Antibodies to SARS-CoV-2 and risk of past or future sick leave

Dillner, Joakim; Elfström, K. Miriam; Blomqvist, Jonas; Eklund, Carina; Lagheden, Camilla; Kleppe, Sara Nordqvist; Hellström, Cecilia; Olofsson, Jennie; Andersson, Eni; Falk, August Jernbom; Bergström, Sofia; Hultin, Emilie; Pin, Elisa; Månberg, Anna; Nilsson, Peter; Hedhammar, My; Hober, Sophia; Mattsson, Johan; Mühr, Laila Sara Arroyo; Lundgren, Kalle Conneryd

doi:10.1038/s41598-021-84356-w

Cited by 10 publications

(14 citation statements)

References 12 publications

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“…In agreement with our results, many studies have reported an increased risk of exposure to SARS-CoV-2 among HCWs [ 19 ], in elderly care homes [ 12 , 15 , 20 ], nursing facilities [ 16 ] as well as among the HCWs at hospitals [ 17 , 18 , 21 ]. Seropositivity was comparable to observational studies from hospitals in the same region and near in time [ 11 , 18 ]. Participating in the active care of COVID-19 patients was a significant risk factor for being seropositive.…”

Section: Discussionsupporting

confidence: 77%

“…Therefore, it is important to efficiently detect and manage healthcare-related SARS-CoV-2 exposures. We have previously found that presymptomatic infection can be readily detected by SARS-CoV-2 antibody screening and SARS-CoV-2 RT-PCR testing [ 10 , 11 ]. Seropositive HCW have no excess risk for disease in the coming months [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…We have previously found that presymptomatic infection can be readily detected by SARS-CoV-2 antibody screening and SARS-CoV-2 RT-PCR testing [ 10 , 11 ]. Seropositive HCW have no excess risk for disease in the coming months [ 11 ]. Subjects who test positive for high amounts (low Cycle Threshold value) of the SARS-CoV-2 viral genome in nasopharyngeal swabs have a very high likelihood to become sick in the near future [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Risk for SARS-CoV-2 infection in healthcare workers outside hospitals: A real-life immuno-virological study during the first wave of the COVID-19 epidemic

Fröberg¹,

Hassan

Pimenoff

et al. 2021

PLoS ONE

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Objectives Most COVID-19 related infections and deaths may occur in healthcare outside hospitals. Here we explored SARS-CoV-2 infections among healthcare workers (HCWs) in this setting. Design All healthcare providers in Stockholm, Sweden were asked to recruit HCWs at work for a study of past or present SARS-CoV-2 infections among HCWs. Study participants This study reports the results from 839 HCWs, mostly employees of primary care centers, sampled in June 2020. Results SARS-CoV-2 seropositivity was found among 12% (100/839) of HCWs, ranging from 0% to 29% between care units. Seropositivity decreased by age and was highest among HCWs <40 years of age. Within this age group there was 19% (23/120) seropositivity among women and 11% (15/138) among men (p<0.02). Current infection, as measured using PCR, was found in only 1% and the typical testing pattern of pre-symptomatic potential “superspreaders” found in only 2/839 subjects. Conclusions Previous SARS-CoV-2 infections were common among younger HCWs in this setting. Pre-symptomatic infection was uncommon, in line with the strong variability in SARS-CoV-2 exposure between units. Prioritizing infection prevention and control including sufficient and adequate personal protective equipment, and vaccination for all HCWs are important to prevent nosocomial infections and infections as occupational injuries during an ongoing pandemic.

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Section: Discussionsupporting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk for SARS-CoV-2 infection in healthcare workers outside hospitals: A real-life immuno-virological study during the first wave of the COVID-19 epidemic

Fröberg¹,

Hassan

Pimenoff

et al. 2021

PLoS ONE

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“…In the previously described Stockholm HCW cohort, all healthcare providers in the capital region of Sweden were asked about participation in a study of past or present SARS-CoV-2 infections [ 8 , 9 ]. Among the major healthcare providers who agreed to participate, a very high proportion (>90%) of the HCWs at work were enrolled, following written informed consent [ 8 , 9 ]. This report focuses on the two largest healthcare providers, Karolinska University Hospital and Stockholm South General Hospital.…”

