 (95% CI: 1.33, 2.55). However, there is an increase in the OR to 1.89 (95% CI: 1.38, 2.59) when we added HCPs who did not use adequate personal protective equipment (PPE) during the procedures to the total estimates.
CONCLUSIONS: The performance of AGP with inadequate PPE can result in an increased risk of disease transmission to HCWs.
中文翻译：
在气雾生成过程中，医护人员面临冠状病毒的风险：系统评价和荟萃分析
背景：人们认为几种医疗程序会增加通过气雾生成机制将传染性病原体传播给医疗保健提供者（HCP）的风险。
AIMS：鉴于发生在20的显著流感和冠状病毒流行病日和21日世纪，包括目前的严重急性呼吸综合征冠状2全球性流行病，这种分析的目的是传播疾病的发生评估从医疗专业人员性能气雾生成程序（AGP）。
设置与设计：这是一项系统的综述和荟萃分析
。我们进行了系统的荟萃分析，研究了AGP导致HCP感染的优势比（OR）。我们搜索了以下数据库：MEDLINE（PubMed），ProQuest，Cochrane数据库和灰色文献（ClinicalTrials.gov和世界卫生组织国际临床试验注册平台）。此外，我们进行了非数据库搜索活动。使用的搜索词是“ MERS-CoV”，“ COVID”和“ SARS”，再加上“提供者”或“医疗保健提供者”。
使用的统计分析： RevMan荟萃分析用于统计分析。
结果：搜索后，我们审查了880项研究，其中6项是合格的。使用暴露于AGP但未发生感染的HCP对照组的估计奇数比为1.85（95％置信区间[CI]：1.33，2.57）。当我们添加另一个对照组时，OR保持不变，尽管该对照组没有暴露于AGP中，但已发生了感染。OR保持1.85（95％CI：1.33，2.55）。但是，当我们将在程序中未使用适当个人防护设备（PPE）的HCP添加到总估算中时，OR会增加到1.89（95％CI：1.38、2.59）。
结论： AGP的性能与PPE不足会导致疾病传播给HCW的风险增加。
更新日期：2021-04-18
Annals of Thoracic Medicine ( IF 2.3 ) Pub Date : 2021-04-01 , DOI: 10.4103/atm.atm_497_20 SharafaldeenA Bin Nafisah , BandrY Mzahim , BakhitahS Aleid , ShahadA Sheerah , DaliahQ Almatrafi , GregoryR Ciottone , KhalidH AlAnazi , AnasA Khan
CONTEXT: Several medical procedures are thought to increase the risk of transmission of infectious agents to health-care providers (HCPs) through an aerosol-generating mechanism.
AIMS: Given the significant influenza and coronavirus pandemics that have occurred in the 20th and 21st century, including the current severe acute respiratory syndrome coronavirus 2 global pandemic, the objective of this analysis is to assess the occurrence of disease transmission to HCPs from the performance aerosol-generating procedures (AGPs).
SETTINGS AND DESIGN: This was a systematic review and meta-analysis
SUBJECTS AND METHODS: We performed a systematic meta-analysis looking at the odds ratio (OR) of AGP, causing infection among HCPs. We searched the following databases: MEDLINE (PubMed), ProQuest, Cochrane databases, and the Gray literature (ClinicalTrials.gov and World Health Organization International Clinical Trials Registry Platform). In addition, we conducted nondatabase search activities. The search terms used were “MERS-CoV,” “COVID,” and “SARS” combined with “provider” or “healthcare provider.”
STATISTICAL ANALYSIS USED: RevMan meta-analysis was used for statistical analysis.
RESULTS: Following the search, we reviewed 880 studies, of which six studies were eligible. The estimated odd ratio utilizing a control group of HCPs who were exposed to AGP but did not develop the infection was 1.85 (95% confidence interval [CI]: 1.33, 2.57). The OR remained the same when we added another control group who, despite not being exposed to AGP, had developed the infection. The OR remained 1.85 (95% CI: 1.33, 2.55). However, there is an increase in the OR to 1.89 (95% CI: 1.38, 2.59) when we added HCPs who did not use adequate personal protective equipment (PPE) during the procedures to the total estimates.
CONCLUSIONS: The performance of AGP with inadequate PPE can result in an increased risk of disease transmission to HCWs.
中文翻译：
在气雾生成过程中，医护人员面临冠状病毒的风险：系统评价和荟萃分析
背景：人们认为几种医疗程序会增加通过气雾生成机制将传染性病原体传播给医疗保健提供者（HCP）的风险。
AIMS：鉴于发生在20的显著流感和冠状病毒流行病日和21日世纪，包括目前的严重急性呼吸综合征冠状2全球性流行病，这种分析的目的是传播疾病的发生评估从医疗专业人员性能气雾生成程序（AGP）。
设置与设计：这是一项系统的综述和荟萃分析
。我们进行了系统的荟萃分析，研究了AGP导致HCP感染的优势比（OR）。我们搜索了以下数据库：MEDLINE（PubMed），ProQuest，Cochrane数据库和灰色文献（ClinicalTrials.gov和世界卫生组织国际临床试验注册平台）。此外，我们进行了非数据库搜索活动。使用的搜索词是“ MERS-CoV”，“ COVID”和“ SARS”，再加上“提供者”或“医疗保健提供者”。
使用的统计分析： RevMan荟萃分析用于统计分析。
结果：搜索后，我们审查了880项研究，其中6项是合格的。使用暴露于AGP但未发生感染的HCP对照组的估计奇数比为1.85（95％置信区间[CI]：1.33，2.57）。当我们添加另一个对照组时，OR保持不变，尽管该对照组没有暴露于AGP中，但已发生了感染。OR保持1.85（95％CI：1.33，2.55）。但是，当我们将在程序中未使用适当个人防护设备（PPE）的HCP添加到总估算中时，OR会增加到1.89（95％CI：1.38、2.59）。
结论： AGP的性能与PPE不足会导致疾病传播给HCW的风险增加。
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