Seroprevalence of antibodies against SARS-CoV-2 among health care workers in a large Spanish reference hospital

García‐Basteiro, Alberto L.; Moncunill, Gemma; Tortajada, Marta; Vidal, Marta; Guinovart, Caterina; Jiménez, Alfons; Santano, Rebeca; Sanz, Sergi; Méndez, Susana; Llupià, Anna; Aguilar, Ruth; Alonso, Selena; Barrios, Diana; Carolis, Carlo; Cisteró, Pau; Chóliz, Eugenia; Cruz, Angeline; Fochs, Sílvia; Jairoce, Chenjerai; Hecht, Jochen; Lamoglia, Montserrat; Martínez, Mikel J; Mitchell, Robert A.; Ortega, Natalia; Pey, Núria; Puyol, Laura; Ribes, Marta; Rosell, Neus; Sotomayor, Patricia; Torres, Sara; Williams, Sarah; Barroso, Sónia; Vilella, Anna; Muñóz, José; Trilla, Antoni; Varela, Pilar; Mayor, Alfredo; Dobaño, Carlota

doi:10.1038/s41467-020-17318-x

Cited by 376 publications

(452 citation statements)

References 35 publications

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“…[23] In a tertiary hospital in Barcelona, 45 (9.3%) out of 578 HCW were seropositive for antibody against SARS-CoV-2. [24] We postulate the discrepancy between our study and others could be multifactorial. First of all, Malaysia had a relatively low COVID-19 incidence compared to these countries during the study period.…”

Section: Discussioncontrasting

confidence: 78%

“…[33][34][35][36] A study from Spain in March 2020 observed no difference in the COVID-19 infection rate of HCW by professional categories and risk of exposure in respective work departments. Other studies in Spain [24] , Italy [23] and Netherlands [37] also suggested the risk to a HCW of contracting COVID-19 infection in a healthcare facility is minimal. Although our study was unable to fully rule out additional risks of COVID-19 infection in a healthcare facility, zero seroprevalence of anti-SARS-CoV-2 antibody among asymptomatic HCW should reassure the public that the risk of being infected by a HCW is very low.…”

Section: Discussionmentioning

confidence: 96%

“…Our study focused only on asymptomatic HCW, but studies from Italy and Spain included both symptomatic HCW and those who were infected with COVID-19 previously. [23,24] The testing method was not standardized across all studies. Any differences between the performances of each testing method can also affect the seroprevalence result.…”

Section: Discussionmentioning

confidence: 99%

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Serology surveillance of anti-SARS-CoV-2 antibodies among asymptomatic healthcare workers in Malaysian healthcare facilities designated for COVID-19 care

Woon

Lee

Chong³

et al. 2020

Preprint

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IntroductionHealthcare workers (HCW) are presumed to be at increased risk of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection due to occupational exposure to infected patients. We aim to determine the prevalence of anti-SARS-CoV-2 antibodies among asymptomatic HCW.MethodsWe prospectively recruited HCW from the National Public Health Laboratory and two COVID-19 designated public hospitals in Klang Valley, Malaysia between April 13th and May 12th, 2020. Quota sampling was applied to ensure adequate representation of the HCW involved in provision of care for patients directly and indirectly. All participants had worked in the respective healthcare facility for at least 30 days prior study enrollment. HCW who were previously confirmed with COVID-19 infection or listed as “patient under investigation” were excluded. A self-administered questionnaire was used to capture sociodemographic information, history of contact with COVID-19 cases within the past month, clinical signs and symptoms and adherence to universal precautions. Blood samples were taken to test for anti-SARS-CoV-2 antibodies by surrogate virus neutralization test.ResultsA total of 400 HCW were recruited, comprising 154 (38.5%) nurses, 103 (25.8%) medical doctors, 47 (11.8%) laboratory technologists and others (23.9%). The mean age was 35±7.8 years, with females predominant (74%). A majority (68.9%) reported direct contact with COVID-19 patients, body fluids of COVID-19 patients and/or contaminated objects and surfaces in the past month within their respective workplaces. Nearly all claimed to adhere to personal protection equipment (PPE) guidelines (97%-100% adherence) and hand hygiene practice (91%-96% adherence). None (95% CI: 0, 0.0095) of the participants had anti-SARS-CoV-2 antibodies detected, despite 135 (33.8%) reporting respiratory symptoms one month prior to study recruitment. One hundred and fifteen (29%) participants claimed to have contact with known COVID-19 persons outside of the workplace.ConclusionOur finding of zero seroprevalence among asymptomatic HCW suggests a low risk of asymptomatic COVID-19 infection in our healthcare setting; which is at expected levels for a country with an incidence of 26 per 100,000. The adequacy of PPE equipment and strict adherence to infection prevention and control measures offers considerable protection during contact with COVID-19 cases and should be ensured to prevent future nosocomial transmission.

