1
|
Odak I, Riemann L, Sandrock I, Cossmann A, Ramos GM, Hammerschmidt SI, Ritter C, Friedrichsen M, Hassan A, Dopfer-Jablonka A, Stankov MV, Weskamm LM, Addo MM, Ravens I, Willenzon S, Schimrock A, Ristenpart J, Janssen A, Barros-Martins J, Hansen G, Falk C, Behrens GMN, Förster R. Systems biology analysis reveals distinct molecular signatures associated with immune responsiveness to the BNT162b COVID-19 vaccine. EBioMedicine 2024; 99:104947. [PMID: 38160529 PMCID: PMC10792461 DOI: 10.1016/j.ebiom.2023.104947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 12/11/2023] [Accepted: 12/16/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Human immune responses to COVID-19 vaccines display a large heterogeneity of induced immunity and the underlying immune mechanisms for this remain largely unknown. METHODS Using a systems biology approach, we longitudinally profiled a unique cohort of female high and low responders to the BNT162b vaccine, who were known from previous COVID-19 vaccinations to develop maximum and minimum immune responses to the vaccine. We utilized high dimensional flow cytometry, bulk and single cell mRNA sequencing and 48-plex serum cytokine analyses. FINDINGS We revealed early, transient immunological and molecular signatures that distinguished high from low responders and correlated with B and T cell responses measured 14 days later. High responders featured a distinct transcriptional activity of interferon-driven genes and genes connected to enhanced antigen presentation. This was accompanied by a robust cytokine response related to Th1 differentiation. Both transcriptome and serum cytokine signatures were confirmed in two independent confirmatory cohorts. INTERPRETATION Collectively, our data contribute to a better understanding of the immunogenicity of mRNA-based COVID-19 vaccines, which might lead to the optimization of vaccine designs for individuals with poor vaccine responses. FUNDING German Center for Infection Research, German Center for Lung Research, German Research Foundation, Excellence Strategy EXC 2155 "RESIST" and European Regional Development Fund.
Collapse
Affiliation(s)
- Ivan Odak
- Institute of Immunology, Hannover Medical School, Germany
| | - Lennart Riemann
- Institute of Immunology, Hannover Medical School, Germany; Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Germany; Clinician Scientist Program TITUS, Else-Kröner-Fresenius Foundation, Hannover Medical School, Germany
| | - Inga Sandrock
- Institute of Immunology, Hannover Medical School, Germany
| | - Anne Cossmann
- Department for Rheumatology and Immunology, Hannover Medical School, Germany
| | - Gema Morillas Ramos
- Department for Rheumatology and Immunology, Hannover Medical School, Germany
| | | | | | | | - Ahmed Hassan
- Institute of Immunology, Hannover Medical School, Germany
| | - Alexandra Dopfer-Jablonka
- Department for Rheumatology and Immunology, Hannover Medical School, Germany; German Center for Infection Research (DZIF), Partner Sites Hannover-Braunschweig, Germany
| | - Metodi V Stankov
- Department for Rheumatology and Immunology, Hannover Medical School, Germany
| | - Leonie M Weskamm
- Institute for Infection Research and Vaccine Development (IIRVD), University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Department for Clinical Immunology of Infectious Diseases, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany; German Centre for Infection Research, Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany
| | - Marylyn M Addo
- Institute for Infection Research and Vaccine Development (IIRVD), University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Department for Clinical Immunology of Infectious Diseases, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany; German Centre for Infection Research, Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany; First Department of Medicine, Division of Infectious Diseases, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Inga Ravens
- Institute of Immunology, Hannover Medical School, Germany
| | | | - Anja Schimrock
- Institute of Immunology, Hannover Medical School, Germany
| | | | - Anika Janssen
- Institute of Immunology, Hannover Medical School, Germany
| | | | - Gesine Hansen
- Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Germany; Clinician Scientist Program TITUS, Else-Kröner-Fresenius Foundation, Hannover Medical School, Germany; German Center of Lung Research (DZL), BREATH, Hannover, Germany; Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Germany
| | - Christine Falk
- Institute for Transplantation Immunology, Hannover Medical School, Hannover, Germany
| | - Georg M N Behrens
- Department for Rheumatology and Immunology, Hannover Medical School, Germany; German Center for Infection Research (DZIF), Partner Sites Hannover-Braunschweig, Germany; Centre for Individualized Infection Medicine (CiiM), Hannover, Germany
| | - Reinhold Förster
- Institute of Immunology, Hannover Medical School, Germany; Clinician Scientist Program TITUS, Else-Kröner-Fresenius Foundation, Hannover Medical School, Germany; German Centre for Infection Research, Partner Site Hamburg-Lübeck-Borstel-Riems, Hamburg, Germany; German Center of Lung Research (DZL), BREATH, Hannover, Germany; Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Germany.
