Новая коронавирусная инфекция профессионального генеза у медицинских работников Республики Татарстан

Abstract

The purpose — to conduct a clinical, epidemiological and expert analysis of occupational cases of new coronavirus infection (NCVI) in medical workers (MW) of the Republic of Tatarstan. Material and methods. On the basis of the Republic Center for Occupational Pathology (RCPP), a retrospective analysis of the medical documentation was conducted (n = 47, 40 fatal cases, 7 complicated COVID-19 without fatal outcome, from April 2020 to August 2023). Results. The study group of MW with NCVI (n = 47) consisted mainly of women — 30 (63.8%), median age 58 (50; 64) years. Doctors of various specialties (20/42.5%) and nurses – 16 (34%) prevailed in the structure of positions of MW with NCVI. According to the vaccination history, only 12 (25.5%) MW were vaccinated. Comorbid is eases were detected in 43 (91.5%) patients. At the time of hospitalization, the leading clinical syndromes were infectious-toxic and respiratory. The diagnosis was verified in 46 (97.9%) MW by PCR when SARS-CoV2 RNA was detected in an oropharyngeal smear. Against the background of the disease severity, 40 (85.1%) MW had a fatal outcome, 7 (14.9%) had a complicated course with outcome in pneumofibrosis or sensor-neural hearing loss. Upon examination of the NCVI cases connection with the occupation, 40 (85.1%) were diagnosed with occupational disease (PD). according to Article 8 of Federal Law No. 125-FZ of 07/24/1998, various types of insurance and a one-time insurance were provided to medical workers and their family members (in case of the MW death), if the connection of the NCVI with the occupation was established. Conclusion. Connection of the NCVI with the occupation was established in 40 (85.1%) out of 47 medical workers (33 cases with a fatal outcome; 7 cases of a complicated COVID-19). The development of complicated and lethal forms of COVID-19 was registered in medical workers aged over 45 years old with unfavorable premorbid, including in vaccinated individuals with multiple comorbidity. Pre-contact immunoprophylaxis is still in demand in middle and older age groups, and in occupational risk groups. At the present stage, timely specific diagnosis of NCVI and the appointment of effective etiotropic and proactive pathogenetic therapy remain relevant.