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Section: Discussioncontrasting

confidence: 78%

Section: Discussionmentioning

confidence: 96%

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Serology surveillance of anti-SARS-CoV-2 antibodies among asymptomatic healthcare workers in Malaysian healthcare facilities designated for COVID-19 care

Woon

Lee

Chong³

et al. 2020

Preprint

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“…To the best of our knowledge, no studies gather such a population without discriminating by other factors. Therefore, the features included in our cohort are not dissected in population-based wide studies such as those performed in Spain 11 or Switzerland 16 , nor in published studies addressing the seroprevalence against SARS-CoV-2 speci cally in HCWs 12,13,[17][18][19][20] .…”

Section: Discussionmentioning

confidence: 99%

“…In this sense, our data confers to HCWs an IgG seroprevalence of 25.58% (95% IC: 13.52 -41.17). Other studies focused in these professionals reveals rates ranging from 2% 18 , 7.5% 17,20 , 10% [11][12][13] to nearly 20% 19,21 . Our results are in the upper range and backed by recent data from a large cohort of HCWs in a secondary teaching hospital in Madrid province 22 .…”

Section: Discussionmentioning

confidence: 99%

IgG seroprevalence against SARS-CoV-2 in a cohort of 449 non-hospitalized, high-risk exposure individuals.

Martínez¹,

García²,

Salas³

et al. 2020

Preprint

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COVID-19 pandemic caused by SARS-CoV-2 led the Spanish government to impose a national lockdown in an attempt to control the spread of the infection. Mobility restrictions but also the requirement of a medical prescription to gain access to serological testing for COVID-19 were included among the measures. Under this scenario, between April 15th to June 15th, 2020, we performed a seroprevalence observational study including 449 individuals that fulfill prescription requirements: manifesting COVID-19 compatible symptoms, being in contact with a COVID-19 confirmed case or belonging to essential occupations including healthcare workers, firefighters or public safety personnel such as police. Importantly, none of the participants was hospitalized. Altogether, we studied this specific, non-commonly addressed cohort for SARS-CoV-2 seroprevalence, uncovering intrinsic features of great demographic interest. The overall rate of IgG seropositivity was 33.69% (95% CI: 29.27 – 38.21). This seroprevalence was comparable between different occupations performed by the participants. However, contacts with confirmed cases associated positively with IgG+ results, with stronger correlation if being a household member. The number of symptoms also correlated positively with IgG+ prevalence. Ageusia/anosmia, pneumonia and cutaneous manifestations were the top-three symptoms that most strongly associated with IgG+ seroprevalence. However, while pneumonia and cutaneous manifestations were barely present in our cohort, fever, ageusia/anosmia and asthenia were the most frequently symptoms described within IgG+ subjects. Therefore, our data illustrate how specific cohorts display heterogeneous characteristics that should be taken into account when identifying population seroprevalence against SARS-CoV-2 and key defining symptoms for COVID-19.

