key: cord-0697036-7awsvdyq authors: Oygar, Pembe Derin; Büyükçam, Ayşe; Bal, Zümrüt Şahbudak; Dalgıç, Nazan; Bozdemir, Şefika Elmas; Karbuz, Adem; Çetin, Benhur Şirvan; Kara, Yalçın; Çetin, Ceren; Hatipoğlu, Nevin; Uygun, Hatice; Aygün, Fatma Deniz; Törün, Selda Hançerli; Okur, Dicle Şener; Çiftdoğan, Dilek Yılmaz; Kara, Tuğçe Tural; Yahşi, Aysun; Özer, Arife; Demir, Sevliya Öcal; Akkoç, Gülşen; Turan, Cansu; Salı, Enes; Şen, Semra; Erdeniz, Emine Hafize; Kara, Soner Sertan; Emiroğlu, Melike; Erat, Tuğba; Aktürk, Hacer; Gürlevik, Sibel Laçinel; Sütçü, Murat; Aydın, Zeynep Gökçe Gayretli; Atikan, Başak Yıldız; Yeşil, Edanur; Güner, Gizem; Çelebi, Emel; Efe, Kadir; İşançlı, Didem Kızmaz; Durmuş, Habibe Selver; Tekeli, Seher; Karaaslan, Ayşe; Bülbül, Lida; Almış, Habip; Kaba, Özge; Keleş, Yıldız Ekemen; Yazıcıoğlu, Bahadır; Oğuz, Şerife Bahtiyar; Ovalı, Hüsnü Fahri; Doğan, Hazal Helin; Çelebi, Solmaz; Çakır, Deniz; Karasulu, Burcugül; Alkan, Gülsüm; Yenidoğan, İrem; Gül, Doruk; Küçükalioğlu, Burcu Parıltan; Avcu, Gülhadiye; Kukul, Musa Gürel; Bilen, Melis; Yaşar, Belma; Üstün, Tuğba; Kılıç, Ömer; Akın, Yasemin; Cebeci, Sinem Oral; Bucak, Ibrahim Hakan; Yanartaş, Mehpare Sarı; Şahin, Aslıhan; Arslanoğlu, Sertaç; Elevli, Murat; Çoban, Rabia; Öz, Şadiye Kübra Tüter; Hatipoğlu, Halil; Erkum, İlyas Tolga; Turgut, Mehmet; Demirbuğa, Asuman; Özçelik, Taha; Çiftçi, Diclehan; Sarı, Emine Ergül; Akkuş, Gökhan; Hatipoğlu, Sadık Sami; Dinleyici, Ener Çağrı; Hacımustafaoğlu, Mustafa; Özkınay, Ferda; Kurugöl, Zafer; Cengiz, Ali Bülent; Somer, Ayper; Tezer, Hasan; Kara, Ateş title: SARS-CoV-2 seropositivity among pediatric health care personnel just after the first peak of pandemic: A nationwide surveillance date: 2021-09-27 journal: Int J Infect Dis DOI: 10.1016/j.ijid.2021.09.054 sha: 795dbe7b6ab2d17a17aeea58d1320de9bfa6ccbf doc_id: 697036 cord_uid: 7awsvdyq Background COVID-19 pandemic affected every single person on earth one way or the other. The healthcare personnel were no exception, their responsibilities as well as their risks being immense. Methods 4927 healthcare personnel all working in pediatric units at 32 hospitals from seven different regions of Turkey enrolled to the study to determine the seroprevalence of SARS Co-V-2 after the first peak wave. Point of care serologic lateral flow rapid test kit for IgM/IgG was used (Ecotest CE Assure Tech. Co. Ltd.). Seroprevalence and its association with demographic characteristics and possible risk factors were analyzed. Results Nearly 6.1% of healthcare personnel were found to be seropositive for SARS Co-V- 2. Seropositivity was more common among those who did not universally wear protective masks (10.6% vs 6.1%). Having a COVID-19 co-worker increased the likelihood of infection. The least and the most experienced personnel affected more. Most of the seropositive healthcare personnel (68%) did not have any suspicion that they had COVID-19 previously. Conclusions Health surveillance for healthcare personnel involving routine point-of-care nucleic acid testing as well as monitoring PPE adherence would be important strategies to protect healthcare personnel from COVID-19 and to reduce nosocomial SARS-CoV-2 transmission. 1 Highlights:  The seropositivity for SARS-CoV-2 is found to be 6.1% among healthcare personnel.  Most of them were healthy young adults.  Surveillance for healthcare personnel should involve routine nucleic acid testing.  Monitoring PPE adherence is important for protection from COVID-19. Being the least and the most experienced in profession seemed to affect seroconversion, the ones in their first five to ten years of profession were tested positive for SARS-CoV-2 antibodies with the highest positivity rate (6.5%) followed by the ones with more than 20 years in profession (6.2%).Seropositivity for those in their one to five years of profession was still high (6.2%) only decreasing for 10-20 years interval (5.4%) (Figure1). Where people work in terms of regions of the country also showed variations in terms of seropositivity. The most seropositivity prevalence being in South East Anatolia followed by Marmara region. Aegean and Mediterranean regions being the least prevalent regions for SARS-CoV-2 antibody formation among health care personnel (Figure 2 ). Among 4927 healthcare personnel from 32 centers distributed throughout seven regions in Turkey with mild to moderate local SARS-CoV-2 activity, 299 (6.1%) of them tested seropositive for SARS-CoV-2 69 days after the first national COVID-19 case was reported and 30 days after the peak wave of 5234 new cases per day were diagnosed (figure2). Only 38% of the healthcare personnel who had antibodies detected reported any symptoms consistent with SARS -CoV-2 or believed they previously had COVID-19. The percentage of asymptomatic SARS-CoV-2 infected