Seroprevalence and Correlates of SARS-CoV-2 Antibodies in Health Care Workers in Chicago

Abstract

Background Identifying factors associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among health care workers (HCWs) may help health systems optimize SARS-CoV-2 infection control strategies. Methods We conducted a cross-sectional analysis of baseline data from the Northwestern HCW SARS-CoV-2 Serology Cohort Study. We used the Abbott Architect Nucleocapsid IgG assay to determine seropositivity. Logistic regression models (adjusted for demographics and self-reported community exposure to coronavirus disease 2019 [COVID-19]) were fit to quantify the associations between occupation group, health care delivery tasks, and community exposure and seropositive status. Results A total of 6510 HCWs, including 1794 nurses and 904 non-patient-facing administrators, participated. The majority were women (79.6%), 74.9% were White, 9.7% were Asian, 7.3% were Hispanic, and 3.1% were non-Hispanic Black. The crude prevalence of seropositivity was 4.8% (95% CI, 4.6%–5.2%). Seropositivity varied by race/ethnicity as well as age, ranging from 4.2% to 9.6%. Out-of-hospital exposure to COVID-19 occurred in 9.3% of HCWs, 15.0% (95% CI, 12.2%–18.1%) of whom were seropositive; those with family members diagnosed with COVID-19 had a seropositivity rate of 54% (95% CI, 44.2%–65.2%). Support service workers (10.4%; 95% CI, 4.6%–19.4%), medical assistants (10.1%; 95% CI, 5.5%–16.6%), and nurses (7.6%; 95% CI, 6.4%–9.0%) had significantly higher seropositivity rates than administrators (referent; 3.3%; 95% CI, 2.3%–4.4%). However, after adjustment, nursing was the only occupation group with a significantly higher odds (odds ratio, 1.9; 95% CI, 1.3–2.9) of seropositivity. Exposure to patients receiving high-flow oxygen therapy and hemodialysis was significantly associated with 45% and 57% higher odds for seropositive status, respectively. Conclusions HCWs are at risk for SARS-CoV-2 infection from longer-duration exposures to people infected with SARS-CoV-2 within health care settings and their communities of residence.

Bronchoscopy on Intubated Patients with COVID-19 Is Associated with Low Infectious Risk to Operators

“…No provider developed COVID-19, and only one had positive serology. Our cohort’s seropositivity rate was actually lower than what was found among all healthcare workers at our institution (4.8%), although they also found that bronchoscopy was not associated with increased seropositive rates ( 20 ).…”

SARS‐CoV‐2 Seroprevalence Among Healthcare Workers by Workplace Exposure Risk in Kashmir, India

“…The authors of the study concluded that exposure in the community setting plays a crucial role in transmission among HCWs. 22 Similarly, higher seroprevalence among housekeeping, nonadministrative staff, and other support service staff has been reported elsewhere. 23 Certain underlying factors related to socioeconomic status and lifestyle may also contribute to higher seroprevalence in some occupational groups.…”

SARS-CoV-2 seroepidemiological study in healthcare workers and discordant results using seven different diagnostic methods

“…The SARS-CoV-2 antibody detection assay we used for the initial screening of our population (Architect ® SARS-CoV-2 IgG, Abbott, Chicago, IL, USA) has been used in several studies as a screening tool for HCWs and in the general population [ 22 – 24 ]. The same assay has been compared with other antibody detection methods in several studies with good performance characteristics [ 25 – 27 ].…”