| |
Collapse
|
2
|
Kuhls LJ, Demiri J, Weidlich A, Weidlich S, Trinkaus J, Steinbrink K, Augustin M, Tsianakas A. Learning from the Experiences in the COVID-19 Pandemic - Impact on Quality of Life and Challenges for the Staff of a Dermatological Hospital and Rehabilitation Center in Germany: A Retrospective Analysis. Clin Cosmet Investig Dermatol 2023; 16:3279-3290. [PMID: 38021425 PMCID: PMC10655726 DOI: 10.2147/ccid.s429065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/10/2023] [Indexed: 12/01/2023]
Abstract
Purpose During the COVID-19 pandemic, infections could also be detected among the staff and patients of the dermatological hospital Bad Bentheim (Germany). This retrospective analysis aims to better understand the impact of the pandemic on health care workers. The results could help improve future pandemic plans and measures to protect health care workers. Patients and Methods In 2020, the whole staff (460 participants) of the dermatological hospital Bad Bentheim had been offered the option to be tested with respect to the antibody status on SARS-CoV-2 (IgG, IgM). The data were collected by means of a blood sample and subsequent questionnaires (22 questions for employees with positive SARS-CoV-2 serology) regarding disease severity, symptoms, disease duration, chains of infection, psychological and physical burden. Both groups were divided by positive or negative serology and data analysis was performed using an independent t-test. Results It was shown that a COVID-19 Infection clinically presented itself as a respiratory tract infection, differed significantly in severity and duration, but also the long-term consequences in employees with proven COVID-19 disease (n=14, 3.7%) from the employees with non-COVID-19 respiratory diseases (33.6% of the seronegative employees). In addition, there was a significant psychological impairment and burden of COVID-19-affected employees. Our study showed unique insights into infection chains, disease courses, disease severity, symptoms and a significant psychological impairment and burden of COVID-19-affected employees among the COVID-19 positive staff. Conclusion Our study shows deep insights into infection chains, disease courses, disease severity and symptoms among the COVID-19 positive staff and led to change of behavior with the disease itself and among the health care professionals. This knowledge has the potential to positively influence the handling of similar future events.
Collapse
Affiliation(s)
- Lorenz Julius Kuhls
- Department of Dermatology and Allergology, Fachklinik Bad Bentheim, Bad Bentheim, Germany
| | - Jeta Demiri
- Department of Dermatology and Allergology, Fachklinik Bad Bentheim, Bad Bentheim, Germany
| | - Adam Weidlich
- Department of Dermatology and Allergology, Fachklinik Bad Bentheim, Bad Bentheim, Germany
| | - Susanne Weidlich
- Department of Dermatology and Allergology, Fachklinik Bad Bentheim, Bad Bentheim, Germany
| | - Janin Trinkaus
- Department of Dermatology and Allergology, Fachklinik Bad Bentheim, Bad Bentheim, Germany
| | - Kerstin Steinbrink
- Department of Dermatology, University Hospital Münster, Münster, Germany
| | - Matthias Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Athanasios Tsianakas
- Department of Dermatology and Allergology, Fachklinik Bad Bentheim, Bad Bentheim, Germany
| |
Collapse
|
3
|
Barros-Martins J, Hammerschmidt SI, Morillas Ramos G, Cossmann A, Hetzel L, Odak I, Köhler M, Stankov MV, Ritter C, Friedrichsen M, Ravens I, Schimrock A, Ristenpart J, Janssen A, Willenzon S, Bernhardt G, Lichtinghagen R, Bošnjak B, Behrens GMN, Förster R. Omicron infection-associated T- and B-cell immunity in antigen-naive and triple-COVID-19-vaccinated individuals. Front Immunol 2023; 14:1166589. [PMID: 37215123 PMCID: PMC10196199 DOI: 10.3389/fimmu.2023.1166589] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/06/2023] [Indexed: 05/24/2023] Open
Abstract
Since early 2022, various Omicron variants have dominated the SARS-CoV-2 pandemic in most countries. All Omicron variants are B-cell immune escape variants, and antibodies induced by first-generation COVID-19 vaccines or by infection with earlier SARS-CoV-2 variants largely fail to protect individuals from Omicron infection. In the present study, we investigated the effect of Omicron infections in triple-vaccinated and in antigen-naive individuals. We show that Omicron breakthrough infections occurring 2-3.5 months after the third vaccination restore B-cell and T-cell immune responses to levels similar to or higher than those measured 14 days after the third vaccination, including the induction of Omicron-neutralizing antibodies. Antibody responses in breakthrough infection derived mostly from cross-reacting B cells, initially induced by vaccination, whereas Omicron infections in antigen-naive individuals primarily generated B cells binding to the Omicron but not the Wuhan spike protein. Although antigen-naive individuals mounted considerable T-cell responses after infection, B-cell responses were low, and neutralizing antibodies were frequently below the limit of detection. In summary, the detection of Omicron-associated B-cell responses in primed and in antigen-naive individuals supports the application of Omicron-adapted COVID-19 vaccines, but calls into question their suitability if they also contain/encode antigens of the original Wuhan virus.
