RESUMO
The coronavirus disease 2019 (COVID-19) pandemic has posed a major challenge for protecting health care workers (HCWs) against the infection. Use of personal protective equipment (PPE) in health care workplace is recommended as a high priority. In order to investigate the relationship between PPE use and the number of COVID-19 cases among HCWs, we conducted a molecular epidemiological study among 142 HCWs who were dispatched from Hefei to work in Wuhan and 284 HCWs who remained in Hefei, China; both provided care for patients with COVID-19. Nucleic acid testing and SARS-CoV-2 specific antibody (IgM, IgG, IgA) detection were performed to confirm SARS-CoV-2 infection among those HCWs. We also extracted publicly released data on daily number of COVID-19 cases among HCWs, daily number of HCWs who were dispatched to Hubei province since January 24, and daily production of PPE in China and daily demand and supply of PPE in Hubei province. Our laboratory testing confirmed that none of the 142 HCWs who were dispatched to work in Wuhan and 284 HCWs who remained in Hefei were infected by SARS-CoV-2. Consistent with these findings, as of April 15, 2020, none of the 42,600 HCWs who were successively dispatched to Hubei province since January 24, 2020 was reported to have COVID-19. These HCWs were provided with adequate supply of PPE as committed by their original institutions or provinces. In contrast, during the early phase of COVID-19 epidemic in Hubei province, a substantial shortage of PPE and an increasing number of COVID-19 infection among HCWs were reported. With the continuing increase in domestic production of PPE in China, the PPE supply started to meet and then exceed the demand. This coincided with a subsequent reduction in the number of reported COVID-19 cases among HCWs. In conclusion, our findings indicate that COVID-19 infection among HCWs could be completely prevented. Appropriate and adequate PPE might play a crucial role in protecting HCWs against COVID-19 infection.
RESUMO
Objective To evaluate the prevalence and risk factors of progressive liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD).Methods A total of 2 054 subjects who underwent health check up and were diagnosed as NAFLD in 9 institutions were included in the study.Blood routine and biochemical findings were collected to calculate aspartate aminotransferase-to-platelet ratio index (APRI).Subjects were divided into three groups according to diagnostic threshold of liver fibrosis:APRI ＜0.43 group,APRI 0.43-0.53 group and APRI ≥ 0.54 group.The correlation between APRI and biochemical variables was analyzed,and the risk factors of progressive fibrosis were also analyzed.Results Among 2 054 subjects (male/female 1 598/456) there were 61 cases with APRI ≥ 0.98 (2.97％,progressive fibrosis),318 with APRI ≥0.54 (15.48％),1 475 with APRI ＜ 0.43 (71.81％),261 with APRI 0.43-0.53 (12.71％).Logistic stepwise regression analysis showed that TG (P =0.002,OR =1.095,95％CI:1.033-1.161),2 hPG(P =0.000,OR =1.103,95％ CI:1.058-1.151,BUN(P =0.034,OR =1.215,95 ％ CI:1.014-1.454) were risk factors,and H DL-C (P =0.034,OR =0.353,95 ％ CI:O.135-0.924) was a protective factor for the progression of fibrosis.Conclusion The progressive fibrosis in patients with NAFLD is closely associated to blood glucose and lipid metabolism disorder.