Prevalence of severe acute respiratory syndrome coronavirus 2 spike antibodies in some healthcare settings in Egypt

Abstract

Background Healthcare workers (HCWs) are at the front line in battling infection transmission, such as that in coronavirus disease 19 (COVID-19). Additionally, they may act as potential carriers passing the virus on to others. Anti-spike (anti-S) antibodies for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are formed either as a result of infection or vaccination with both indicating immunity against future COVID-19 infection. Aim This study aimed to identify the prevalence of COVID-19 seropositivity among HCWs. Methods This cross-sectional study included 559 HCWs from 39 hospitals with variable degrees of COVID-19 exposure risk (depending on the occupation, department, and hospital type). Demographic data were recorded as well as history of COVID-19 infection and vaccination. Serum samples were collected and tested for SARS-CoV-2 spike antibodies. Results Anti-S positivity was found in 59.0% of the participating 559 HCWs, indicating a high level of seroprotection. Of the 559 HCWs, 34.1% had reported previous infection with COVID-19. Following infection, only 46 (24.0%) of those affected received vaccination. Anti-S seropositivity was found in 39.1% of participants who were unvaccinated and had no history of infection. Physicians had the highest median anti-S titers (58.0 relative units (RU)/mL), whereas pharmacists and office staff had the lowest (25.7 and 38.2 RU/mL, respectively). Conclusions Overall, 59.0% of the 559 HCWs were anti-S positive, indicating a relatively high seroprotective status. Among those who were unvaccinated and had no history of infection, 39.1% were seropositive for anti-S, denoting a high rate of silent/asymptomatic infections. Screening of HCWs for SARS-CoV-2 anti-S is recommended, along with the vaccination of seronegative individuals.

Adherence of healthcare workers to COVID-19 infection prevention practices and its relationship with SARS-CoV-2 seropositivity

“…Zabarsky et al found that 25% of HCWs testing positive for SARS-CoV-2 had a higher risk of exposure at work, as opposed to 14% of infected HCWs who reported higher-risk exposures to family members or other infected individuals in the community (Zabarsky et al, 2021). Other communityrelated behaviors might also influence the risk of COVID-19 infection among HCWs, and these factors were analyzed by the authors elsewhere (El-Ghitany et al, 2022a).…”

“…This study was a part of a larger survey that was conducted originally for the purpose of determining COVID-19 seroprevalence in the Egyptian community and among HCWs and the relevant determinants of infection. Details of sampling of HCWs are described elsewhere by the authors (El-Ghitany et al, 2022b). Briefly, a total of 39 hospitals from five governorates were selected using the multistage cluster sampling technique.…”

“…Vaccinated HCWs were excluded from our study since vaccine-induced immune response would have confused our interpretation of seropositivity. Details of the sampling technique were described elsewhere (El-Ghitany et al, 2022b).…”

Delayed seropositivity is associated with lower levels of SARS-CoV-2 antibody levels in patients with mild to moderate COVID-19

“…However, an Egyptian study among HCWs reported a much higher rate of asymptomatic cases, where anti-S seropositivity was found in 39.1% of unvaccinated participants. This might be due to their higher exposure to COVID-19 infection [ 21 ].…”

Self-reported adherence of healthcare workers to infection prevention and control practices during the early waves of the COVID-19 pandemic in Egypt

“…This period coincided with the second and third waves of the COVID-19 pandemic in Egypt. This study was a part of another project which enrolled 559 HCWs (10).…”