people is estimated to be around 40-45% (Oran et al., 2020; CDC c, 2020). Our study revealed a higher percentage of asymptomatic healthcare personnel. It is a possibility that healthcare personnel might have underestimated mild symptoms or attributed them to tiredness. Only 1527 ( 31%) healthcare personnel had prior PCR testing for SARS-CoV-2, all either symptomatic or with an unprotected close contact history with a confirmed COVID-19 case. Only 23.2% of PCR positive participants had antibodies against SARS-CoV-2. A further 24.9% who were previously reported to be PCR negative were also found to be seropositive. It is suggested that healthcare providers should be tested regularly with serological test and swabs and symptom monitoring in order to protect healthcare workers from the disease as well as preventing nosocomial transmission (Chirico et al., 2021) . Our study showed that healthcare personnel with five to ten years of experience and more than 20 years of experience had similar seropositivity for SARS -CoV-2 while there was a tendency among the inexperienced ones to be tested positive. This could be because although working hours were the same, the most inexperienced ones usually work more and possibly have longer durations of contact with the patients. The reason behind the high seropositivity among the healthcare personnel with more than 20 years of experience could be due to a false sense of overconfidence gained over years leading to a laxity in self-protection. In our study the place where healthcare personnel worked in terms of clean or contaminated areas or number of working days were not related with seropositivity. Hence inexperience and over experience seemed to be risk factors by themselves. Widespread health surveillance of healthcare personnel could be considered as a strategy to protect and prevent transmission. Conducting health surveillance programs with the intervention of occupational health professionals in the hospital setting could prevent both workers and patients from getting sick (Chirico, Magnavita b, 2020) . We should develop strategies for educating the less experienced and warning the most experienced healthcare personnel on self-protection as well as conducting health care surveillance programs among healthcare workers in the hospital setting in order to prevent both workers and patients from getting sick. Although it was not statistically meaningful (p= 0.024) the ones who did not universally wear a mask, surgical or PPE, are tested positive for SARS-CoV-2 antibodies more frequently. Wearing a face shield affected seropositivity as well, those not wearing face shields were tested positive more than those who did. Colleagues rather than household contact led to infection more frequently among those who were tested positive for SARS-CoV-2 antibodies. One of the limitations of the study is that we did not ask the prior PCR timing. Most healthcare personnel with PCR positivity were seronegative. Either these people did not develop antibodies at all, or the antibodies declined to levels where the test kit we used could not measure or declined completely (Patel et al., 2020) . In our study 6.1% of healthcare personnel had SARS-CoV-2 antibodies within three to four months of COVID-19 being reported nationally . The majority with positive serology tests did not suspect that they had been infected nor had been tested for SARS-CoV-2 with PCR. In conclusion our study results suggest developing health surveillance strategies for healthcare personnel involving routine point-of-care nucleic acid testing as well as monitoring PPE adherence would be important strategies to protect healthcare personnel from COVID-19 and to reduce nosocomial SARS-CoV-2 transmission. The promise and peril of antibody testing for COVID-19 Centers for Disease Control and Prevention guidelines for testing COVID-19 Response Team. 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Workplace Health & Safety. 2021 (b) Epidemiology of and risk factors for coronavirus infection in health care workers Epidemiology of COVID-19 among children in China Knowledge and practice of physicians during COVID-19 pandemic: a cross-sectional study in Lebanon Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia Death from Covid-19 of 23 Health Care Workers in China Prevalence of Asymptomatic SARS-CoV-2 Infection Over 60 Days Among Health Care Personnel in Nashville Risk factors of healthcare workers with corona virus disease 2019: a retrospective cohort study in a designated hospital of Wuhan in China Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention Conflict of interest: All contributing authors declare no conflict of interest.The study is not funded by any organization.The study is approved by Hacettepe University Ethics Committee (Approval No: 2020/11-57).