key: cord-1026653-24gyq3bh
authors: Godbout, Emily J.; Pryor, Rachel; Harmon, Mary; Montpetit, Alison; Greer, Joan; Bachmann, Lorin M.; Doll, Michelle; Stevens, Michael P.; Bearman, Gonzalo
title: Severe acute respiratory coronavirus virus 2 (SARS-CoV-2) seroprevalence among healthcare workers in a low prevalence region
date: 2020-12-14
journal: Infection control and hospital epidemiology
DOI: 10.1017/ice.2020.1374
sha: b48f55f0907a0c52f5066679b56f76375523c33a
doc_id: 1026653
cord_uid: 24gyq3bh

nan

out electronic survey questions about demographic characteristics, role and years of experience, exposure history, and history of symptoms consistent with COVID-19. Participants underwent phlebotomy for serum collection on our clinical research unit. All serum samples were tested at our institution's laboratory utilizing the Abbott Architect SARS-CoV-2 IgG antibody immunoassay (Abbott Molecular, Des Plaines, IL). We used descriptive statistics to describe participants, stratified by SARS-CoV-2 antibody result. We compared groups using the Fisher exact test or χ2 test for categorical variables, and we used the Student t test for continuous variables to identify potential risk factors associated with SARS-CoV-2 seropositivity. We used Research Electronic Data Capture (REDCap) data collection tools hosted at VCU for survey and data collection 8 and SAS version 9.4 software (SAS Institute, Cary NC) to analyze the data. The VCU Institutional Review Board approved this study.

We enrolled 1,962 participants, including 937 nurses (47.8%), 490 physicians (25.0%), 283 other HCWs (14.3%), 141 advanced practice providers (7.2%), 86 care partners (4.4%), and 25 respiratory therapists (1.3%). Among them, 1,360 (69.3%) self-reported providing direct patient care to a patient with COVID-19. We identified 27 participants (1.4%) with detectable SARS-CoV-2 antibodies. Demographics were similar among those with positive serology and negative serology ( Table 1 ). History of symptoms of fever, cough, or shortness of breath since February 2020 were more prevalent in participants with antibodies detected, (44.4% vs 20.5%; P = .002), and those with antibodies detected were more likely to believe that they had previously had COVID-19 (33.3% vs 9.5%; P ≤ .001). There was no difference among HCWs who worked on high-risk units, those with the highest number of COVID-19 patient days, versus low-risk units and clinics (2.1% vs 1.1%; P = .098) or among HCWs who worked on adult versus pediatric units (1.5% vs 2.2%; P = .429).

The seroprevalence of SARS-CoV-2 in HCWs at a large, academic medical center in a low-prevalence region was low (1.4%) and comparable to our community prevalence based on a large serologic survey of 4,685 adult Virginians 7 (1.4% vs 2.4%; P = .011). Thus, our current infection prevention strategies are likely effective at preventing patient to HCW transmission. Most serology-positive participants (55.5%) were asymptomatic, suggesting that HCWs may be an important reservoir for HCWto-HCW transmission in the hospital setting. Serology-positive participants were more likely to believe they had COVID-19 and to have clinical symptoms consistent with COVID-19, yet they infrequently had SARS-CoV-2 PCR testing (14.8%), which highlights the need to continue to address presenteeism in the workplace.

This study has several limitations. It was conducted in a singlecenter setting, with potential for selection bias and exclusion of HCWs who previously tested positive for SARS-CoV-2 via PCR. Testing was offered on a voluntary basis, and HCWs with a lower or higher risk for infection may have been more likely to volunteer. Exclusion of HCWs with a history of a laboratory-confirmed COVID-19 infection may have led to an underestimation of SARS-CoV-2 seroprevalence. Furthermore, the true prevalence may not be captured with serologic testing due to transient antibody response, which has been documented in HCWs, 9 and it is a shared feature with circulating seasonal coronaviruses that are associated with the common cold. The circumstances and unprecedented demands of the pandemic on HCWs is high, and ensuring HCWs are protected from infection is imperative. Our study demonstrates comparable rates of COVID-19 among HCWs and our local community, suggesting that our infection prevention strategies offer protection, including universal droplet mask or face shields, and reservation of N95 masks for patients with COVID-19 with aerosolizing device or procedures. Exposure sources likely expand outside the workplace, and most seropositive HCWs were asymptomatic, potentially serving as reservoirs for transmission in the hospital setting.

Seroprevalence of SARS-CoV-2 among frontline health care personnel in a multistate hospital network-13 academic medical centers

Seroprevalence of SARS-CoV-2 among frontline healthcare personnel during the first month of caring for patients with COVID-19

Seroprevalence and Correlates of SARS-CoV-2 Antibodies in Healthcare Workers in Chicago

SARS-CoV-2 seroprevalence across a diverse cohort of healthcare workers

Prevalence of SARS-CoV-2 among healthcare workers at a tertiary academic hospital in New York City

Prevalence of SARS-CoV-2 antibodies in health care personnel in the New York City Area

Virginia Department of Health website

The REDCap consortium: building an international community of software platform partners

Change in antibodies to SARS-CoV-2 over 60 days among healthcare personnel in

Acknowledgments. We are deeply grateful to our healthcare workers for their grit and resilience throughout the COVID-19 pandemic, to our healthcare system for their unwavering support of this project, to our information system analysts for their expertise, and to our team on the clinical research unit for making this project a reality.Financial support. This work received partial support from the Medical College of Virginia Foundation's COVID-19 Response Fund and from the National Center for Advancing Translational Sciences (grant no. UL1TR002649).

All authors report no conflicts of interest relevant to this article.