Seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection among Veterans Affairs healthcare system employees suggests higher risk of infection when exposed to SARS-CoV-2 outside the work environment

Dimcheff, Derek E.; Schildhouse, Richard J; Hausman, Mark S.; Vincent, Brenda M.; Markovitz, Erica; Chensue, Stephen W.; Deng, Jane C.; McLeod, Melissa; Hagan, Danielle; Russell, Jon W.; Bradley, Suzanne F.

doi:10.1017/ice.2020.1220

Cited by 42 publications

(50 citation statements)

References 13 publications

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“…However, these studies have been conducted within health care systems and not community settings and within varying population densities. 2,3,5 Although, to date, there have not been any widespread SARS-CoV-2 seroprevalence studies completed in North Dakota, one could also compare our findings with those from the nucleic acid test used to detect SARS-CoV-2. As of July 31, 2020, there was a cumulative of 12,319 positive tests for SARS-CoV-2 and a 14-day rolling average positivity rate of 2.74% for North Dakota residents.…”

Section: Discussionmentioning

confidence: 91%

“…A wide range of seroprevalence among frontline health care providers have been reported: 7.6% in Nashville, 36% in New York City, 44% in London, and 4.9% in Michigan. [2][3][4][5] Most studies have found that health care providers have a greater seropositivity than the estimated general population ranging from 2.8% to 6.9%. [6][7][8][9] Community pharmacy personnel, similar to other health care workers, have been deemed essential workers and have continued to serve their patients.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of SARS-CoV-2 antibodies among North Dakota community pharmacy personnel: A seroprevalence survey

Johnson¹,

Vincent²,

Carson³

et al. 2021

Journal of the American Pharmacists Association

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Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the cause of the coronavirus disease 2019 (COVID-19) pandemic, has disrupted much of the health care system. Despite changes in routine practices, community pharmacists have continuously served their patients throughout the pandemic. Frontline health care workers, including community pharmacy personnel, are at risk of becoming infected with SARS-CoV-2. Objective: The purpose of this observational study was to report the prevalence of antibodies to SARS-CoV-2 from a sample of North Dakota community pharmacy personnel. Methods: This observational study was conducted in 2 cities in North Dakota with the highest COVID-19 rates at the time of investigation. Community pharmacy personnel were tested for the presence of the SARS-CoV-2 IgG and IgM antibodies using a rapid antibody test. In addition to antibody testing, participants completed a questionnaire reporting on demographics, previous COVID-19 exposure, previous COVID-19 symptoms, and personal protection equipment (PPE) practices. Results: A total of 247 pharmacy personnel from 29 pharmacies were tested for SARS-CoV-2 antibodies. The timing and use of PPE varied by location. Among the 247 community pharmacy personnel, 14.6% tested positive for IgM, IgG, or both. Survey data revealed a statistically significant association (P < 0.05) between a positive antibody test and direct contact with an individual who tested positive for COVID-19 (odds ratio: 2.65 [95% CI: 1.18e5.95]), but there were no statistically significant effects related to the workplace, including PPE use, personnel role, or the number of hours worked. The self-reported loss of taste or smell was the only significant symptom associated with a positive antibody test (18.91 [3.10e115.59]). Conclusion: Community pharmacy personnel may be at an increased risk for SARS-CoV-2 exposure compared with the general population.

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Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Prevalence of SARS-CoV-2 antibodies among North Dakota community pharmacy personnel: A seroprevalence survey

Johnson¹,

Vincent²,

Carson³

et al. 2021

Journal of the American Pharmacists Association

View full text Add to dashboard Cite

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“…Within HCWs, physicians showed the lowest seroprevalence, compared to nurses and other HCWs, and this finding is consistent with previous studies conducted in Sweden [ 18 ] and Italy [ 55 ], where nurses and healthcare assistants were more likely to test positive. Moreover, no significant differences were revealed according to working area, and this result is more controversial, with studies confirming this finding [ 52 , 58 ] and others that found significant associations between working in COVID-19 wards or having had contact with patients with COVID-19 and HCWs’ seropositivity [ 18 , 59 ]. Taken together, the results of the present study suggest that the occupational risk might be more related to the specific professional practice rather than to the characteristics of the treated patients and to the workplace.…”

Section: Discussionmentioning

confidence: 95%

“…Furthermore, non-urgent surgical procedures have been postponed, and this has resulted in reductions in terms of surgical volume, diagnoses and hospitalizations [ 48 , 49 , 50 , 51 ]. Large differences in seroprevalence have been reported among HCWs, but the comparisons are undermined by the difficulty to distinguish the role of occupational risks to that related to the underlying SARS-CoV-2 infection community prevalence [ 52 ], and this seems to be confirmed by the finding, detected in the present and in previous studies [ 53 , 54 ], that even in the subgroup of HCWs, SARS-CoV-2 antibodies seropositivity is strongly associated to contact with COVID-19 family members/cohabiting rather than with patients and workplace colleagues. The rate of positivity among HCWs found in this study was higher compared to the results of other investigations conducted in Italy among HCWs in hospital settings [ 23 , 55 ], and, interestingly, also compared to that reported in a study conducted in the same area among HCWs working with suspected and confirmed cases of COVID-19 (3.5%) [ 22 ] and in a study conducted in Tuscany (4.1%) [ 56 ]—although during the first wave of the pandemic, when, as expected, it was lower compared to the findings in the geographic areas of Brescia [ 54 ] and Milan [ 57 ] (Lombardy region), where the prevalence of antibodies against SARS-CoV-2 were 8.6% and 14.3%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Seroprevalence of SARS-CoV-2 Antibodies in Adults and Healthcare Workers in Southern Italy