Collapse
Affiliation(s)
| | | | - Gema Morillas Ramos
- Department for Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Anne Cossmann
- Department for Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Laura Hetzel
- Department for Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | - Ivan Odak
- Institute of Immunology, Hannover Medical School, Hannover, Germany
| | - Miriam Köhler
- Institute of Immunology, Hannover Medical School, Hannover, Germany
| | - Metodi V. Stankov
- Department for Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
| | | | | | - Inga Ravens
- Institute of Immunology, Hannover Medical School, Hannover, Germany
| | - Anja Schimrock
- Institute of Immunology, Hannover Medical School, Hannover, Germany
| | | | - Anika Janssen
- Institute of Immunology, Hannover Medical School, Hannover, Germany
| | | | - Günter Bernhardt
- Institute of Immunology, Hannover Medical School, Hannover, Germany
| | - Ralf Lichtinghagen
- Department of Clinical Chemistry, Hannover Medical School, Hannover, Germany
| | - Berislav Bošnjak
- Institute of Immunology, Hannover Medical School, Hannover, Germany
| | - Georg M. N. Behrens
- Department for Rheumatology and Immunology, Hannover Medical School, Hannover, Germany
- German Center for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Hannover, Germany
- Centre for Individualized Infection Medicine (CiiM), Hannover Medical School, Hannover, Germany
| | - Reinhold Förster
- Institute of Immunology, Hannover Medical School, Hannover, Germany
- German Center for Infection Research (DZIF), Partner Site Hannover-Braunschweig, Hannover, Germany
- Cluster of Excellence RESIST (EXC 2155), Hannover Medical School, Hannover, Germany
| |
Collapse
|
4
|
Helou M, Zoghbi S, El Osta N, Mina J, Mokhbat J, Husni R. COVID-19 infection and seroconversion rates in healthcare workers in Lebanon: An observational study. Medicine (Baltimore) 2023; 102:e32992. [PMID: 37115042 PMCID: PMC10143398 DOI: 10.1097/md.0000000000032992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 04/29/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) infection is a recent pandemic. Healthcare workers (HCW) are at high risk of acquiring the infection and transmitting it to others. Seroprevalence for COVID-19 among HCW varies between countries, hospitals in the same country and even among different departments in the same hospital. In this study, we aim to determine the prevalence of severe acute respiratory syndrome coronavirus 2 antibodies and the seroconversion among the HCW in our hospital. A total of 203 HCW were included. The rate of conversion to seropositive was 19.7% in total, with a rate of 13.4% in female versus 25% in male. The seropositivity in the House keeping group was 83%, followed by 45% in the COVID Floor while the seropositivity in the Anesthesia was 4% and the Infection Control 0%. The highest seropositivity rate in the COVID floor, and in the intensive care unit was explained by the long time spent with the patients. While in the inhalation team and the anesthesia, the lower rates of seropositivity was due to the N95 mask wearing the whole time. Seropositivity for COVID-19 in HCW is a major public health concern. Policies should be implemented to better protect HCWs.
Collapse
Affiliation(s)
- Mariana Helou
- Division of Emergency, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Sanaa Zoghbi
- Division of Infection Control, Lebanese American University Medical Center, Beirut, Lebanon
| | - Nour El Osta
- Division of Emergency, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Jonathan Mina
- Division of Infectious Diseases, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Jacques Mokhbat
- Division of Infectious Diseases, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| | - Rola Husni
- Division of Infectious Diseases, Department of Internal Medicine, Lebanese American University, School of Medicine, Beirut, Lebanon
| |
Collapse
|
5
|
Hâncean MG, Lerner J, Perc M, Oană I, Bunaciu DA, Stoica AA, Ghiţă MC. Occupations and their impact on the spreading of COVID-19 in urban communities. Sci Rep 2022; 12:14115. [PMID: 35982107 PMCID: PMC9387884 DOI: 10.1038/s41598-022-18392-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 08/10/2022] [Indexed: 11/09/2022] Open
Abstract
The current pandemic has disproportionally affected the workforce. To improve our understanding of the role that occupations play in the transmission of COVID-19, we analyse real-world network data that were collected in Bucharest between August 1st and October 31st 2020. The data record sex, age, and occupation of 6895 patients and the 13,272 people they have interacted with, thus providing a social network from an urban setting through which COVID-19 has spread. Quite remarkably, we find that medical occupations have no significant effect on the spread of the virus. Instead, we find common transmission chains to start with infected individuals who hold jobs in the private sector and are connected with non-active alters, such as spouses, siblings, or elderly relatives. We use relational hyperevent models to assess the most likely homophily and network effects in the community transmission. We detect homophily with respect to age and anti-homophily with respect to sex and employability. We note that, although additional data would be welcomed to perform more in-depth network analyses, our findings may help public authorities better target under-performing vaccination campaigns.
