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

Galanis, Petros; Vraka, Irène; Fragkou, Despoina; Kaitelidou, Daphne

doi:10.1101/2020.10.23.20218289

Cited by 59 publications

(96 citation statements)

References 103 publications

(276 reference statements)

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“…Our study calculated the pooled seroprevalence of SARS-CoV-2 IgG antibodies among the HCWs 8.6%, which is higher than the general population. Similar meta researches find different seroprevalences in the HCWs, varying from 7% to 11% [15] , [16] , [17] .…”

Section: Discussionsupporting

confidence: 55%

“…The prevalence of such antibodies from a large-scale serosurvey conducted over four collection periods in the US ranged from less than 1% to 23% [13] . To date, three meta-analyses of antibody prevalence among HCWs have been published, and the presence of IgG and/or IgM antibodies has been found to vary between 8% and 17% globally [15] , [16] , [17] . These articles included pre-print articles as well as accounted IgG and/or IgM antibodies.…”

Section: Introductionmentioning

confidence: 99%

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Seroprevalence of SARS-CoV-2 IgG antibodies among health care workers prior to vaccine administration in Europe, the USA and East Asia: A systematic review and meta-analysis

et al. 2021

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Background Knowing the seroprevalence of SARS-CoV-2 IgG antibodies across geographic regions before vaccine administration is one key piece of knowledge to achieve herd immunity. While people of all ages, occupations, and communities are at risk of getting infected with SARS-CoV-2, the health care workers (HCWs) are possibly at the highest risk. Most seroprevalence surveys with HCWs conducted worldwide have been limited to Europe, North America, and East Asia. We aimed to understand how the seroprevalence of SARS-CoV-2 IgG antibodies varied across these geographic regions among HCWs based on the available evidences. Methods By searching through PubMed, ScienceDirect, and Google Scholar databases, eligible studies published from January 1, 2020 to January 15, 2021 were included for the systematic review and meta-analysis. The random-effects model was used to estimate the pooled proportion of IgG seropositive HCWs. Publication bias was assessed by funnel plot and confirmed by Egger's test. Heterogeneity was quantified using I 2 statistics. We performed sensitivity analyses based on sample size, diagnostic method and publication status. The study protocol was registered with PROSPERO (CRD42020219086). Findings A total of 53 peer-reviewed articles were selected, including 173,353 HCWs (32.7% male) from the United States, ten European, and three East Asian countries. The overall seropositive prevalence rate of IgG antibodies was 8.6% in these regions (95% CI= 7.2–9.9%). Pooled seroprevalence of IgG antibodies was higher in studies conducted in the USA (12.4%, 95% CI= 7.8–17%) than in Europe (7.7%, 95% CI=6.3–9.2%) and East Asia (4.8%, 95% CI=2.9–6.7%). The subgroup study also estimated that male HCWs had 9.4% (95% CI= 7.2–11.6%) IgG seroconversion, and female HCWs had 7.8% (95% CI=5.9–9.7%). The study exhibits a high prevalence of IgG antibodies among HCWs under 40 years in the USA, conversely, it was high in older HCWs (≥40 years of age) in Europe and East Asia. In the months February-April 2020, the estimated pooled seroprevalence was 5.7% (4.0–7.4%) that increased to 8·2% (6.2–10%) in April-May and further to 9.9% (6.9–12.9%) in the May-September time-period. Interpretation In the view of all evidence to date, a significant variation in the prevalence of SARS-CoV-2 antibodies in HCWs is observed in regions of Europe, the United States, and East Asia. The patterns of IgG antibodies by time, age, and gender suggest noticeable regional differences in transmission of the virus. Based on the insights driven from the analysis, priority is required for effective vaccination for older HCWs from Europe and East Asia. A considerable high seroprevalence of IgG among HCWs from the USA suggests a high rate of past infection that indicates the need to take adequate measures to prevent hospital spread. Moreover, the seroprevalence trend was not substantially changed after May 2020, suggesting a slow ...

