COVID -19 у медицинских работников (обзор литературы и собственные данные)

Introduction. Health care workers are at risk of infection with the SARS-CoV-2 virus. However, many aspects of the professionally conditioned COVID-19 are still poorly understood. The aim of study is to conduct a brief review and analysis of scientific data on the prevalence, features of clinical and laboratory COVID-19 syndromes in medical professionals. To evaluate the structure of post-COVID syndrome in health care workers who are observed in a large multidisciplinary medical organization that has a center for occupational pathology. To present the current state of the problem of examination of the connection of COVID-19 with the profession and admission to work in conditions of high risk of SARS-CoV-2 infection. Materials and methods. At the first stage, a brief review of the literature on the problem of COVID-19 in health care workers was performed, at the second — a single-center observational prospective study of COVID-19 convalescents. The main group consisted of health care workers (n=203), the comparison group — people who do not have occupational health risks (n=156). The groups were comparable in demographic characteristics. The work experience of the medical staff was 15 (5; 21) years. Of the participants in the main group, 20.2% worked in hospitals, and 79.8% in outpatient institutions. Three of the participants (1.5%) were employees of specialized COVID hospitals. Doctors were 25.6%, secondary medical personnel — 51.7%, junior medical and technical personnel — 22.7%. A severe form of COVID-19 was suffered by 25 (12.3%) people, after the artificial ventilation of the lungs (AVL) — two participants. The observation time is 60 days. Statistical analysis included standard methods of descriptive statistics, determination of relationships by the method of logistic regression. The significance level is p<0.05. Results. Most of the known data on COVID-19 in health care workers is obtained in cross-sectional studies. The possibility of occupational infection has been sufficiently proven. The risk probably depends on the work performed and is higher in conditions of direct contact of medical personnel with adults, potentially infected patients, but not in a specialized hospital. It is possible that the course of COVID-19 in health care workers differs from the general population of patients there is evidence of a greater frequency of weakness and myalgia. Studies of the features of post-COVID syndrome in health care workers in available sources could not be identified. According to the results of their own research, health care workers who had experienced COVID-19 had a higher frequency of central thermoregulation disorders, arrhythmias, heart failure, panic attacks and depression. Conclusions. Health care workers are at risk of COVID-19. Professionally conditioned post-COVID syndrome is characterized by the frequency of violations of the central mechanisms of thermoregulation and arrhythmias. COVID-19 in health care workers meets the definition of occupational disease.