SARS-CoV-2 antigen and antibody prevalence among UK staff working with cancer patients during the COVID-19 pandemic

Abstract

Background International guidelines for testing potentially immunosuppressed cancer patients receiving non-surgical anticancer therapies for SARS-CoV-2 (COVID-19) are currently lacking. The value of routinely testing staff treating cancer patients is not known. Methods: Patient-facing oncology department staff at work during the COVID-19 pandemic consented to have a nasopharyngeal swab SARS-CoV-2 antigen test by polymerase chain reaction (PCR) and blood tests for SARS-CoV-2 antibody using a laboratory Luminex-based assay and a rapid point-of-care (POC) assay on 2 occasions 28 days apart in June and July 2020. Results 434 participants were recruited: nurses (58.3%), doctors (21.2%), radiographers (10.4%) and administrators (10.1%). 82% were female; median age 40-years (range 19-66). 26.3% reported prior symptoms suggestive of SARS-CoV-2 infection and 1.4% tested PCR-positive prior to June 2020. All were PCR-negative at both study day 1 and 28. 18.4% were SARS-CoV-2 sero-positive on day 1 by Luminex, of whom 42.5% also tested positive by POC. 47.5% of Luminex sero-positives had antibodies to both nucleocapsid (N) and surface (S) antigens. Nurses (21.3%) and doctors (17.4%) had higher prevalence trends of Luminex sero-positivity compared with administrators (13.6%) and radiographers (8.9%) (p=0.2). 38% of sero-positive participants reported previous symptoms suggestive of SARS-CoV-2 infection, a 1.9-fold higher odds than sero-negative participants (p=0.01). 400 participants re-tested on day 28: 13.3% were Luminex sero-positive of whom 92.5% were previously positive and 7.5% newly positive. Nurses (16.5%) had the highest seroprevalence trend amongst staff groups (p=0.07). 32.5% of day 1 sero-positives became sero-negative by day 28: the majority being previously reactive to the N-antigen only (p<0.0001). Conclusion The high prevalence of SARS-CoV-2 IgG sero-positivity in oncology nurses, and the high decline of positivity over 4 weeks supports regular antigen and antibody testing in this staff group for SARS-CoV-2 as part of routine patient care prior to availability of a vaccine.

A functional assay for serum detection of antibodies against SARS‐CoV‐2 nucleoprotein

“…Staff from RPH were recruited through staff email over the course of 2 months: 20 April 2020‐10 June 2020, as part of a prospective study to establish seroprevalence and immune correlates of protective immunity to SARS‐CoV‐2 (Ethics Approval: HRA IRAS: 96194 REC: 12/WA/0148). Staff from CUH and QEH were recruited through the COVID‐19 Serology in Oncology Staff (CSOS) study (Favara et al , 2021a; Favara et al , 2021b) with samples collected in June, July and December 2020 (Ethics approval: HRA IRAS: 284231). Samples were screened for SARS‐CoV‐2 N and S binding antibodies by Luminex assay as previously described (Kemp et al , 2021) and selected for further investigation based on selective binding profiles.…”

Anosmia but Not Ageusia as a COVID-19-Related Symptom among Cancer Patients—First Results from the PAPESCO-19 Cohort Study

“…This approach was used by many previous studies [ 11 , 13 , 15 , 25 ]. Participants who did not report any of the 13 symptoms were considered asymptomatic [ 28 , 38 ].…”

“…Studies reporting associations between seroprevalence and self-reported symptoms for healthcare workers (HCWs) found that fever, malaise, and fatigue were especially common alongside anosmia and ageusia [ 25 , 26 ]. However, little is known about HCWs from oncology departments and cancer centers despite the fact that they have been a under major strain during the pandemic [ 27 , 28 ].…”