• Anaesthesia · Nov 2020

    Multicenter Study

    Risks to healthcare workers following tracheal intubation of patients with COVID-19: a prospective international multicentre cohort study.

    Within 30 days of their first COVID intubation, 10% of anaesthetists reported positive COVID infection.

    pearl
    • K El-Boghdadly, WongD J NDJNDepartment of Anaesthesia and Perioperative Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK., R Owen, M D Neuman, S Pocock, J B Carlisle, C Johnstone, P Andruszkiewicz, P A Baker, B M Biccard, G L Bryson, ChanM T VMTVThe Chinese University of Hong Kong, Hong Kong., M H Cheng, K J Chin, M Coburn, M Jonsson Fagerlund, S N Myatra, P S Myles, E O'Sullivan, L Pasin, F Shamim, W A van Klei, and I Ahmad.
    • Department of Anaesthesia and Perioperative Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK.
    • Anaesthesia. 2020 Nov 1; 75 (11): 1437-1447.

    AbstractHealthcare 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 women, 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.© 2020 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists.

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    This article appears in the collection: Anaesthesiology, Personal Protective Equipment (PPE) and COVID.

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    Within 30 days of their first COVID intubation, 10% of anaesthetists reported positive COVID infection.

    Daniel Jolley  Daniel Jolley
     
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