Collapse
Affiliation(s)
- Marian-Gabriel Hâncean
- Department of Sociology, University of Bucharest, Panduri 90-92, 050663, Bucharest, Romania.
| | - Jürgen Lerner
- Department of Computer and Information Science, University of Konstanz, 78457, Konstanz, Germany.,Human Technology Center, RWTH Aachen University, 52062, Aachen, Germany
| | - Matjaž Perc
- Faculty of Natural Sciences and Mathematics, University of Maribor, Koroška cesta 160, 2000, Maribor, Slovenia.,Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, 404332, Taiwan.,Alma Mater Europaea, Slovenska ulica 17, 2000, Maribor, Slovenia.,Complexity Science Hub Vienna, Josefstädterstraße 39, 1080, Vienna, Austria
| | - Iulian Oană
- Department of Sociology, University of Bucharest, Panduri 90-92, 050663, Bucharest, Romania
| | - David-Andrei Bunaciu
- Department of Sociology, University of Bucharest, Panduri 90-92, 050663, Bucharest, Romania
| | | | - Maria-Cristina Ghiţă
- Department of Sociology, University of Bucharest, Panduri 90-92, 050663, Bucharest, Romania
| |
Collapse
|
6
|
BNT162b2-boosted immune responses six months after heterologous or homologous ChAdOx1nCoV-19/BNT162b2 vaccination against COVID-19. Nat Commun 2022; 13:4872. [PMID: 35982040 PMCID: PMC9387891 DOI: 10.1038/s41467-022-32527-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 08/03/2022] [Indexed: 02/05/2023] Open
Abstract
Heterologous prime/boost vaccination with a vector-based approach (ChAdOx-1nCov-19, ChAd) followed by an mRNA vaccine (e.g. BNT162b2, BNT) has been reported to be superior in inducing protective immunity compared to repeated application of the same vaccine. However, data comparing immunity decline after homologous and heterologous vaccination as well as effects of a third vaccine application after heterologous ChAd/BNT vaccination are lacking. Here we show longitudinal monitoring of ChAd/ChAd (n = 41) and ChAd/BNT (n = 88) vaccinated individuals and the impact of a third vaccination with BNT. The third vaccination greatly augments waning anti-spike IgG but results in only moderate increase in spike-specific CD4 + and CD8 + T cell numbers in both groups, compared to cell frequencies already present after the second vaccination in the ChAd/BNT group. More importantly, the third vaccination efficiently restores neutralizing antibody responses against the Alpha, Beta, Gamma, and Delta variants of the virus, but neutralizing activity against the B.1.1.529 (Omicron) variant remains severely impaired. In summary, inferior SARS-CoV-2 specific immune responses following homologous ChAd/ChAd vaccination can be compensated by heterologous BNT vaccination, which might influence the choice of vaccine type for subsequent vaccination boosts.
Collapse
|
7
|
SARS-CoV-2 Seroprevalence among Healthcare Workers after the First and Second Pandemic Waves. Viruses 2022; 14:v14071535. [PMID: 35891515 PMCID: PMC9322964 DOI: 10.3390/v14071535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/08/2022] [Accepted: 07/11/2022] [Indexed: 02/01/2023] Open
Abstract
Background: The Grand Hôpital de Charleroi is a large non-academic Belgian hospital that treated a large number of COVID-19 inpatients. In the context of this pandemic, all professions-combined healthcare workers (HCWs), and not only direct caregivers, are a frontline workforce in contact with suspected and confirmed COVID-19 cases and seem to be a high-risk group for exposure. The aim of our study was to estimate the prevalence of anti-SARS-CoV-2 antibodies in HCWs in our hospital after the first and second pandemic waves and to characterize the distribution of this seroprevalence in relation to various criteria. Methods: At the end of the two recruitment periods, a total of 4008 serological tests were performed in this single-center cross-sectional study. After completing a questionnaire including demographic and personal data, possible previous COVID-19 diagnostic test results and/or the presence of symptoms potentially related to COVID-19, the study participants underwent blood sampling and serological testing using DiaSorin’s LIAISON® SARS-CoV-2 S1/S2 IgG test for the first phase and LIAISON® SARS-CoV-2 TrimericS IgG test for the second phase of this study. Results: In total, 302 study participants (10.72%) in the first round of the study and 404 (33.92%) in the second round were positive for SARS-CoV-2-IgG antibodies. The prevalence of seropositivity observed after the second wave was 3.16 times higher than after the first wave. We confirmed that direct, prolonged, and repeated contact with patients or their environment was a predominant seroconversion factor, but more unexpectedly, that this was the case for all HCWs and not only caregivers. Finally, the notion of high-risk contact seemed more readily identifiable in one’s workplace than in one’s private life. Conclusions: Our study confirmed that HCWs are at a significantly higher risk of contracting COVID-19 than the general population, and suggests that repeated contacts with at-risk patients, regardless of the HCWs’ professions, represents the most important risk factor for seroconversion (Clinicaltrials.gov number, NCT04723290).
