tetano
Editor, Senior Moderator
Anaesthesia
. 2020 Jun 9.
doi: 10.1111/anae.15170. Online ahead of print.
Risks to Healthcare Workers Following Tracheal Intubation of Patients With COVID-19: A Prospective International Multicentre Cohort Study
K El-Boghdadly[SUP] 1 2 [/SUP], D J N Wong[SUP] 3 [/SUP], R Owen[SUP] 4 [/SUP], M D Neuman[SUP] 5 [/SUP], S Pocock[SUP] 6 [/SUP], J B Carlisle[SUP] 7 [/SUP], C Johnstone[SUP] 1 [/SUP], P Andruszkiewicz[SUP] 8 [/SUP], P A Baker[SUP] 9 [/SUP], B M Biccard[SUP] 10 [/SUP], G L Bryson[SUP] 11 [/SUP], M T V Chan[SUP] 12 [/SUP], M H Cheng[SUP] 13 [/SUP], K J Chin[SUP] 14 [/SUP], M Coburn[SUP] 15 [/SUP], M J Fagerlund[SUP] 16 [/SUP], S N Myatra[SUP] 17 [/SUP], P S Myles[SUP] 18 [/SUP], E O'Sullivan[SUP] 19 [/SUP], L Pasin[SUP] 20 [/SUP], F Shamim[SUP] 21 [/SUP], W A van Klei[SUP] 22 [/SUP], I Ahmad[SUP] 1 2 [/SUP]
Affiliations
Abstract
Healthcare workers involved in aerosol-generating procedures, such as tracheal intubation, may be at elevated risk of acquiring COVID-19. However, the magnitude of this risk is unknown. We conducted a prospective international multicentre cohort study recruiting healthcare workers participating in tracheal intubation of patients with suspected or confirmed COVID-19. Information on tracheal intubation episodes, personal protective equipment use, and subsequent provider health status was collected via self-reporting. The primary endpoint was the incidence of laboratory-confirmed COVID-19 diagnosis or new symptoms requiring self-isolation or hospitalisation after a tracheal intubation episode. Cox regression analysis examined associations between the primary endpoint and healthcare worker characteristics, procedure-related factors, and personal protective equipment use. Between 23 March and 2 June 2020, 1718 healthcare workers from 503 hospitals in 17 countries reported 5148 tracheal intubation episodes. The overall incidence of the primary endpoint was 10.7% over a median (IQR [range]) follow-up of 32 (18-48 [0-116]) days. The cumulative incidence within 7, 14 and 21 days of the first tracheal intubation episode was 3.6%, 6.1%, and 8.5%, respectively. The risk of the primary endpoint varied by country and was higher in females, but was not associated with other factors. Around 1 in 10 healthcare workers involved in tracheal intubation of patients with suspected or confirmed COVID-19 subsequently reported a COVID-19 outcome. This has human resource implications for institutional capacity to deliver essential healthcare services, and wider societal implications for COVID-19 transmission.
Keywords: COVID-19; airway; coronavirus; healthcare workers; intubation.
. 2020 Jun 9.
doi: 10.1111/anae.15170. Online ahead of print.
Risks to Healthcare Workers Following Tracheal Intubation of Patients With COVID-19: A Prospective International Multicentre Cohort Study
K El-Boghdadly[SUP] 1 2 [/SUP], D J N Wong[SUP] 3 [/SUP], R Owen[SUP] 4 [/SUP], M D Neuman[SUP] 5 [/SUP], S Pocock[SUP] 6 [/SUP], J B Carlisle[SUP] 7 [/SUP], C Johnstone[SUP] 1 [/SUP], P Andruszkiewicz[SUP] 8 [/SUP], P A Baker[SUP] 9 [/SUP], B M Biccard[SUP] 10 [/SUP], G L Bryson[SUP] 11 [/SUP], M T V Chan[SUP] 12 [/SUP], M H Cheng[SUP] 13 [/SUP], K J Chin[SUP] 14 [/SUP], M Coburn[SUP] 15 [/SUP], M J Fagerlund[SUP] 16 [/SUP], S N Myatra[SUP] 17 [/SUP], P S Myles[SUP] 18 [/SUP], E O'Sullivan[SUP] 19 [/SUP], L Pasin[SUP] 20 [/SUP], F Shamim[SUP] 21 [/SUP], W A van Klei[SUP] 22 [/SUP], I Ahmad[SUP] 1 2 [/SUP]
Affiliations
- PMID: 32516833
- DOI: 10.1111/anae.15170
Abstract
Healthcare workers involved in aerosol-generating procedures, such as tracheal intubation, may be at elevated risk of acquiring COVID-19. However, the magnitude of this risk is unknown. We conducted a prospective international multicentre cohort study recruiting healthcare workers participating in tracheal intubation of patients with suspected or confirmed COVID-19. Information on tracheal intubation episodes, personal protective equipment use, and subsequent provider health status was collected via self-reporting. The primary endpoint was the incidence of laboratory-confirmed COVID-19 diagnosis or new symptoms requiring self-isolation or hospitalisation after a tracheal intubation episode. Cox regression analysis examined associations between the primary endpoint and healthcare worker characteristics, procedure-related factors, and personal protective equipment use. Between 23 March and 2 June 2020, 1718 healthcare workers from 503 hospitals in 17 countries reported 5148 tracheal intubation episodes. The overall incidence of the primary endpoint was 10.7% over a median (IQR [range]) follow-up of 32 (18-48 [0-116]) days. The cumulative incidence within 7, 14 and 21 days of the first tracheal intubation episode was 3.6%, 6.1%, and 8.5%, respectively. The risk of the primary endpoint varied by country and was higher in females, but was not associated with other factors. Around 1 in 10 healthcare workers involved in tracheal intubation of patients with suspected or confirmed COVID-19 subsequently reported a COVID-19 outcome. This has human resource implications for institutional capacity to deliver essential healthcare services, and wider societal implications for COVID-19 transmission.
Keywords: COVID-19; airway; coronavirus; healthcare workers; intubation.