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      Una visión global de la pandemia por SARS-COV-2 en la población laboral del Servicio Navarro de Salud-Osasunbidea Translated title: Global view of the SARS-COV-2 pandemic in the working population of the Navarran Health Service-Osasunbidea

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          Abstract

          RESUMEN. Objetivos: El SARS-CoV-2 tuvo gran impacto entre los profesionales del ámbito sanitario. El presente estudio pretende describir los acontecimientos más relevantes experimentados por los profesionales del Servicio Navarro de Salud-Osasunbidea, relacionados con infecciones, reinfecciones, vacunación y contingencias profesionales durante la pandémicas. Material y Métodos: Estudio transversal descriptivo que engloba el periodo entre el 04 de marzo de 2020 y el 30 de septiembre del 2022. Los datos se obtuvieron de la aplicación informática Rastrea® y del Registro Poblacional de vacunas INMUNIS®. Los resultados se agruparon según edad y puesto de trabajo. Se estimaron el impacto vacunal y las contingencias profesionales mediante modelos estadísticos. Resultados: El total de infecciones estudiadas fue de 9692: un 88,17% de profesionales padecieron una infección; el 11,32% dos y solo el 0,49% tres infecciones. El impacto de la intervención vacunal fue importante durante la cuarta y quinta onda pandémica y disminuyó a partir de la sexta. Un 99,5% (0,97-1,01) cuarta, un 97,3% (0,95-0,99) quinta, bajando al 72,8% (0,71-0,74) durante la sexta y 81,6% (0,79-0,83) y 84,7% (0,83-0,86) durante la sexta A y B respectivamente (efectividad directa con IC95%). Conclusiones: La sexta onda tuvo gran impacto en los sanitarios. Los profesionales con mayor proximidad en atención al paciente experimentaron mayor tasa de infecciones y reinfecciones (enfermeras y médicos). La edad fue una variable asociada a mayor prevalencia de infección en grupos de edad menores. El mayor número de infecciones y reinfecciones correspondió al ámbito hospitalario. Debido a la intervención vacunal, casi no se observó cuarta onda en el ámbito laboral sanitario.

          Translated abstract

          ABSTRACT Objectives: The pandemic caused by the biological agent SARS-CoV-2 had a great impact among the working population in the health field. This study aims to describe the most relevant events experienced by the professionals of the Navarro Health Service-Osasunbidea, related to infections, reinfections, vaccination and professional contingencies, throughout the pandemic waves. Material and Methods: Descriptive cross-sectional study that encompasses the period between March 4, 2020 to September 30, 2022. The data was obtained from the computer application for registration and monitoring of cases RASTREA® and of the Population Vaccine Registry INMUNIS®. The results were grouped and presented according to age range and job position. The vaccination impact and professional contingencies were estimated using statistical models. Results: The total number of infections studied was 9,692: 88.17% professionals suffered a single infection; 11.32% were reinfected for the second time and only 0.49% professionals registered three infections. The impact of the vaccination intervention was significant during the fourth and fifth pandemic waves and decreased after the sixth. 99.5% (0.97-1.01) fourth, 97.3% (0.95-0.99) fifth, dropping to 72.8% (0.71-0.74) during the sixth and 81.6% (0.79-0.83) and 84.7% (0.83-0.86) during the sixth A and B respectively (direct effectiveness with 95%CI). Conclusions: The sixth wave of the pandemic had a great impact on health workers. The professionals with greater proximity in patient care experienced a higher rate of infections and reinfections of doctors and nurses. Age was a variable associated with a higher prevalence of infection in younger age groups. The highest number of infections and reinfections corresponded to hospital setting. Due to the vaccination intervention, almost no fourth wave was observed in the healthcare workplace.

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          Emergence of a SARS-CoV-2 variant of concern with mutations in spike glycoprotein

          Continued uncontrolled transmission of SARS-CoV-2 in many parts of the world is creating conditions for substantial evolutionary changes to the virus1,2. Here we describe a newly arisen lineage of SARS-CoV-2 (designated 501Y.V2; also known as B.1.351 or 20H) that is defined by eight mutations in the spike protein, including three substitutions (K417N, E484K and N501Y) at residues in its receptor-binding domain that may have functional importance3-5. This lineage was identified in South Africa after the first wave of the epidemic in a severely affected metropolitan area (Nelson Mandela Bay) that is located on the coast of the Eastern Cape province. This lineage spread rapidly, and became dominant in Eastern Cape, Western Cape and KwaZulu-Natal provinces within weeks. Although the full import of the mutations is yet to be determined, the genomic data-which show rapid expansion and displacement of other lineages in several regions-suggest that this lineage is associated with a selection advantage that most plausibly results from increased transmissibility or immune escape6-8.
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            SARS-CoV-2 infection rates of antibody-positive compared with antibody-negative health-care workers in England: a large, multicentre, prospective cohort study (SIREN)