Collapse
|
8
|
Colton H, Hodgson D, Hornsby H, Brown R, Mckenzie J, Bradley KL, James C, Lindsey BB, Birch S, Marsh L, Wood S, Bayley M, Dickson G, James DC, Nicklin MJ, Sayers JR, Zafred D, Rowland-Jones SL, Kudesia G, Kucharski A, Darton TC, de Silva TI, Collini PJ. Risk factors for SARS-CoV-2 seroprevalence following the first pandemic wave in UK healthcare workers in a large NHS Foundation Trust. Wellcome Open Res 2022; 6:220. [PMID: 35600250 PMCID: PMC9091808 DOI: 10.12688/wellcomeopenres.17143.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2022] [Indexed: 11/22/2022] Open
Abstract
Background: We aimed to measure SARS-CoV-2 seroprevalence in a cohort of healthcare workers (HCWs) during the first UK wave of the COVID-19 pandemic, explore risk factors associated with infection, and investigate the impact of antibody titres on assay sensitivity. Methods: HCWs at Sheffield Teaching Hospitals NHS Foundation Trust were prospectively enrolled and sampled at two time points. We developed an in-house ELISA for testing participant serum for SARS-CoV-2 IgG and IgA reactivity against Spike and Nucleoprotein. Data were analysed using three statistical models: a seroprevalence model, an antibody kinetics model, and a heterogeneous sensitivity model. Results: Our in-house assay had a sensitivity of 99·47% and specificity of 99·56%. We found that 24·4% (n=311/1275) of HCWs were seropositive as of 12th June 2020. Of these, 39·2% (n=122/311) were asymptomatic. The highest adjusted seroprevalence was measured in HCWs on the Acute Medical Unit (41·1%, 95% CrI 30·0-52·9) and in Physiotherapists and Occupational Therapists (39·2%, 95% CrI 24·4-56·5). Older age groups showed overall higher median antibody titres. Further modelling suggests that, for a serological assay with an overall sensitivity of 80%, antibody titres may be markedly affected by differences in age, with sensitivity estimates of 89% in those over 60 years but 61% in those ≤30 years. Conclusions: HCWs in acute medical units and those working closely with COVID-19 patients were at highest risk of infection, though whether these are infections acquired from patients or other staff is unknown. Current serological assays may underestimate seroprevalence in younger age groups if validated using sera from older and/or more severe COVID-19 cases.
Collapse
Affiliation(s)
- Hayley Colton
- South Yorkshire Regional Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
| | - David Hodgson
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Hailey Hornsby
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
| | - Rebecca Brown
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
| | - Joanne Mckenzie
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
| | - Kirsty L. Bradley
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
| | - Cameron James
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
| | - Benjamin B. Lindsey
- South Yorkshire Regional Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
| | - Sarah Birch
- Academic Directorate of Communicable Diseases and Specialised Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
| | - Louise Marsh
- Academic Directorate of Communicable Diseases and Specialised Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
| | - Steven Wood
- Department of Scientific Computing and Informatics, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
| | - Martin Bayley
- Department of Scientific Computing and Informatics, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
| | - Gary Dickson
- Department of Scientific Computing and Informatics, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
| | - David C. James
- Department of Chemical and Biological Engineering, University of Sheffield, Sheffield, S10 2TN, UK
| | - Martin J. Nicklin
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
| | - Jon R. Sayers
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
- The Florey Institute for Host-Pathogen Interactions, University of Sheffield, Sheffield, S10 2TN, UK
- Sheffield Institute for Nucleic Acids, University of Sheffield, Sheffield, S10 2TN, UK
| | - Domen Zafred
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
| | - Sarah L. Rowland-Jones
- South Yorkshire Regional Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
- The Florey Institute for Host-Pathogen Interactions, University of Sheffield, Sheffield, S10 2TN, UK
| | - Goura Kudesia
- Department of Virology, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S5 7AU, UK
| | - Adam Kucharski
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - CMMID COVID-19 Working Group
- South Yorkshire Regional Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
- Academic Directorate of Communicable Diseases and Specialised Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
- Department of Scientific Computing and Informatics, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
- Department of Chemical and Biological Engineering, University of Sheffield, Sheffield, S10 2TN, UK
- The Florey Institute for Host-Pathogen Interactions, University of Sheffield, Sheffield, S10 2TN, UK
- Sheffield Institute for Nucleic Acids, University of Sheffield, Sheffield, S10 2TN, UK
- Department of Virology, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S5 7AU, UK
| | - Thomas C. Darton
- South Yorkshire Regional Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
- The Florey Institute for Host-Pathogen Interactions, University of Sheffield, Sheffield, S10 2TN, UK
| | - Thushan I. de Silva
- South Yorkshire Regional Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
- The Florey Institute for Host-Pathogen Interactions, University of Sheffield, Sheffield, S10 2TN, UK
| | - Paul J. Collini
- South Yorkshire Regional Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
- The Florey Institute for Host-Pathogen Interactions, University of Sheffield, Sheffield, S10 2TN, UK
| |
Collapse
|
9
|
