Puas Yog Lub Qhov Ncauj Kho Mob Puas Zoo Los Tiv Thaiv COVID-19 Raws li N95 Qhov Ncauj?

Hais txog kev kawm

Cov kws tshawb fawb tau xav tias lub ntsej muag phais yuav tsis zoo dua rau N95 lub tshuab ua pa. Nyob rau tam sim no multicenter, uas tsis yog-inferiority RCT, lawv tau tshuaj xyuas 29 lub chaw kho mob hauv Canada, Pakistan, Egypt, thiab Ixayees thaum lub Tsib Hlis 4 2020 thiab 29 Lub Peb Hlis 2022. 1009 HCWs uas tau tso npe hauv txoj kev tshawb fawb tau muab kev saib xyuas ncaj qha rau cov neeg mob COVID{{ 9} }, tau lees paub los ntawm cov ntawv ceeb toom zoo ntawm qhov rov qab transcription-polymerase saw cov tshuaj tiv thaiv (RT-PCR).

Cov neeg koom nrog kev kawm feem ntau yog cov kws saib mob uas tsis tau txhaj tshuaj tiv thaiv; txawm li cas los xij, pab neeg no suav nrog lwm cov HCW tom qab los ua kom cov neeg koom nrog hauv qhov kev sim no. Lawv kuj tau txo lub sij hawm los soj ntsuam los ntawm 12 mus rau 10 lub lis piam kom txo qis kev rov qab los. Tsis tas li ntawd, lawv tau khaws cov neeg koom nrog uas tau txais ib koob tshuaj tiv thaiv COVID-19 ib zaug tom qab tso npe thiab ua raws lawv li ob lub lis piam tom qab lawv thawj koob tshuaj.

Tam sim no RCT nws thiaj li muaj lub sijhawm rov qab los sib txawv thiab siv qhov tsis muaj qhov tsis txaus ntseeg los suav cov kev phom sij (HRs). Qhov tshwj xeeb, cov kws tshawb fawb tau muab tag nrho cov neeg koom nrog sim rau lub ntsej muag kho mob lossis N95 pab pawg ua pa hauv qhov sib piv 1: 1 siv lub khoos phis tawj randomized, ntxiv stratified los ntawm lub koom haum koom hauv permuted blocks ntawm plaub.

Cov neeg koom nrog lawv tus kheej tau tshaj tawm txog qhov uas lawv tau siv lub npog ntsej muag (kev phais lossis N95 lub tshuab ua pa) txhua lub lim tiam. Tsis tas li ntawd, lawv txhua tus tau ua raws li lawv lub koom haum txoj cai hais txog kev pov tseg lub qhov ncauj qhov ntswg. Cov txiaj ntsig tseem ceeb ntawm kev tshawb fawb yog SARS-CoV-2- tau lees paub qhov kev sim RT-PCR txij li hnub ntawm kev sib tw mus txog thaum kawg ntawm kev soj ntsuam. Txawm li cas los xij, pab pawg kuj tau tshawb nrhiav cov pov thawj serological ntawm tus kab mob, xws li mob ua pa nyuaj, mob ntsws, thiab lwm yam.

Pab neeg no kuj tau soj ntsuam cov neeg koom nrog sim kom ua raws li qhov kev cuam tshuam. Txog qhov kawg no, lub chaw sib koom tes tau xaiv 20 feem pua ​​​​ntawm kev hloov pauv ntawm cov chaw kho mob uas koom nrog los saib xyuas cov neeg koom nrog sim. Thaum kawg, cov kws tshawb fawb tau siv tus qauv Cox feem cuam tshuam txog kev phom sij los ntawm cov chaw kho mob los kwv yees HR thiab sib luag ob sab 95 feem pua ​​​​ntawm kev ntseeg siab (CIs).