            Background Increased understanding of whether individuals who have recovered from COVID-19 are protected from future SARS-CoV-2 infection is an urgent requirement. We aimed to investigate whether antibodies against SARS-CoV-2 were associated with a decreased risk of symptomatic and asymptomatic reinfection. Methods A large, multicentre, prospective cohort study was done, with participants recruited from publicly funded hospitals in all regions of England. All health-care workers, support staff, and administrative staff working at hospitals who could remain engaged in follow-up for 12 months were eligible to join The SARS-CoV-2 Immunity and Reinfection Evaluation study. Participants were excluded if they had no PCR tests after enrolment, enrolled after Dec 31, 2020, or had insufficient PCR and antibody data for cohort assignment. Participants attended regular SARS-CoV-2 PCR and antibody testing (every 2–4 weeks) and completed questionnaires every 2 weeks on symptoms and exposures. At enrolment, participants were assigned to either the positive cohort (antibody positive, or previous positive PCR or antibody test) or negative cohort (antibody negative, no previous positive PCR or antibody test). The primary outcome was a reinfection in the positive cohort or a primary infection in the negative cohort, determined by PCR tests. Potential reinfections were clinically reviewed and classified according to case definitions (confirmed, probable, or possible) and symptom-status, depending on the hierarchy of evidence. Primary infections in the negative cohort were defined as a first positive PCR test and seroconversions were excluded when not associated with a positive PCR test. A proportional hazards frailty model using a Poisson distribution was used to estimate incidence rate ratios (IRR) to compare infection rates in the two cohorts. Findings From June 18, 2020, to Dec 31, 2020, 30 625 participants were enrolled into the study. 51 participants withdrew from the study, 4913 were excluded, and 25 661 participants (with linked data on antibody and PCR testing) were included in the analysis. Data were extracted from all sources on Feb 5, 2021, and include data up to and including Jan 11, 2021. 155 infections were detected in the baseline positive cohort of 8278 participants, collectively contributing 2 047 113 person-days of follow-up. This compares with 1704 new PCR positive infections in the negative cohort of 17 383 participants, contributing 2 971 436 person-days of follow-up. The incidence density was 7·6 reinfections per 100 000 person-days in the positive cohort, compared with 57·3 primary infections per 100 000 person-days in the negative cohort, between June, 2020, and January, 2021. The adjusted IRR was 0·159 for all reinfections (95% CI 0·13–0·19) compared with PCR-confirmed primary infections. The median interval between primary infection and reinfection was more than 200 days. Interpretation A previous history of SARS-CoV-2 infection was associated with an 84% lower risk of infection, with median protective effect observed 7 months following primary infection. This time period is the minimum probable effect because seroconversions were not included. This study shows that previous infection with SARS-CoV-2 induces effective immunity to future infections in most individuals. Funding Department of Health and Social Care of the UK Government, Public Health England, The National Institute for Health Research, with contributions from the Scottish, Welsh and Northern Irish governments.
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              El nuevo Coronavirus y la pandemia del Covid-19

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                Author and article information

                Journal
                medtra
                Revista de la Asociación Española de Especialistas en Medicina del Trabajo
                Rev Asoc Esp Espec Med Trab
                Asociación Española de Especialistas en Medicina del Trabajo (Madrid, Madrid, Spain )
                1132-6255
                3020-1160
                2023
                : 32
                : 2
                : 117-130
                Affiliations
                [1] Pamplona orgnameServicio Navarro de Salud-Osasunbidea orgdiv1Servicio de Prevención de Riesgos Laborales Spain
                [3] Pamplona orgnameServicio Navarro de Salud-Osasunbidea orgdiv1Servicio de Prevención de Riesgos Laborales Spain
                [4] Pamplona orgnameServicio Navarro de Salud-Osasunbidea orgdiv1Servicio de Prevención de Riesgos Laborales Spain
                [6] Pamplona orgnameServicio Navarro de Salud-Osasunbidea orgdiv1Servicio de Prevención de Riesgos Laborales Spain
                [7] Pamplona orgnameServicio Navarro de Salud-Osasunbidea Spain
                [5] Pamplona orgnameServicio Navarro de Salud-Osasunbidea orgdiv1Servicio de Prevención de Riesgos Laborales Spain
                [2] Pamplona orgnameServicio Navarro de Salud-Osasunbidea orgdiv1Servicio de Prevención de Riesgos Laborales Spain
                Article
                S3020-11602023000200004 S3020-1160(23)03200200004
                ca56afb8-ff7b-422a-b12e-f4640ae8f554

                This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

                History
                : 17 February 2023
                : 27 July 2023
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 35, Pages: 14
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                SciELO Spain

                Categories
                Textos Originales

                vaccine,COVID-19,reinfección,vacuna,personal de la salud,determinación de contingencia,estudio transversal,reinfection,cross-sectional study,contingency determination,health workers

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