Work at inpatient care units is associated with an increased risk of SARS-CoV-2 infection; a cross-sectional study of 8679 healthcare workers in Sweden

Abstract

Background During the Covid-19 pandemic, the protection of healthcare workers has been in focus throughout the world, but the availability and quality of personal protective equipment has at times and in some settings been suboptimal. Materials and methods A total of 8679 healthcare workers and healthcare support staff in the county of Uppsala, north of Stockholm, were included in this cross-sectional study. All subjects were analysed for IgG anti-SARS-CoV-2, and predictors for positive serostatus were analysed in a logistic regression model including demographic parameters and self-reported employment characteristics. Results Overall, 577 (6.6%) were classified as seropositive, with no statistically significant differences between healthcare workers and support staff. Among healthcare workers, age (OR 0.987 per year, 95% CI 0.980–0.995), time to sampling (OR 1.019 per day, 95% CI 1.004–1.035), and employment at an outpatient care unit (OR 0.620, 95% CI 0.487–0.788) were statistically significantly associated with risk of infection. Covid-19 specific units were not at particular risk, compared to other units with comparable characteristics and staff demography. Conclusion Our findings indicate that SARS-CoV-2 transmission is related to inpatient healthcare work, and illustrate the need for a high standard of basic hygiene routines in all inpatient care settings.

Low rate of COVID-19 seroconversion in health-care workers at a Department of Infectious Diseases in Sweden during the later phase of the first wave; a prospective longitudinal seroepidemiological study

“…To our knowledge, this is the first longitudinal seroepidemiological cohort study of frontline HCWs in Sweden. The overall seroconversion of 19% is in line with a crossectional study of 2149 HCWs at Danderyd Hospital, Stockholm, where a 19.1% seroprevalence was found in April-May [9], but higher than the 8.7% IgG seroprevalence found in 1005 nursing home staff in Stockholm in early-mid April [10], the 6.6% noted among 8679 HCWs tested in May-June in a nearby region in Sweden [11], and the reported community seroprevalence of 7.3% in Stockholm at the end of April [12]. Our study is consistent with the growing body of evidence that HCWs caring for COVID-19 patients are at increased risk of contracting the virus [13][14][15][16].…”

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

“… [60] Sweden April Cross-Sectional NA 1005 NA NA NA Moderate Lidstrom et al. [61] Sweden May-June Cross Sectional Chemiluminescent Microparticle Immunoassay 8679 42.0 76.7 25.6 Moderate Madsen et al. [62] USA April Cross Sectional NA 270 NA NA NA High Mansour et al.…”

The seroprevalence of SARS-CoV-2 antibodies among health care workers before the era of vaccination: a systematic review and meta-analysis

“…However, there were conflicting results in the studies we have included. Lidström et al in Sweden [ 25 ], Iversen et al in Denmark [ 13 ], Martin et al [ 26 ], Eyre et al [ 27 ] and Jones et al [ 14 ] in UK have found that age was inversely associated with seropositivity. While their analysis depended on multivariate analysis, a similar statistically significant finding in univariate analysis by Goenka et al [ 12 ] was diminished in the logistic regression model.…”

“…Our systematic review indicates that there has been a significantly increased seroposisitivity rate for HCWs in contact with patients either working in frontline service or COVID-19 unit [ 5 , 22 , 25 , 26 , 28 , 41 ]. For example, Rudberg et al [ 5 ] have shown that patient related work has increased the risk 2.3 times compared to other occupational groups.…”