Tshawb nrhiav pom

Ntawm 1,009 tus neeg koom nrog RCT, pab pawg tau muab 500 tus tib neeg rau lub ntsej muag kho mob thiab N95 pab pawg ua pa. Muaj 268, 34, 187, thiab 520 tus neeg tuaj koom los ntawm Canada, Israel, Pakistan, thiab Egypt, raws li, nrog rau qhov sib npaug thiab yuav luag zoo ib yam hauv txhua lub tebchaws. Txawm li cas los xij, seropositivity ntawm lub hauv paus sib txawv los ntawm lub teb chaws, nrog qhov siab tshaj plaws seropositivity ntawm 81 feem pua ​​​​pom hauv Egypt. Lub sijhawm nruab nrab ntawm kev soj ntsuam yog 9.06 lub lis piam thiab 9.03 lub lis piam hauv pawg kws phais mob thiab pab pawg N95 ua pa, raws li.

RT-PCR-pom paub txog COVID{1}} tau tshwm sim hauv 52/497 thiab 47/507 cov neeg koom nrog hauv pab pawg npog ntsej muag tiv thaiv N95 pab pawg ua pa (10.46 feem pua ​​​​vs. 9.27 feem pua), nrog HR sib npaug rau 1.14. Ob pab pawg tau tshaj tawm 47 thiab 59 (10.8 feem pua ​​​​vs. 13.6 feem pua) cov xwm txheej tsis zoo cuam tshuam txog kev cuam tshuam, raws li.

Lub teb chaws-wise unplaned subgroup tsom xam uncovered tias variable proportions of HCWs are RT-PCR-confirmed COVID-19 positive in ob pawg. Piv txwv li, RT-PCR-confirmed COVID-19 tshwm sim hauv Canada nyob rau hauv 8/131 thiab 3/135 cov tib neeg nyob rau hauv cov pab pawg neeg lub ntsej muag kho mob vs. N95 pab pawg neeg ua pa, raws li, nrog HR{{10 ib.} 83. Qhov xwm txheej ntawm RT-PCR-confirmed COVID{13}} rau Isreal, Pakistan, thiab Egypt yog 6/17 vs. 4/17 (HR, 1.54), 3/92 vs. 2/94 (HR, 1.50), thiab 35/257 vs. 38/261 (HR, 0.95), feem.

Cov lus xaus

Txoj kev tshawb no qhia txog lub teb chaws-theem heterogeneity nyob rau hauv RT-PCR positivity thiab lub hauv paus seropositivity tus nqi. Txawm hais tias qhov sib xyaw CI kwv yees rau kev tiv thaiv RT-PCR-tau lees paub COVID-19 rau lub ntsej muag phais yog nyob rau hauv qhov tsis muaj qhov tsis zoo ntawm ob, cov npoo no tau dav dua piv nrog N95 lub tshuab ua pa. Ib qho kev piav qhia tuaj yeem yog tias thaum txoj kev kawm rau npe kawm hauv Canada tau tshwm sim ntxov thaum muaj kev sib kis, tib yam tau ua tom qab hauv Pakistan thiab Egypt thaum tib neeg twb tau cog lus COVID-19 tsawg kawg ib zaug thiab tau txais tshuaj tiv thaiv.

Tshaj li 50 feem pua ​​​​ntawm cov neeg koom nrog sim tau cuv npe los ntawm tim lyiv teb chaws thaum Omicron tau ncig. Yog li, cov kws tshawb fawb tau sau tseg qhov tsis muaj txiaj ntsig ntawm lub ntsej muag phais cuam tshuam rau N95 lub tshuab ua pa hauv tebchaws Egypt. Ib qho laj thawj tuaj yeem yog qhov kev sib kis hauv zej zog ntau dua hauv tebchaws Iziv tau pom ntau dua ntawm Omicron kab mob cuam tshuam nrog kev siv lub npog ntsej muag tiv thaiv N95 lub tshuab ua pa, qhov kev tshawb pom sib txawv nrog cov kws tshawb fawb tau pom hauv Canada.

Txawm li cas los xij, kev kwv yees ntawm pab pawg hauv teb chaws sib txawv, thiab txawm tias qhov kev kwv yees tag nrho tseem siv tsis tau rau tib lub teb chaws vim muaj kev kho mob heterogeneity. Txawm li cas los xij, txoj kev tshawb fawb no tau taw qhia txog ob zaug qhov phom sij ntawm RT-PCR-pom zoo COVID-19 hauv HCWs muab kev saib xyuas niaj hnub rau cov neeg mob COVID-19 thiab siv lub ntsej muag phais tiv thaiv cov neeg siv N95 lub tshuab ua pa.