Section: Methodsmentioning

confidence: 99%

“…The Stockholm HCW study of past or present SARS-CoV-2 invited all healthcare workers (HCWs) in the region for PCR and antibody testing in April-June 2020, with about 27,000 HCWs enrolled [ 7 – 9 ]. Whereas antibodies and low amounts of virus in PCR (high Ct values) were associated with past disease (post-symptomatic subjects) [ 7 , 8 ], high amounts of virus in PCR predicted future disease in the next 1–2 weeks [ 7 ]. The pattern with no symptoms, high amounts of virus and no antibodies was unfortunately particularly common among HCWs working with home care for older persons [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Potential SARS-CoV-2 infectiousness among asymptomatic healthcare workers

et al. 2021

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A majority of SARS-CoV-2 infections are transmitted from a minority of infected subjects, some of which may be symptomatic or pre-symptomatic. We aimed to quantify potential infectiousness among asymptomatic healthcare workers (HCWs) in relation to prior or later symptomatic disease. We previously (at the onset of the SARS-CoV-2 epidemic) performed a cohort study of SARS-CoV-2 infections among 27,000 healthcare workers (HCWs) at work in the capital region of Sweden. We performed both SARS-CoV-2 RT-PCR and serology. Furthermore, the cohort was comprehensively followed for sick leave, both before and after sampling. In the present report, we used the cohort database to quantify potential infectiousness among HCWs at work. Those who had sick leave either before or after sampling were classified as post-symptomatic or pre-symptomatic, whereas the virus-positive subjects with no sick leave were considered asymptomatic. About 0.2% (19/9449) of HCW at work were potentially infectious and pre-symptomatic (later had disease) and 0.17% (16/9449) were potentially infectious and asymptomatic (never had sick leave either before nor after sampling). Thus, 33% and 28% of all the 57 potentially infectious subjects were pre-symptomatic or asymptomatic, respectively. When a questionnaire was administered to HCWs with past infection, only 10,5% of HCWs had had no indication at all of having had SARS-CoV-2 infection (“truly asymptomatic”). Our findings provide a unique quantification of the different groups of asymptomatic, potentially infectious HCWs.

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Predicting past and future SARS-CoV-2-related sick leave using discrete time Markov modelling

Lei

Clements

Elfström

et al. 2022

Preprint

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BackgroundPrediction of SARS-CoV-2-induced sick leave among healthcare workers (HCWs) is essential for being able to plan the healthcare response to the epidemic.MethodsDuring first wave of the SARS-Cov-2 epidemic (April 23rd to June 24th, 2020), the HCWs in the greater Stockholm region in Sweden were invited to a study of past or present SARS-CoV-2 infection. We develop a discrete time Markov model using a cohort of 9449 healthcare workers (HCWs) who had complete data on SARS-CoV-2 RNA and antibodies as well as sick leave data for the calendar year 2020. The one-week and standardized longer term transition probabilities of sick leave and the ratios of the standardized probabilities for the baseline covariate distribution were compared with the referent period (an independent period when there were no SARS-CoV-2 infections) in relation to PCR results, serology results and gender.ResultsThe one-week probabilities of transitioning from healthy to partial sick leave or full sick leave during the outbreak as compared to after the outbreak were highest for healthy HCWs testing positive for large amounts of virus (3.69, (95% confidence interval, CI: 2.44-5.59) and 6.67 (95% CI: 1.58-28.13), respectively). The proportion of all sick leaves attributed to COVID-19 during outbreak was at most 55% (95% CI: 50%-59%).ConclusionsA robust Markov model enabled use of simple SARS-CoV-2 testing data for quantifying past and future COVID-related sick leave among HCWs, which can serve as a basis for planning of healthcare during outbreaks.

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Antibodies to SARS-CoV-2 and risk of past or future sick leave

Cited by 10 publications

References 12 publications

Risk for SARS-CoV-2 infection in healthcare workers outside hospitals: A real-life immuno-virological study during the first wave of the COVID-19 epidemic

Risk for SARS-CoV-2 infection in healthcare workers outside hospitals: A real-life immuno-virological study during the first wave of the COVID-19 epidemic

Potential SARS-CoV-2 infectiousness among asymptomatic healthcare workers

Predicting past and future SARS-CoV-2-related sick leave using discrete time Markov modelling

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