Kuhlmann E, Behrens GMN, Cossmann A, Homann S, Happle C, Dopfer-Jablonka A. Healthcare Workers' Perceptions and Medically Approved COVID-19 Infection Risk: Understanding the Mental Health Dimension of the Pandemic. A German Hospital Case Study. Front Public Health 2022; 10:898840. [PMID: 35669735 PMCID: PMC9163950 DOI: 10.3389/fpubh.2022.898840] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 04/29/2022] [Indexed: 12/04/2022] Open
Abstract
Introduction This study analyses how healthcare workers (HCWs) perceived risks, protection and preventive measures during the COVID-19 pandemic in relation to medically approved risks and organizational measures. The aim is to explore “blind spots” of pandemic protection and make mental health needs of HCWs visible. Methods We have chosen an “optimal-case” scenario of a high-income country with a well-resourced hospital sector and low HCW infection rate at the organizational level to explore governance gaps in HCW protection. A German multi-method hospital study at Hannover Medical School served as empirical case; document analysis, expert information and survey data (n = 1,163) were collected as part of a clinical study into SARS-CoV-2 serology testing during the second wave of the pandemic (November 2020-February 2021). Selected survey items included perceptions of risks, protection and preventive measures. Descriptive statistical analysis and regression were undertaken for gender, profession and COVID-19 patient care. Results The results reveal a low risk of 1% medically approved infections among participants, but a much higher mean personal risk estimate of 15%. The majority (68.4%) expressed “some” to “very strong” fear of acquiring infection at the workplace. Individual protective behavior and compliance with protective workplace measures were estimated as very high. Yet only about half of the respondents felt strongly protected by the employer; 12% even perceived “no” or “little” protection. Gender and contact with COVID-19 patients had no significant effect on the estimations of infection risks and protective workplace behavior, but nursing was correlated with higher levels of personal risk estimations and fear of infection. Conclusions A strong mismatch between low medically approved risk and personal risk perceptions of HCWs brings stressors and threats into view, that may be preventable through better information, training/education and risk communication and through investment in mental health and inclusion in pandemic preparedness plans.
Collapse
Affiliation(s)
- Ellen Kuhlmann
- Clinic for Rheumatology and Immunology, Hannover Medical School, Hanover, Germany
| | - Georg M N Behrens
- Clinic for Rheumatology and Immunology, Hannover Medical School, Hanover, Germany.,German Center for Infection Research (DZIF), Braunschweig, Germany
| | - Anne Cossmann
- Clinic for Rheumatology and Immunology, Hannover Medical School, Hanover, Germany
| | - Stefanie Homann
- Clinic for Rheumatology and Immunology, Hannover Medical School, Hanover, Germany
| | - Christine Happle
- Clinic for Rheumatology and Immunology, Hannover Medical School, Hanover, Germany
| | - Alexandra Dopfer-Jablonka
- Clinic for Rheumatology and Immunology, Hannover Medical School, Hanover, Germany.,German Center for Infection Research (DZIF), Braunschweig, Germany
| |
Collapse
|
10
|
Atzl M, Muendlein A, Winder T, Fraunberger P, Brandtner EM, Geiger K, Klausberger M, Duerkop M, Sprenger L, Mutschlechner B, Volgger A, Benda M, Severgnini L, Jaeger JB, Drexel H, Lang A, Leiherer A. SARS-CoV-2 RBD-specific and NP-specific antibody response of healthcare workers in the westernmost Austrian state Vorarlberg: a prospective cohort study. BMJ Open 2022; 12:e052130. [PMID: 35613821 PMCID: PMC9174531 DOI: 10.1136/bmjopen-2021-052130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES Austria, and particularly its westernmost federal state Vorarlberg, developed an extremely high incidence rate during the COVID-19 pandemic. Healthcare workers (HCWs) worldwide are known to have an increased risk of contracting the disease within the working environment and, therefore, the seroprevalence in this population is of particular interest. We thus aimed to analyse SARS-CoV-2-specific antibody dynamics in Vorarlberg HCWs. DESIGN Prospective cohort study of HCWs including testing at three different time points for the prevalence of anti-SARS-CoV-2 IgG antibodies specific for nucleocapsid protein (NP) and receptor-binding domain (RBD). SETTING All five state hospitals of Vorarlberg. PARTICIPANTS A total of 395 HCWs, enrolled in June 2020 (time point 1 (t1)), 2 months after the end of the first wave, retested between October and November at the beginning of the second wave (time point 2 (t2)) and again at the downturn of the second wave in January 2021 (time point 3 (t3)). MAIN OUTCOMES We assessed weak and strong seropositivity and associated factors, including demographic and clinical characteristics, symptoms consistent with COVID-19 infection, infections verified by reverse transcription PCR (RT-PCR) and vaccinations. RESULTS At t1, 3% of HCWs showed strong IgG-specific responses to either NP or RBD. At t2, the rate had increased to 4%, and at t3 to 14%. A strong response was found to be stable for up to 10 months. Overall, only 55% of seropositive specimen had antibodies against both antigens RBD and NP; 29% had only RBD-specific and 16% only NP-specific antibodies. Compared with the number of infections found by RT-PCR, the number of HCWs being seropositive was 38% higher. CONCLUSION AND RELEVANCE Serological testing based on only one antigen implicates the risk of missing infections; thus, the set of antigens should be broadened in the future. The seroprevalence among participating HCWs was comparable to the general population in Austria. Nevertheless, in view of undetected infections, monitoring and surveillance should be reconsidered.
