Occupational risk factors for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection among healthcare personnel: A cross-sectional analysis of subjects enrolled in the COVID-19 Prevention in Emory Healthcare Personnel (COPE) study

Howard‐Anderson, Jessica; Adams, Carly; Sherman, Amy C; Dube, William C; Smith, Teresa; Edupuganti, Neena; Chea, Nora; Magill, Shelley S.; Espinoza, Daniel; Zhu, Yerun; Phadke, Varun K; Edupuganti, Srilatha; Steinberg, James P.; Lopman, Benjamin A.; Jacob, Jesse T; Collins, Matthew H.; Fridkin, Scott K.

doi:10.1017/ice.2021.54

Cited by 13 publications

(20 citation statements)

References 12 publications

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“…SARS-CoV-2 seroprevalence was determined by RBD ELISA in a cohort of healthcare personnel (HCP) in Atlanta, GA, following baseline enrollment that occurred from May 5 to June 12, 2020. This result of 23/353 RBD ELISA positive [6.5% seroprevalence)] was previously reported ( 16 ). The distribution of NR values is shown in Figure 2A .…”

Section: Resultssupporting

confidence: 87%

“…“Surveillance” specimens were obtained and allocated for research use as part of a longitudinal surveillance cohort study of healthcare personnel (The COVID-19 Prevention in Emory Healthcare Personnel (COPE) Study, Emory IRB# 00000505). Baseline enrollment for this study was open May 1, 2020, and completed June 12, 2020 ( 16 ). Subjects were healthy at time of enrollment and donated serum and saliva.…”

Section: Methodsmentioning

confidence: 99%

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Application of SARS-CoV-2 Serology to Address Public Health Priorities

Sherman

Smith

Zhu

et al. 2021

Front. Public Health

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Background: Antibodies against SARS-CoV-2 can be detected by various testing platforms, but a detailed understanding of assay performance is critical.Methods: We developed and validated a simple enzyme-linked immunosorbent assay (ELISA) to detect IgG binding to the receptor-binding domain (RBD) of SARS-CoV-2, which was then applied for surveillance. ELISA results were compared to a set of complimentary serologic assays using a large panel of clinical research samples.Results: The RBD ELISA exhibited robust performance in ROC curve analysis (AUC> 0.99; Se = 89%, Sp = 99.3%). Antibodies were detected in 23/353 (6.5%) healthcare workers, 6/9 RT-PCR-confirmed mild COVID-19 cases, and 0/30 non-COVID-19 cases from an ambulatory site. RBD ELISA showed a positive correlation with neutralizing activity (p = <0.0001, R2 = 0.26).Conclusions: We applied a validated SARS-CoV-2-specific IgG ELISA in multiple contexts and performed orthogonal testing on samples. This study demonstrates the utility of a simple serologic assay for detecting prior SARS-CoV-2 infection, particularly as a tool for efficiently testing large numbers of samples as in population surveillance. Our work also highlights that precise understanding of SARS-CoV-2 infection and immunity at the individual level, particularly with wide availability of vaccination, may be improved by orthogonal testing and/or more complex assays such as multiplex bead assays.

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Section: Resultssupporting

confidence: 87%

Section: Methodsmentioning

confidence: 99%

Application of SARS-CoV-2 Serology to Address Public Health Priorities

Sherman

Smith

Zhu

et al. 2021

Front. Public Health

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“…Although those associations might be biased by unbalanced case and control populations for professions, they might also reflect that nurses and nurse's assistants were engaged in more prolonged and closer patient care than other professions. This higher risk of infection was described for domestic cleaners and porters, but not for nurses and nurse's assistants to our knowledge [5,10,21]. The result associated with the "other profession" category must be interpreted with caution because of the heterogeneity of professions, but numbers were too small to fit a statistical model to each individual profession.…”

Section: Discussionmentioning

confidence: 68%

“…As in the general population, younger male HCWs with comorbidities, in contact with an infected household member or who participated in gathering events are at higher risk for contracting COVID-19 [5][6][7][8]. Specific occupational exposures were identified: regular patientfacing activities and contacts with infected colleagues [2,5,6,9,10]. PPE-conferred protection was mainly studied for Influenza, Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS), but evidence is controversial for COVID-19 [11][12][13].…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 Exposures of Healthcare Workers from Primary Care, Long-Term Care Facilities and Hospitals: A Nationwide Matched Case-Control Study

Belan

Charmet

Schaeffer

et al. 2022

Preprint

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Objectives. Healthcare workers (HCWs) are at higher risk of contracting coronavirus disease 19 (COVID 19) than the general population. This study assessed the roles of various exposures and personal protective equipment (PPE) use on that risk for HCWs working in primary care, long term care facilities (LTCFs) or hospitals. Methods. We conducted a matched case-control (1:1) study (10 April; 9 July 2021). Cases (HCWs with confirmed COVID-19) and controls (HCWs without any COVID 19 positive test or symptoms) recruited by email were invited to complete an online questionnaire on their exposures and PPE use. Questions covered the 10 days preceding symptom onset for cases (or testing if asymptomatic) or inclusion for controls. Results. A total of 4152 matched cases and controls were included. The multivariable conditional logistic regression analysis retained exposure to an infected person outside work (adjusted odds ratio, 19.9 [95% confidence intervaI, 12.4, 31.9]), an infected colleague (2.26 [1.53, 3.33]) or COVID-19 patients (2.37 [1.66, 3.40]), as independent predictors of COVID-19 in HCWs, while partial or complete immunization was protective. Eye protection (0.57 [0.37, 0.87]) and wearing a gown (0.58 [0.34, 0.97]) during COVID-19 patient care were protective, while wearing an apron slightly increased the risk of infection (1.47 [1.00, 2.18]). N95-respirator protection was comparable to that of surgical masks. Results were consistent across healthcare-facility categories. Conclusions. HCWs were more likely to get COVID-19 in their personal sphere than during occupational activities. Our results suggest that eye protection for HCWs during patient care should be actively promoted.

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“…Like in the general population, younger male HCWs with comorbidities, in contact with an infected household member or who participated in gathering events have higher risk for COVID-19 [ [5] , [6] , [7] , [8] ]. Specific occupational exposures were identified in HCWs: regular patient-facing activities and contacts with infected colleagues [ 2 , 5 , 6 , 9 , 10 ]. Protection conferred by PPE was mainly studied for Influenza, Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS), but evidence is controversial for COVID-19 [ [11] , [12] , [13] ].…”

Section: Introductionmentioning

confidence: 99%