Background

Health care personnel (HCP) worldwide are at-risk for contracting the novel Coronavirus disease (COVID-19). Among health care personnel, nurses are at a particularly high risk due to the physical proximity and duration of time spent providing direct care. Documenting accurate rates of COVID-19 infection and deaths among nurses worldwide has been problematic, and many countries such as the USA have no systematic mechanism for collecting this information. Brazil is unique in that it prioritized the implementation of a dedicated database, the Nursing Observatory to collect accurate and timely data regarding COVID-19 and Brazilian nursing personnel.

Objectives

The aim of this study was to analyze COVID-19 infections and deaths among nurses registered in the centralized and dedicated Brazilian database called the Nursing Observatory.

Design

A cross-sectional study using secondary data from the Brazilian Nursing Observatory was conducted.

Participants

Data are reported for two occupational categories: professional Nurse and technical nurse by country regions. All cases or deaths of professional Nurse and technical nurse registered between the 12th and 31st epidemiological weeks of 2020 were included.

Methods

From a unique numerical identification, the appropriate records of nursing personnel affected by COVID-19 were entered by the Technical Responsible Nurse for each service, according to the condition regarding COVID-19. All suspected, confirmed or unconfirmed infections were considered “cases”, and all confirmed or unconfirmed deceased as “deaths”. Cases and deaths were analyzed according to the variables: 1. region of the country where the case occurred, 2. nursing category and 3. epidemiological week. Universal protocols for collecting and cleaning data were used throughout the country. Infection and mortality rates (per 100,000) were obtained from the relationship between deaths registered and the population of nursing personnel by category and region.

Results

Nursing personnel in the Northern, Northeast and Southeast Regions of Brazil had the highest number of COVID-19 infections and deaths overall with an ascending curve occurring mainly after Epidemiological Week 19. COVID-19 infections and deaths spread later to the Midwest and Southern regions also showing an ascending curve, although the total numbers were less.

Conclusions

All occupational categories of nursing personnel showed higher than expected rates of infection and death. Inequalities and a lack of adequate healthcare resources, hospital beds and Personal Protective Equipment varied by region in Brazil. The politicization of COVID-19 and the lack of a coherent national pandemic plan is a factor to be taken into account.

Tweetable abstract– This cross-sectional study shows the evolution of cases and deaths of Brazilian nursing personnel over the first months of the COVID-19 pandemic.

中文翻译：

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巴西护理人员因 COVID-19 感染和死亡：一项横断面研究

背景

全世界的医护人员 (HCP) 都面临感染新型冠状病毒病 (COVID-19) 的风险。在医护人员中，护士由于身体距离和提供直接护理的时间长短而面临特别高的风险。记录全球护士 COVID-19 感染和死亡率的准确率一直存在问题，许多国家（例如美国）没有收集此信息的系统机制。巴西的独特之处在于它优先实施了一个专门的数据库，即护理观察站，以收集有关 COVID-19 和巴西护理人员的准确和及时的数据。

目标

本研究的目的是分析在称为护理观察站的巴西集中专用数据库中注册的护士的 COVID-19 感染和死亡情况。

设计

使用巴西护理观察站的二手数据进行了一项横断面研究。

参加者

报告了两个职业类别的数据：按国家/地区划分的专业护士和技术护士。包括 2020 年第 12 至 31 个流行病学周之间登记的所有专业护士和技术护士的病例或死亡。

方法

根据有关 COVID-19 的情况，负责技术的护士根据唯一的数字标识，为每项服务输入了受 COVID-19 影响的护理人员的适当记录。所有疑似、确诊或未确诊的感染者都称为“病例”，所有确诊或未确诊的死亡者都称为“死亡”。病例和死亡根据以下变量进行分析：1. 病例发生所在国家/地区，2. 护理类别和 3. 流行病学周。收集和清理数据的通用协议在全国范围内使用。感染率和死亡率（每 100,000 人）是根据类别和地区登记的死亡人数与护理人员人数之间的关系得出的。

结果

巴西北部、东北部和东南部地区的护理人员总体上 COVID-19 感染和死亡人数最多，上升曲线主要出现在第 19 流行病学周之后。COVID-19 感染和死亡后来也蔓延到中西部和南部地区显示上升曲线，尽管总数较少。

结论

所有职业类别的护理人员感染率和死亡率均高于预期。巴西不同地区的不平等和缺乏足够的医疗保健资源、病床和个人防护设备的情况各不相同。COVID-19 的政治化和缺乏连贯的国家大流行计划是一个需要考虑的因素。

可发布的摘要——这项横断面研究显示了巴西护理人员在 COVID-19 大流行的头几个月里病例和死亡的演变。