Background COVID-19 seroprevalence data, particularly in less developed countries with a relatively low incidence, has been scant. We aimed to explore the seroprevalence of hospital staff in the area with zero confirmed COVID-19 case to shed light on the situation of COVID-19 infection in zero or low infection rate countries where mass screening was not readily available. Methods A locally developed rapid immunoglobulin M (IgM)/immunoglobulin G (IgG) test kit was used for hospital staff screening of Ranong hospital which is located in a province with zero COVID-19 prevalence in Thailand from 17th April to 17th May 2020. All staff was tested, 100 of which were randomly invited to have a repeating antibody test in one month. (Thai Clinical Trials Registry: TCTR20200426002) Results Of 844 hospital staff, 82 were tested twice one month apart (response rate for repeating antibody test 82%). Overall, 0.8% of the participants (7 of 844) had positive IgM, none had positive IgG. Female staff had 1.0% positive IgM (95% CI: 0.5–2.1%) while male had 0.5% positive IgM (95% CI: 0.1–2.6%). No participants with a history of travel to the high-risk area or close contact with PCR-confirmed COVID-19 case developed SARS-CoV-2 antibodies. Among 844 staff, 811 had no symptoms and six of them developed IgM seropositive (0.7%) while 33 had minor symptoms and only one of them developed IgM seropositive (3.0%). No association between SARS-CoV-2 IgM status and gender, history of travel to a high-risk area, close contact with PCR-confirmed or suspected COVID-19 case, presence of symptoms within 14 days, or previous PCR status was found. None of the hospital staff developed SARS-CoV-2 IgG. Conclusions COVID-19 antibody test could detect a considerable number of hospital staff who could be potential silent spreaders in a province with zero COVID-19 cases. Accurate antibody testing is a valuable screening tool, particularly in asymptomatic healthcare workers. Trial registration: This study was approved by the Institutional Review Board of Chulalongkorn University (IRB No.236/63) and the Institutional Review Board of Ranong Hospital. (Thai Clinical Trials Registry: TCTR20200426002).
Abstract. Pneumonia was the most common cause of death during the 2009 pandemic H1N1 influenza virus infection. Clinical risk factors for pneumonia caused by this virus are limited. We enrolled consecutive patients treated at the H1N1 Clinic in Thungsong Hospital in Nakhon Si Thammarat, Thailand, during June-December 2009 who had positive polymerase chain reaction results for H1N1 virus. Clinical features for patients given a diagnosis with and without pneumonia were studied. There were 441 patients with positive polymerase chain reaction results for H1N1 virus. Of these patients, 51 (11.56%) had pneumonia. Three independent clinical factors for H1N1 pneumonia were myalgia, dyspnea, and an absolute neutrophil count 7,700 cells/μL. Adjusted odds ratios (95% confidence intervals) for these three variables were 0.413 (0.173-0.988), 2.625 (1.230-5.604), and 4.475 (1.882-10.644), respectively. Clinical features may be a useful tool for predicting risk for pneumonia caused by H1N1 virus.
BACKGROUND. COVID-19 seroprevalence data has been scarce, especially in less developed countries with a relatively low infection rate. METHODS. A locally developed rapid IgM/IgG test kit was used for screening hospital staff in Ranong hospital which located in a province with zero COVID-19 prevalence in Thailand from April 17 to May 17, 2020. A total of 844 participants were tested; 82 of which were tested twice with one month apart. (Thai Clinical Trials Registry: TCTR20200426002) RESULTS. Overall, 0.8% of the participants (7 of 844) had positive immunoglobulin M (IgM), none had positive immunoglobulin G (IgG). Female staffs seemed to have higher IgM seropositive than male staffs (1.0% vs. 0.5%). None of the participants with a history of travel to the high-risk area or a history of close contact with PCR-confirmed COVID-19 case had developed antibodies against SARS-CoV-2. Among 844 staff, 811 had no symptom and six of them developed IgM seropositive (0.7%) while 33 had minor symptoms and only one of them developed IgM seropositive (3.0%). No association between IgM antibody against SARS-CoV-2 status and gender, history of travel to a high-risk area, history of close contact with PCR-confirmed COVID-19 case, history of close contact with suspected COVID-19 case, presence of symptoms within 14 days, or previous PCR status was found. None of the hospital staff developed IgG against SARS-CoV-2. CONCLUSION. COVID-19 antibody test could detect a substantial number of hospital staffs who could be potential silent spreaders in a province with zero COVID-19 case. Antibody testing should be encouraged for mass screening, especially in asymptomatic healthcare workers.
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