Occupational risk factors for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection among healthcare personnel: A 6-month prospective analysis of the COVID-19 Prevention in Emory Healthcare Personnel (COPE) Study

Abstract

Objective: Determine the incidence of SARS-CoV-2 infection among healthcare personnel (HCP) and assess occupational risks for SARS-CoV-2 infection Design: Prospective cohort of HCP followed for 6-months from May–December 2020 Setting: Large academic healthcare system including four hospitals and affiliated clinics in Atlanta, GA Participants: HCP, including those with and without direct patient care activities, working during the COVID-19 pandemic Methods: Incident SARS-CoV-2 infections were determined through serologic testing for SARS-CoV-2 IgG at enrollment, 3 and 6 months. HCP completed monthly surveys regarding occupational activities. Multivariable logistic regression was used to identify occupational factors that increased the risk of SARS-CoV-2 infection. Results: Of the 304 evaluable HCP that were seronegative at enrollment, 26 (9%) seroconverted for SARS-CoV-2 IgG by 6 months. Participants self-identified predominantly as White (n=219, 73%), nurses (n=119, 40%), and working in inpatient medical/surgical floors (n=121, 40%). In a multivariable analysis, HCP who identified as Black were more likely to seroconvert than HCP who identified as White (odds ratio 4.5, 95% confidence interval 1.3–14.2). Increased risk for SARS-CoV-2 infection was not identified for any occupational activity, including spending >50% of a typical shift at a patient’s bedside, working in COVID-19 units, or performing/being present for aerosol generating procedures (AGPs). Conclusions: In our study cohort of HCP working in an academic healthcare system, <10% had evidence of SARS-CoV-2 infection over six months. No specific occupational activities were identified as increasing risk for SARS-CoV-2 infection.

SARS-CoV-2 Antibody Prevalence among Industrial Livestock Operation Workers and Nearby Community Residents, North Carolina, 2021 to 2022

“…The prevalence of SARS-CoV-2 infection-induced IgG was significantly higher in the ILO group of our study population than two other southern United States cohorts sampled at times overlapping the interview and sampling dates of our study. Infection-induced IgG prevalence was significantly higher in the ILO group of our study population sampled between March 2021 and July 2022 (63%) than the COVID-19 Prevention in Emory Healthcare Personnel (COPE) Study cohort sampled between January and December 2021 (23.2%) using the same salivary multiplex assay (PR, 2.45; 95% CI, 1.80 to 3.33) (M. H. Collins and C. D. Heaney, correspondence) ( 28 , 29 ) ( Fig. 2 ).…”

SARS-CoV-2 antibody prevalence among industrial livestock operation workers and nearby community residents, North Carolina, USA, 2021-2022

“…We found prevalence of SARS-CoV-2 infection-induced IgG higher than in comparable cohorts. Infection-induced IgG prevalence in the ILO group of our study population was more than twice that in Emory University’s COPE cohort of Atlanta healthcare workers sampled from January to December 2021 using the same salivary multiplex assay (M. H. Collins and C. D. Heaney, correspondence) (29, 30) (Figure 2). Healthcare workers are at higher risk for COVID-19 compared to the general population (46, 47).…”

“…The prevalence of SARS-CoV-2 infection-induced IgG was significantly higher in the ILO group of our study population compared to two other southern US cohorts sampled at times overlapping the enrollment and interview dates of our cohort. Infection-induced IgG prevalence was significantly higher in the ILO group of our study population sampled between March 2021 and July 2022 (63%) compared to the COVID-19 Prevention in Emory Healthcare Personnel (COPE) Study cohort sampled between January and December 2021 (23.2%) using the same salivary multiplex assay (PR=2.45, 95% CI: 1.80, 3.33) (M. H. Collins and C. D. Heaney, correspondence) (29, 30) (Figure 2). Infection-induced IgG prevalence was also significantly higher in the ILO group of our study population (63%) compared to the MURDOCK Cabarrus County COVID-19 Prevalence and Immunity (C3PI) Study cohort, representative of Cabarrus County, North Carolina, sampled March and monthly June through November 2021, using blood testing with the Abbot Alinity N IgG assay (5.9% to 9.9%; PR range 6.37 to 10.67) (L. K. Newby and D. Wixted, correspondence) (31).…”

“…Participants were health care providers recruited from 4 university-affiliated hospitals and clinics in Atlanta, Georgia, and saliva samples for serology were collected at enrollment, at 3 months, and at 6 months. Oral fluid saliva samples were tested with the multiplex assay described above, as in our North Carolina study population (19, 20, 29, 30). Monthly seropositivity and N seropositivity data from the Cabarrus County COVID-19 Prevalence and Immunity (C3PI) were also obtained through correspondence (L. K. Newby and D. Wixted, correspondence).…”

“…Participants were health care providers recruited from 4 university-affiliated hospitals and clinics in Atlanta, Georgia, and saliva samples for serology were collected at enrollment, at 3 months, and at 6 months. Oral fluid saliva samples were tested with the multiplex assay described above, as in our North Carolina study population (19,20,29,30).…”