Collapse
Affiliation(s)
- Michele Atzl
- Department of Internal Medicine II, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - Axel Muendlein
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria
| | - Thomas Winder
- Department of Internal Medicine II, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - Peter Fraunberger
- Medical Central Laboratories, Feldkirch, Austria
- Private University in the Principality of Liechtenstein, Triesen, Liechtenstein
| | - Eva-Maria Brandtner
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria
| | - Kathrin Geiger
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria
- Medical Central Laboratories, Feldkirch, Austria
| | - Miriam Klausberger
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Wien, Austria
| | - Mark Duerkop
- Department of Biotechnology, University of Natural Resources and Life Sciences (BOKU) Vienna, Wien, Austria
| | - Lukas Sprenger
- Department of Internal Medicine II, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
- Private University in the Principality of Liechtenstein, Triesen, Liechtenstein
| | - Beatrix Mutschlechner
- Department of Internal Medicine II, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
- Private University in the Principality of Liechtenstein, Triesen, Liechtenstein
| | - Andreas Volgger
- Department of Internal Medicine II, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - Magdalena Benda
- Department of Internal Medicine II, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
- Private University in the Principality of Liechtenstein, Triesen, Liechtenstein
| | - Luciano Severgnini
- Department of Internal Medicine II, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - Johannes B Jaeger
- Department of Internal Medicine II, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - Heinz Drexel
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria
- Private University in the Principality of Liechtenstein, Triesen, Liechtenstein
- Department of Internal Medicine and Intensive Care, Academic Teaching Hospital Bregenz, Bregenz, Austria
- Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Alois Lang
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - Andreas Leiherer
- Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria
- Medical Central Laboratories, Feldkirch, Austria
- Private University in the Principality of Liechtenstein, Triesen, Liechtenstein
| |
Collapse
|
11
|
Contexto de trabalho e manifestações clínicas da COVID-19 em profissionais de saúde. ACTA PAUL ENFERM 2022. [DOI: 10.37689/acta-ape/2022ao0163345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
12
|
Su WY, Du PX, Santos HM, Ho TS, Keskin BB, Pau CH, Yang AM, Chou YY, Shih HC, Syu GD. Antibody Profiling in COVID-19 Patients with Different Severities by Using Spike Variant Protein Microarrays. Anal Chem 2022; 94:6529-6539. [PMID: 35442638 PMCID: PMC9045038 DOI: 10.1021/acs.analchem.1c05567] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 04/11/2022] [Indexed: 12/21/2022]
Abstract
The disease progression of COVID-19 varies from mild to severe, even death. However, the link between COVID-19 severities and humoral immune specificities is not clear. Here, we developed a multiplexed spike variant protein microarray (SVPM) and utilized it for quantifying neutralizing activity, drug screening, and profiling humoral immunity. First, we demonstrated the competition between antispike antibody and ACE2 on SVPM for measuring the neutralizing activity against multiple spike variants. Next, we collected the serums from healthy subjects and COVID-19 patients with different severities and profile the neutralizing activity as well as antibody isotypes. We identified the inhibition of ACE2 binding was stronger against multiple variants in severe compared to mild/moderate or critical patients. Moreover, the serum IgG against nonstructural protein 3 was elevated in severe but not in mild/moderate and critical cases. Finally, we evaluated two ACE2 inhibitors, Ramipril and Perindopril, and found the dose-dependent inhibition of ACE2 binding to all the spike variants except for B.1.617.3. Together, the SVPM and the assay procedures provide a tool for profiling neutralizing antibodies, antibody isotypes, and reagent specificities.
