Prospective SARS-CoV-2 cohort study among general practitioners during the second COVID-19 wave in Flanders, Belgium

Mariën, Joachim; Ceulemans, Ann; Bakokimi, Diana; Lammens, Christine; Ieven, Margareta; Heytens, Stefan; Sutter, An De; Bruel, Ann Van den; Goossens, Herman; Damme, Pierre Van; Ariën, Kevin K.; Coenen, Samuel

doi:10.1101/2021.03.26.21254327

Cited by 3 publications

(5 citation statements)

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“…35 36 A study of primary healthcare providers in the region of Flanders revealed the same trend: here, the seroprevalence remained stable between June and September (around 5%) and increased substantially thereafter (up to 13% in December). 37 The consistently higher estimates in our study compared with the general population confirm the occupational risk for SARS-CoV-2 infection among HCW. Nevertheless, the difference between HCW and the general population (about 4%) was smaller than we had expected and did not increase over time, which suggests that HCW in Belgian hospitals managed to implement relatively adequate personal protection measures.…”

Section: Discussionsupporting

confidence: 71%

Prevalence and incidence of anti-SARS-CoV-2 antibodies among healthcare workers in Belgian hospitals before vaccination: a prospective cohort study

et al. 2021

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ObjectivesTo describe prevalence and incidence of anti-SARS-CoV-2 antibodies among Belgian hospital healthcare workers (HCW) in April–December 2020.DesignProspective cohort study. Follow-up was originally planned until September and later extended.SettingMulticentre study, 17 hospitals.Participants50 HCW were randomly selected per hospital. HCW employed beyond the end of the study and whose profession involved contact with patients were eligible. 850 HCW entered the study in April–May 2020, 673 HCW (79%) attended the September visit and 308 (36%) the December visit.Outcome measuresA semiquantitative ELISA was used to detect IgG against SARS-CoV-2 in serum (Euroimmun) at 10 time points. In seropositive samples, neutralising antibodies were measured using a virus neutralisation test. Real-time reverse transcription PCR (RT-qPCR) was performed to detect SARS-CoV-2 on nasopharyngeal swabs. Participant characteristics and the presence of symptoms were collected via an online questionnaire.ResultsAmong all participants, 80% were women, 60% nurses and 21% physicians. Median age was 40 years. The seroprevalence remained relatively stable from April (7.7% (95% CI: 4.8% to 12.1%) to September (8.2% (95% CI: 5.7% to 11.6%)) and increased thereafter, reaching 19.7% (95% CI: 12.0% to 30.6%) in December 2020. 76 of 778 initially seronegative participants seroconverted during the follow-up (incidence: 205/1000 person-years). Among all seropositive individuals, 118/148 (80%) had a positive neutralisation test, 83/147 (56%) presented or reported a positive RT-qPCR, and 130/147 (88%) reported COVID-19-compatible symptoms at least once. However, only 46/73 (63%) of the seroconverters presented COVID-19-compatible symptoms in the month prior to seroconversion.ConclusionsThe seroprevalence among hospital HCW was slightly higher than that of the general Belgian population but followed a similar evolution, suggesting that infection prevention and control measures were effective and should be strictly maintained. After two SARS-CoV-2 waves, 80% of HCW remained seronegative, justifying their prioritisation in the vaccination strategy.Trial registration numberNCT04373889

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Section: Discussionsupporting

confidence: 71%

Prevalence and incidence of anti-SARS-CoV-2 antibodies among healthcare workers in Belgian hospitals before vaccination: a prospective cohort study

et al. 2021

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“…This is suggested by the lower seroprevalence in this study for PHCPs in Flanders compared to that in an earlier prospective cohort study using dried blood spots analysed in the lab. 25 Not finding a higher seroprevalence among PHCPs, generally concerned about being at high risk of COVID-19 infections, compared to the general population might be explained by the availability and proper usage of personal protective equipment (PPE). 25 Most PHCPs in our study (94.49%) received a first vaccine dose in the period January -March explaining the increase in seroprevalence to 84.1% in April 2021.…”

Section: Discussionmentioning

confidence: 99%

“…25 Not finding a higher seroprevalence among PHCPs, generally concerned about being at high risk of COVID-19 infections, compared to the general population might be explained by the availability and proper usage of personal protective equipment (PPE). 25 Most PHCPs in our study (94.49%) received a first vaccine dose in the period January -March explaining the increase in seroprevalence to 84.1% in April 2021. The monthly incidence of antibodies due to natural infection in those not yet vaccinated in the same time period was estimated to be around 4% in this study.…”

Section: Discussionmentioning

confidence: 99%

“…Compared to laboratory tests, a valid easy-touse RST could speed up the availability of the test results for both the participants and the national health authorities. 25 Furthermore, by using RSTs in this study, PHCPs got the opportunity to become more familiar with this type of technology.…”

Section: Introductionmentioning

confidence: 99%

“…23 In Italy, GPs represented up to 38% of the physicians who died from COVID-19 early in the epidemic. 24 Before the start of this study (December 2020) data on how many PHCPs in Belgium had been infected by SARS-CoV-2 was not readily available, 25 and effective vaccines for PHCPs were not anticipated to be available in the near future.…”

Section: Introductionmentioning

confidence: 99%

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The prevalence, incidence and longevity of antibodies against SARS-CoV-2 among primary healthcare providers in Belgium: a prospective cohort study with 12 months of follow-up

