key: cord-1013892-q81tul4s authors: Kiefer, Miranda K.; Mckiever, Monique E.; Russo, Jessica R.; Ma’Ayeh, Marwan; Gee, Stephen E.; Smith, Devin D.; Kniss, Douglas A.; Cackovic, Michael; Costantine, Maged M.; Landon, Mark B.; Rood, Kara M. title: Exposure and Seroconversion to SARS-CoV-2 Among Obstetric Healthcare Providers Following a Contained Outbreak date: 2020-06-15 journal: Am J Obstet Gynecol DOI: 10.1016/j.ajog.2020.06.029 sha: b492da45d1efee3f5eddc1b25e2e0864eea67366 doc_id: 1013892 cord_uid: q81tul4s nan Obstetric units are an underestimated hotspot in the pandemic, owing to an asymptomatic 17 population, high patient turnover, integrated workstations, and frequent emergencies requiring 18 response from multiple disciplines and expedient transfer to onsite surgical suites. These factors 19 underscore current advocacy from professional obstetric and anesthesia societies for universal 20 PPE in obstetric units and use of N95 masks during vaginal deliveries of infected patients due to 21 suspected aerosolization during this procedure. 2-3 Therefore, we investigated exposure and 22 seroconversion to SARS-CoV-2 among obstetric HCWs in a tertiary care center. This prospective cohort study investigated SARS-CoV-2 antibody levels in obstetric HCWs at a 25 tertiary hospital with approximately 5,500 deliveries per year. The study included HCWs 26 employed in the inpatient obstetric unit. Written consent was obtained, and blood samples were One-hundred and ten obstetric HCWs completed the survey and blood collection at the two time Table) . Emerging data have identified large asymptomatic cohorts positive for SARS-CoV-2 that are 76 likely responsible for significant community spread. Supply shortages initially limited hospital 77 PPE to patients with suspected COVID-19 infections. As more information became available, 78 our institution was quick to transition to a policy of universal employee screening and masking. Baseline labs were collected before this change in policy and prior to a SARS-CoV-2 outbreak of 80 HCWs within our inpatient obstetric unit. This contributed to the high number of reported 81 exposures in our cohort (82%). Importantly, we found none of our participants to be positive for 82 SARS-CoV-2 by nasopharyngeal PCR beyond the expected incubation period once universal 83 masking was implemented. Our experience is not unique, and our effectiveness in containing the 84 outbreak with these measures is similar to that reported from a maternity ward in Germany. 6 Our study is limited by potential for recall bias on voluntary surveys as well as the novel nature 86 of SARS-CoV-2 antibody testing. Although our cohort is made up entirely of females, we feel 87 this is not a limitation. Obstetrics is female-predominant, and our data is generalizable to this 88 healthcare field. Furthermore, we suspect our experience is not unique, and rather is a 89 representation of underlying trends in labor and delivery units throughout the country. This study 90 is strengthened by a robust sample size and longitudinal design. We recruited and analyzed CDC COVID-19 Response Team. Characteristics of Health Care Personnel with COVID-19 -104 United States American College of Obstetricians and Gynecologists. ACOG Urges Action on PPE and 107 Testing for Labor and Delivery Society for MFM and Society for Obstetric and Anesthesia and Perinatology Delivery COVID-19 Considerations. Society for Maternal Fetal Medicine SOAP_COVID_LD_Considerations_-_revision_4-14-20_-_changes_highlighted.pdf Diagnostic Immunoassay solutions for coronavirus 117 detection Strong associations and moderate 120 predictive value of early symptoms for SARS-CoV-2 test positivity among healthcare workers, 121 the Netherlands Successful containment of COVID-19 outbreak 124 in a large maternity and perinatal center while continuing clinical service Accepted Author Manuscript