Napolitano

Giuseppe

Montemurro

et al. 2021

IJERPH

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Background: This study was carried out to estimate the seroprevalence of SARS-CoV-2 antibodies in a Southern Italian population. Methods: The study was performed among students and workers of the University of Campania “Luigi Vanvitelli” and the relative Teaching Hospital. Participants were invited to undergo a blood sampling, an interview or to complete a self-administered questionnaire. Results: A total of 140 participants (5.8%) tested positive for SARS-CoV-2 antibodies. Positive SARS-CoV-2 test results increased significantly during the months of testing, and those who had had at least one symptom among fever, cough, dyspnea, loss of taste or smell and who had had contact with a family member/cohabitant with confirmed COVID-19 were more likely to test positive. Faculty members were less likely to have a positive test result compared to the healthcare workers (HCWs). Among HCWs, physicians showed the lowest rate of seroconversion (5.2%) compared to nurses (8.9%) and other categories (10%). Nurses and other HCWs compared to the physicians, those who had had at least one symptom among fever, cough, dyspnea, loss of taste or smell, and who had had contact with a family member/cohabitant with confirmed COVID-19 were more likely to test positive. Conclusions: The results have demonstrated that SARS-CoV-2 infection is rapidly spreading even in Southern Italy and confirm the substantial role of seroprevalence studies for the assessment of SARS-CoV-2 infection circulation and potential for further spreading.

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“… 13–15 However, it contrasts with reports from China and Europe in which no differences were observed when comparing HCW from high-risk areas (involved in close contact with COVID-19 patients) with personnel without direct contact with patients, both in the detection of SARS-CoV-2 infection by PCR 16–19 and by the presence of antibodies. 20 , 21 In this context, we think our methodology is more appropriate to evaluate this point, since we have evaluated the presence of SARS-CoV-2 infection by detecting antibodies (which is more accessible than PCR testing for detecting asymptomatic infection) in all of the employees (avoiding possible selection bias) of a large cohort of participants.…”

Section: Discussionmentioning

confidence: 99%

Seroprevalence of SARS-CoV-2 antibodies in over 6000 healthcare workers in Spain

Varona

Madurga

Peñalver

et al. 2021

International Journal of Epidemiology

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Background: Spain has one of the highest incidences of coronavirus disease 2019 (COVID-19) worldwide, so Spanish health care workers (HCW) are at high risk of exposure. Our objective was to determine severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody seroprevalence amongst HCW and factors associated with seropositivity. Methods: A cross-sectional study evaluating 6190 workers (97.8% of the total workforce of a healthcare-system of 17 hospitals across four regions in Spain) was carried out between April and June 2020, by measuring immunoglobulin G (IgG)-SARS-CoV-2 antibody titres and related clinical data. Exposure risk was categorized as high (clinical environment; prolonged/direct contact with patients), moderate (clinical environment; non-intense/no patient contact) and low (non-clinical environment). Results: A total of 6038 employees (mean age 43.8 years; 71% female) were included in the final analysis. A total of 662 (11.0%) were seropositive for IgG against SARS-CoV-2 (39.4% asymptomatic). Adding available PCR-testing, 713 (11.8%) employees showed evidence of previous SARS-CoV-2 infection. However, before antibody testing, 482 of them (67%) had no previous diagnosis of SARS-CoV-2-infection. Seroprevalence was higher in high- and moderate-risk exposure (12.1 and 11.4%, respectively) compared with low-grade risk subjects (7.2%), and in Madrid (13.8%) compared with Barcelona (7.6%) and Coruña (2.0%). High-risk [odds ratio (OR): 2.06; 95% confidence interval (CI): 1.63–2.62] and moderate-risk (OR: 1.77; 95% CI: 1.32–2.37) exposures were associated with positive IgG-SARS-CoV-2 antibodies after adjusting for region, age and sex. Higher antibody titres were observed in moderate–severe disease (median antibody-titre: 13.7 AU/mL) compared with mild (6.4 AU/mL) and asymptomatic (5.1 AU/mL) infection, and also in older (>60 years: 11.8 AU/mL) compared with younger (<30 years: 4.2 AU/mL) people. Conclusions: Seroprevalence of IgG-SARS-CoV-2 antibodies in HCW is a little higher than in the general population and varies depending on regional COVID-19 incidence. The high rates of subclinical and previously undiagnosed infection observed in this study reinforce the utility of antibody screening. An occupational risk for SARS-CoV-2 infection related to working in a clinical environment was demonstrated in this HCW cohort.

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Seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection among Veterans Affairs healthcare system employees suggests higher risk of infection when exposed to SARS-CoV-2 outside the work environment

Cited by 42 publications

References 13 publications

Prevalence of SARS-CoV-2 antibodies among North Dakota community pharmacy personnel: A seroprevalence survey

Prevalence of SARS-CoV-2 antibodies among North Dakota community pharmacy personnel: A seroprevalence survey

Seroprevalence of SARS-CoV-2 Antibodies in Adults and Healthcare Workers in Southern Italy

Seroprevalence of SARS-CoV-2 antibodies in over 6000 healthcare workers in Spain

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