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Section: Discussionsupporting

confidence: 55%

Section: Introductionmentioning

confidence: 99%

Seroprevalence of SARS-CoV-2 IgG antibodies among health care workers prior to vaccine administration in Europe, the USA and East Asia: A systematic review and meta-analysis

et al. 2021

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“…A systematic review of seroprevalence studies suggested high risk of SARS-CoV-2 infection among HCW. 2 In contrast, we observed a very low seropositive rate in the staff of NCGM as of July 2020, which was even lower than that among the general population in Tokyo. In a tertile hospital in the US, rate of SARS-CoV-2 infection among HCW was lower than that among the general public in the surrounding region.…”

contrasting

confidence: 61%

Seroprevalence of antibodies against SARS-CoV-2 in a large national hospital and affiliated facility in Tokyo, Japan

Tanaka

Yamamoto

Miyo

et al. 2021

Journal of Infection

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“…The prevalence of SARS-CoV-2 antibodies among HCWs which are presumed at higher risk for infection, has been increasingly investigated [ 40 ]. In a meta-analysis of 49 studies including 127,480 health care workers overall seroprevalence of SARS-CoV-2 antibodies was 8.7% (95% CI: 6.7-10.9%) [ 41 ]. Major factors driving seropositivity are the type of hospital setting assessed, the job duties and patient contacts of the HCW, and the intensity of the COVID-19 pandemic in the area [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

Immunoglobin G/total antibody testing for SARS-CoV-2: A prospective cohort study of ambulatory patients and health care workers in two Belgian oncology units comparing three commercial tests

Dam

Huizing²,

Roelant

et al. 2021

European Journal of Cancer

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Background Coronavirus disease (COVID-19) is interfering heavily with the screening, diagnosis and treatment of cancer patients. Better knowledge of the seroprevalence and immune response after Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection in this population is important to manage them safely during the pandemic. Methods 922 cancer patients, 100 non-cancer patients and 94 healthcare workers (HCW) attending the Multidisciplinary Oncology Unit of Antwerp University Hospital from 24 th of March 2020 till 31 st of May 2020, and in the Oncology Unit of AZ Maria Middelares Hospital Gent from 13 th of April 2020 till 31 st of May 2020 participated. The Alinity® (A; Abbott) and Liaison® (D; Diasorin) commercially available assays were used to measure SARS-CoV-2 IgG, while total SARS-CoV-2 Ig was measured by Elecsys® (R; Roche) Results In the overall study population IgG/total SARS-CoV-2 antibodies were found in respectively 32/998 (3.2%), 68/1020(6.7%), 37/1010 (3.7%) and of individuals using the A, D or R test. Forty six out of 618 (7.4%) persons had a positive SARS-CoV-2 polymerase chain reaction (RT-PCR) test. Seroprevalence in cancer patients (A:2.2%, D:6.2%, R:3.0%), did not significantly differ from that in non-cancer patients (A:1.1%, D:5.6%, R:0.0%), but was lower than the HCW (A:13%, D:12%, R:12%; respectively Fisher’s exact test p=0.00001, p=0.046, p=0.0004). A positive SARS-CoV-2 RT-PCR was found in 6.8% of the cancer patients, 2.3% of the non-cancer patients and 28.1% of the HCW (Fisher’s exact test p=0.0004). Correlation between absolute value of the different Ig tests was poor in the cancer population. Dichotomizing a positive versus negative test result, the A and R test correlated well (kappa 0.82 p McNemar test=0.344), while A and D, and R and D did not (respectively kappa 0.49 and 0.57; result significantly different p McNemar test=<0.0001 for both). The rate of seroconversion (>75%) and median absolute antibody levels (A: 7.0 vs 4.7; D 74.0 vs 26.6, R: 16.34 vs 7.32; all > P Mann Whitney test=0.28) in cancer patients and HCW with a positive RT-PCR at least 7 days earlier did not show any differences. However, none (N=0/4) of the patients with hematological tumors had seroconversion and absolute antibody levels remained much lower compared to patients with solid tumors (R: 0.1 vs 37.6, p 0.003; D 4.1 vs 158, p 0.008) or HCW (all p<0.0001). Conclusion HCW were at high risk to be infected by SARS-CoV-2 during the first wave of the pandemic. Seroprevalence in cancer patients was low in the study period. Although Ig immune response in cancer patients with solid tumors does not differ from healthy volunteers, patients with hematological tumors have a very poor humoral immune response. This has to be taken into account in future vaccination programs in this population. SARS-C...

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

Cited by 59 publications

References 103 publications

Seroprevalence of SARS-CoV-2 IgG antibodies among health care workers prior to vaccine administration in Europe, the USA and East Asia: A systematic review and meta-analysis

Seroprevalence of SARS-CoV-2 IgG antibodies among health care workers prior to vaccine administration in Europe, the USA and East Asia: A systematic review and meta-analysis

Seroprevalence of antibodies against SARS-CoV-2 in a large national hospital and affiliated facility in Tokyo, Japan

Immunoglobin G/total antibody testing for SARS-CoV-2: A prospective cohort study of ambulatory patients and health care workers in two Belgian oncology units comparing three commercial tests

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