Antibody evidence of SARS-CoV-2 infection in healthcare workers in the Bronx

Abstract

The first recorded case of coronavirus disease (COVID-19) in New York City was on March 1, 2020, and by May 5, there were 171,723 confirmed cases with 13,724 confirmed deaths. 1 The Bronx had the highest rates of hospitalization and death related to COVID-19 compared to the other 4 boroughs in New York City. 2 Jacobi Medical Center, one of 11 acute-care facilities in the NYC municipal hospital system, is a 457-bed level 1 trauma center located in the Bronx with 3,225 healthcare workers. We began testing symptomatic employees on March 16 using the nasopharyngeal polymerase chain reaction (PCR) severe acute respiratory coronavirus virus 2 (SARS-CoV-2) test. In the first 6 weeks, we tested 1,264 employees, of whom 302 tested positive (23.9%). Recent reports showed that 12.2% of NYC healthcare workers had a confirmed positive SARS-CoV-2 PCR result. 3 Preliminary data reveal that 19.9% of NYC residents have antibodies to SARS-CoV-2 virus, and 27.6% of Bronx residents have antibodies. Given this high prevalence of antibodies in the Bronx, we predicted that our staff would have higher prevalence of antibodies, especially those staff working in areas of perceived risk, such as the emergency department and critical care areas. Once Abbott Labs (Abbott Park, IL) received the emergency use authorization for antibody testing using the SARS-CoV-2 IgG test, 4 we began a voluntarily testing all employees at our facility. This test has a reported sensitivity of 100% and specificity of 99.6% when performed 2 weeks after symptom onset. 5 Individuals were offered the IgG test as long as they were asymptomatic and had not had COVID-19 symptoms during the prior 2 weeks. A retrospective chart review was performed to answer the following questions:

Seroprevalence of SARS-CoV-2 antibodies and associated factors in healthcare workers: a systematic review and meta-analysis

“…The majority of studies was conducted in Europe (n=31), and then in North America (n=9), Asia (n=6), and Africa (n=3). In particular, nine studies was conducted in USA [ 14 , 15 , 24 , 26 , 27 , 29 , 32 , 34 , 40 ], eight studies in Italy [ 23 , 28 , 30 , 36 , 44 , 45 , 56 , 57 ], seven studies in United Kingdom [ 16 , 17 , 20 , 25 , 33 , 59 , 61 ], five studies in Germany [ 21 , 35 , 42 , 43 , 46 ], four studies in Spain [ 31 , 38 , 49 , 52 ], and three studies in and Japan [ 53 , 58 , 62 ], Belgium [ 18 , 19 , 22 ] and China [ 47 , 48 , 51 ]. Twenty-nine studies did not report the response rate [ [15] , [16] , [17] , 20 , 24 , [26] , [27] , [28] , [29] , [30] , [32] , [33] , [34] , 38 , [40] , [41] , [42] , [43] , 45 , 47 , 48 ,…”

“…Mean age of HCWs ranged from 31.2 [ 51 ] years to 47.9 years [ 57 ], while sample size ranged from 25 [ 40 ] to 40,329 HCWs [ 14 ]. Regarding the study design, 26 studies were cross-sectional studies [ 14 , 15 , 18 , 19 , 21 , [23] , [24] , [25] , [27] , [28] , [29] , [30] , [31] , [32] , [34] , [35] , [36] , [37] , 39 , 44 , 47 , 52 , 54 , 58 , 60 , 61 ], 20 studies were prevalence studies [ 17 , 26 , 33 , 38 , [40] , [41] , [42] , [43] , 45 , 46 , [48] , [49] , [50] , [51] , 53 , 55 , 56 , 57 , 59 , 62 ], and three studies were cohort studies [ 16 , 20 , 22 ]. All studies except one [ 31 ] used a convenience sample, while response rate ranged from 47.7% [ 19 ] to 100% [ 36 , 60 ].…”

“…All studies except one [ 31 ] used a convenience sample, while response rate ranged from 47.7% [ 19 ] to 100% [ 36 , 60 ]. Forty-two studies were conducted in hospitals [ [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , 26 , 27 , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] ], four studies in primary care facilities and hospitals [ 14 , 25 , 28 , 49 ], two studies in primary care facilities [ 35 , 62 ] and one study in cancer centers [ 59 ]. Thirty-five studies were published in journals [ [14] , [15] , [16] , [17] , [18] , [19] , [20] , <...>…”

“…Twenty-seven studies [ 14 , 15 , 18 , 19 , [21] , [22] , [23] , [24] , [25] , [27] , [28] , [29] , [30] , [31] , [32] , [34] , [35] , [36] , [37] , 39 , 44 , 47 , 52 , 54 , 58 , 60 , 61 ] investigated factors associated with SARS-CoV-2 antibodies positivity and 13 studies found associations [ 14 , 18 , [23] , [24] , [25] , 28 , 30 , 32 , 34 , 36 , 39 , 47 , 60 ] ( Table 2 ). Twenty-four studies [ 15 , 19 , [21] , [22] , [23] , [24] , [25] , [27] , [28] , [29] , [30] , [31] , [32] , [34] , [35] , [36] , [37] , 44 , 47 , 52 , 54 , 58 , 60 , 61 ] used univariate analysis, while three studies [ 14 ...…”

“…Results regarding age were controversial since SARS-CoV-2 antibodies positivity was associated with HWCs aged <30 years (OR=1.40, 95% CI=1.22-1.60) [ 39 ], HWCs aged ≥40 years (OR=1.36, 95% CI=1.09-1.60) [ 28 ], and HWCs aged ≥65 years (p<0.001) [ 47 ]. A significantly higher percentage of SARS-CoV-2 antibodies found among African American HCWs (p<0.05) [ 32 ] and Black, Asian, and Hispanic HCWs compared to White participants (OR=2.30, 95% CI=1.71-3.10, p<0.001) [ 24 ].…”