Adriaenssens

Scholtes

Bruyndonckx

et al. 2022

Preprint

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Objectives: To estimate the prevalence, incidence, and longevity of antibodies against SARS-CoV-2 among primary healthcare providers (PHCPs). Design: Prospective cohort study with 12 months of follow-up. Setting: Primary care in Belgium Participants: Any general practitioner (GP) working in primary care in Belgium and any other PHCP from the same GP practice who physically manages (examines, tests, treats) patients were eligible. A convenience sample of 3,648 eligible PHCPs from 2,001 GP practices registered for this study (3,044 and 604 to start in December 2020 and January 2021, respectively). 3,390 PHCPs (92,9%) participated in their first testing timepoint (2,820 and 565, respectively) and 2,557 PHCPs (70,1%) in the last testing timepoint (December 2021). Interventions: Participants were asked to perform a rapid serological test (RST) targeting IgM and IgG against the receptor binding domain (RBD) of SARS-CoV-2 and to complete an online questionnaire at each of maximum 8 testing timepoints. Primary and secondary outcome measures: The prevalence, incidence, and longevity of antibodies against SARS-CoV-2 both after natural infection and after vaccination. Results: Among all participants, 67% were women and 77% GPs. Median age was 43 years. The seroprevalence in December 2020 (before vaccination availability) was 15.1% (95% CI: 13.5% to 16.6%), increased to 84.2% (95% CI: 82.9% to 85.5%) in March 2021 (after vaccination availability) and reached 93.9% (95% CI: 92.9% to 94.9%) in December 2021 (during booster vaccination availability and fourth (delta variant dominant) covid wave). Among not (yet) vaccinated participants the first monthly incidence of antibodies against SARS-CoV-2 was estimated to be 2.91% (95% CI: 1.80% to 4.01%). The longevity of antibodies is higher in PHCPs with self-reported COVID-19 infection. Conclusions: This study confirms that occupational health measures provided sufficient protection when managing patients. High uptake of vaccination resulted in high seroprevalence of SARS-CoV-2 antibodies in PHCPs in Belgium. Longevity of antibodies was supported by booster vaccination and virus circulation. Registration: Trial registration number: NCT04779424

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Revisiting a COVID-19 seroprevalence cohort survey among health care workers and their household members in Kinshasa, DR Congo, 2020-2022

Madinga,

Mbala,

Nkuba

et al. 2023

Preprint

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Serological surveys provide the most direct measurement to define the immunity landscape for many infectious diseases, including COVID-19, yet this methodology remains underexploited to clarify transmission dynamics. This is specifically the case in the context of the Democratic Republic of Congo, where COVID-19 case presentation was apparently largely oligo- or asymptomatic, and vaccination coverage remained extremely low. A cohort of 635 health care workers from 5 health zones of Kinshasa and 670 of their household members was followed up between July 2020 and January 2022, with 6- to 8-week intervals in the first year and 4- and 8-month intervals in the last year. At each visit, information on risk exposure and a blood sample were collected. Serology was defined as positive when binding antibodies against SARS-CoV-2 spike and nucleocapsid proteins were simultaneously present. The anti-SARS-CoV-2 antibody seroprevalence was high at baseline, at 17.3% (95% CI 14.4–20.6) and 7.8% (95% CI 5.5–10.8) for health care workers and household members, respectively, and fluctuated over time, between 9% and 62.1%. Seropositivity was heterogeneously distributed over the health zones (p < 0.001), ranging from 12.5% (95% CI 6.6–20.8) in N’djili to 33.7% (95% CI 24.6–43.8) in Bandalungwa at baseline for health care workers. Seropositivity was associated with increasing rounds aOR 1.75 (95% CI 1.66–1.85), with increasing age aOR 1.11 (95% CI 1.02–1.20), being a female aOR 1.35 (95% CI 1.10–1.66) and being a health care worker aOR 2.38 (95% CI 1.80–3.14). There was no evidence that health care workers brought the COVID-19 infection back home, with increased seropositivity risk among household members in subsequent surveys. There was much seroreversion and seroconversion detected over the different surveys, and health care workers had a 40% lower probability of seroreverting than household members (aOR 0.60 (95% CI 0.42–0.86)). Based on the WHO guidelines on the potential use of sero-surveys, the results of this cohort were revisited, and evidence provided by such studies in a ‘new disease’ epidemic and in a setting with low molecular testing capacities, such as COVID-19 in DRCongo, was insufficient to guide policy makers for defining control strategies.

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Prospective SARS-CoV-2 cohort study among general practitioners during the second COVID-19 wave in Flanders, Belgium

Cited by 3 publications

References 9 publications

Prevalence and incidence of anti-SARS-CoV-2 antibodies among healthcare workers in Belgian hospitals before vaccination: a prospective cohort study

Prevalence and incidence of anti-SARS-CoV-2 antibodies among healthcare workers in Belgian hospitals before vaccination: a prospective cohort study

The prevalence, incidence and longevity of antibodies against SARS-CoV-2 among primary healthcare providers in Belgium: a prospective cohort study with 12 months of follow-up

Revisiting a COVID-19 seroprevalence cohort survey among health care workers and their household members in Kinshasa, DR Congo, 2020-2022

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