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Serologic Surveillance and Phylogenetic Analysis of SARS-CoV-2 Infection Among Hospital Health Care Workers

et al. 2021

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IMPORTANCE It is unclear when, where, and by whom health care workers (HCWs) working in hospitals are infected with SARS-CoV-2. OBJECTIVE To determine how often and in what manner nosocomial SARS-CoV-2 infection occurs in HCW groups with varying exposure to patients with COVID-19. DESIGN, SETTING, AND PARTICIPANTS This cohort study comprised 4 weekly measurements of SARS-CoV-2-specific antibodies and collection of questionnaires from March 23 to June 25, 2020, combined with phylogenetic and epidemiologic transmission analyses at 2 university hospitals in the Netherlands. Included individuals were HCWs working in patient care for those with COVID-19, HCWs working in patient care for those without COVID-19, and HCWs not working in patient care. Data were analyzed from August through December 2020. EXPOSURES Varying work-related exposure to patients infected with SARS-CoV-2. MAIN OUTCOMES AND MEASURESThe cumulative incidence of and time to SARS-CoV-2 infection, defined as the presence of SARS-CoV-2-specific antibodies in blood samples, were measured. RESULTSAmong 801 HCWs, there were 439 HCWs working in patient care for those with COVID-19, 164 HCWs working in patient care for those without COVID-19, and 198 HCWs not working in patient care. There were 580 (72.4%) women, and the median (interquartile range) age was 36 (29-50) years. The incidence of SARS-CoV-2 was increased among HCWs working in patient care for those with COVID-19 (54 HCWs [13.2%; 95% CI, 9.9%-16.4%]) compared with HCWs working in patient care for those without COVID-19 (11 HCWs [6.7%; 95% CI, 2.8%-10.5%]; hazard ratio [HR], 2.25; 95% CI, 1.17-4.30) and HCWs not working in patient care (7 HCWs [3.6%; 95% CI, 0.9%-6.1%]; HR, 3.92; 95% CI, 1.79-8.62). Among HCWs caring for patients with COVID-19, SARS-CoV-2 cumulative incidence was increased among HCWs working on COVID-19 wards (32 of 134 HCWs [25.7%; 95% CI, 17.6%-33.1%]) compared with HCWs working on intensive care units (13 of 186 HCWs [7.1%; 95% CI, 3.3%-10.7%]; HR, 3.64; 95% CI, 1.91-6.94), and HCWs working in emergency departments (7 of 102 HCWs [8.0%; 95% CI, 2.5%-13.1%]; HR, 3.29; 95% CI, 1.52-7.14). Epidemiologic data combined with phylogenetic analyses on COVID-19 wards identified 3 potential HCW-to-HCW transmission clusters.No patient-to-HCW transmission clusters could be identified in transmission analyses. CONCLUSIONS AND RELEVANCEThis study found that HCWs working on COVID-19 wards were at increased risk for nosocomial SARS-CoV-2 infection with an important role for HCW-to-HCW (continued) Key Points Question Which hospital health care workers are at increased risk for SARS-CoV-2 infection, and by whom are they infected? Findings In this cohort study of 801 hospital health care workers (HCWs), the risk of getting infected with SARS-CoV-2 was nearly 4-fold higher among HCWs on COVID-19 wards compared with HCWs not in patient care. Combined phylogenetic and epidemiological analyses found no patient-to-HCW transmission but several occurrences of HCW-to-HCW transmission. Meaning These findin...

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Seroprevalence of antibodies against SARS-CoV-2 among health care workers in a large Spanish reference hospital

Cited by 376 publications

References 35 publications

Serology surveillance of anti-SARS-CoV-2 antibodies among asymptomatic healthcare workers in Malaysian healthcare facilities designated for COVID-19 care

Serology surveillance of anti-SARS-CoV-2 antibodies among asymptomatic healthcare workers in Malaysian healthcare facilities designated for COVID-19 care

IgG seroprevalence against SARS-CoV-2 in a cohort of 449 non-hospitalized, high-risk exposure individuals.

Serologic Surveillance and Phylogenetic Analysis of SARS-CoV-2 Infection Among Hospital Health Care Workers

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