SARS-CoV-2 Testing of 11,884 Healthcare Workers at an Acute NHS Hospital Trust in England: A Retrospective Analysis

Abstract

Healthcare workers (HCWs) are known to be at increased risk of infection with SARS-CoV-2, although whether these risks are equal across all roles is uncertain. Here we report a retrospective analysis of a large real-world dataset obtained from 10 March to 6 July 2020 in an NHS Foundation Trust in England with 17,126 employees. 3,338 HCWs underwent symptomatic PCR testing (14.4% positive, 2.8% of all staff) and 11,103 HCWs underwent serological testing for SARS-CoV-2 IgG (8.4% positive, 5.5% of all staff). Seropositivity was lower than other hospital settings in England but higher than community estimates. Increased test positivity rates were observed in HCWs from BAME backgrounds and residents in areas of higher social deprivation. A multiple logistic regression model adjusting for ethnicity and social deprivation confirmed statistically significant increases in the odds of testing positive in certain occupational groups, most notably domestic services staff, nurses, and health-care assistants. PCR testing of symptomatic HCWs appeared to underestimate overall infection levels, probably due to asymptomatic seroconversion. Clinical outcomes were reassuring, with only a small minority of HCWs with COVID-19 requiring hospitalization (2.3%) or ICU management (0.7%) and with no deaths. Despite a relatively low level of HCW infection compared to other UK cohorts, there were nevertheless important differences in test positivity rates between occupational groups, robust to adjustment for demographic factors such as ethnic background and social deprivation. Quantitative and qualitative studies are needed to better understand the factors contributing to this risk. Robust informatics solutions for HCW exposure data are essential to inform occupational monitoring.

Durable Antibody Responses in Staff at Two Long-Term Care Facilities, during and Post SARS-CoV-2 Outbreaks

“…Many studies have sought to define the antibody response following SARS-CoV-2 infection ( 14 , 15 ). These include studies on hospitalized COVID-19 patients ( 16 – 19 ), asymptomatic individuals ( 20 , 21 ), and retrospective serological studies ( 22 – 25 ). The vast majority of infected individuals seroconvert and generate IgA, IgM, and IgG-specific antibodies within 3 weeks of infection ( 15 ).…”

Willingness and SARS-CoV-2 Vaccination Coverage among Healthcare Workers in China: A Nationwide Study

“…It is critical to ensure the safety of HCWs not only to safeguard continuous disease control and treatment but also to ensure they do not transmit the virus under more frequent social communication conditions [ 17 ]. A retrospective analysis in England showed that overall infection level among HCWs was probably underestimated due to asymptomatic seroconversion [ 18 ]. In the aspect of COVID-19 vaccination, HCWs play an important role in vaccine propagation and education, and their vaccination willingness can also influence the attitude and uptake choice of the general population [ 15 , 19 ].…”

Sars-Cov-2 Infection: What Makes It So Different?

“…In a paper published by Hanrath et al, it was concluded that, by comparing the healthcare workers who had no infection in the first wave with those who have been positive, the positivity rate was 0% among those who had the infection before, as compared to almost 14% among the healthcare workers who had not the infection before [2]. This is a strong proof that having had SARS-CoV-2 infection in the past does actually provide protection at least for a short time.…”