Collapse
Affiliation(s)
- Wen-Yu Su
- Department
of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan 701, Taiwan
| | - Pin-Xian Du
- Department
of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan 701, Taiwan
| | - Harvey M. Santos
- Department
of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan 701, Taiwan
- School
of Chemical, Biological and Materials Engineering and Sciences, Mapúa University, Intramuros, Manila 1002, Philippines
| | - Tzong-Shiann Ho
- Department
of Pediatrics, National Cheng Kung University
Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Center
of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan 701, Taiwan
- Department
of Pediatrics, Tainan Hospital, Ministry
of Health and Welfare, Tainan 700, Taiwan
| | - Batuhan Birol Keskin
- Department
of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan 701, Taiwan
| | - Chi Ho Pau
- Department
of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan 701, Taiwan
| | - An-Ming Yang
- Department
of Internal Medicine, En Chu Kong Hospital, New Taipei City 237, Taiwan
- Department
of Nursing, Yuanpei University of Medical
Technology, Hsinchu 300, Taiwan
| | - Yi-Yu Chou
- Department
of Nursing, Kaohsiung Armed Forces General
Hospital, Kaohsiung 802, Taiwan
| | - Hsi-Chang Shih
- Department
of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, United States
| | - Guan-Da Syu
- Department
of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan 701, Taiwan
- Research
Center of Excellence in Regenerative Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Medical
Device Innovation Center, National Cheng
Kung University, Tainan 701, Taiwan
| |
Collapse
|
13
|
Hussein K, Shachor-Meyouhas Y, Dabaja-Younis H, Szwarcwort-Cohen M, Tarabeia J, Weissman A, Mekel M, Hyams G, Halberthal M. COVID-19: Healthcare Workers May Be at Greater Risk Outside Their Work Environment-A Retrospective Observational Study. Rambam Maimonides Med J 2022; 13:RMMJ.10469. [PMID: 35482461 PMCID: PMC9049148 DOI: 10.5041/rmmj.10469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND With the availability of coronavirus disease 2019 (COVID-19) vaccine, concerns have been raised regarding pre-vaccination seroprevalence in healthcare workers (HCW). This study examines the seroprevalence of HCW at an Israeli tertiary medical center before first BNT162b2 vaccination. METHODS This was a retrospective observational study. Before vaccination, HCW at our center were offered serological testing. Data on their epidemiological, workplace, and quarantine history were collected. The SARS-CoV-2 IgG assay was performed pre-vaccination. RESULTS A total of 4,519 (82.5%) of the HCW were tested. Of these, 210 were seropositive; 101 had no known history of COVID-19. Of the 101 asymptomatic HCW, only 3 (3%) had worked at COVID-19 departments, and 70 (69.3%) had not been previously quarantined. Positive serology was similarly distributed across age groups, and about 40% had no children. Nearly half of the HCW tested were administrative and service staff. Overall, seropositive tests were associated with having no children (OR 1.42, 95% CI 1.06-1.89; P=0.0218), history of having been quarantined without proof of disease (OR 6.04, 95% CI 4.55-8.01; P<0.001), and Arab ethnicity (OR 3.36, 95% CI 2.54-4.43; P<0.001). Seropositivity was also more prevalent in members of the administration compared to other sectors, medical and paramedical, who are exposed to patients in their daily work (OR 1.365, 95% CI 1.02-1.82; P=0.04). CONCLUSIONS The low percentage of asymptomatic COVID-19 among our HCW may reflect the high compliance to personal protective equipment use despite treating hundreds of COVID-19 patients. The relatively high number of childless seropositive HCW could reflect misconceptions regarding children as a main source of infection, leading to carelessness regarding the need for appropriate out-of-hospital protection.
Collapse
Affiliation(s)
- Khetam Hussein
- The Infection Control Unit, Rambam Health Care Campus, Haifa, Israel
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel
- To whom correspondence should be addressed. E-mail: or
| | - Yael Shachor-Meyouhas
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel
- Pediatric Infectious Diseases Unit, Ruth Rappaport Children’s Hospital, Rambam Health Care Campus, Haifa, Israel
- Management, Rambam Health Care Campus, Haifa, Israel
- To whom correspondence should be addressed. E-mail: or
| | - Halima Dabaja-Younis
- Pediatric Infectious Diseases Unit, Ruth Rappaport Children’s Hospital, Rambam Health Care Campus, Haifa, Israel
| | | | - Jalal Tarabeia
- The Infection Control Unit, Rambam Health Care Campus, Haifa, Israel
| | - Avi Weissman
- Management, Rambam Health Care Campus, Haifa, Israel
| | - Michal Mekel
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel
- Management, Rambam Health Care Campus, Haifa, Israel
| | - Gila Hyams
- Nursing Administration and Management, Rambam Health Care Campus, Haifa, Israel
| | - Michael Halberthal
- The Ruth & Bruce Rappaport Faculty of Medicine, Technion–Israel Institute of Technology, Haifa, Israel
- Management, Rambam Health Care Campus, Haifa, Israel
| |
Collapse
|
14
|
Colton H, Hodgson D, Hornsby H, Brown R, Mckenzie J, Bradley KL, James C, Lindsey BB, Birch S, Marsh L, Wood S, Bayley M, Dickson G, James DC, Nicklin MJ, Sayers JR, Zafred D, Rowland-Jones SL, Kudesia G, Kucharski A, Darton TC, de Silva TI, Collini PJ. Risk factors for SARS-CoV-2 seroprevalence following the first pandemic wave in UK healthcare workers in a large NHS Foundation Trust. Wellcome Open Res 2022; 6:220. [PMID: 35600250 PMCID: PMC9091808 DOI: 10.12688/wellcomeopenres.17143.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2022] [Indexed: 11/20/2022] Open
Abstract
Background: We aimed to measure SARS-CoV-2 seroprevalence in a cohort of healthcare workers (HCWs) during the first UK wave of the COVID-19 pandemic, explore risk factors associated with infection, and investigate the impact of antibody titres on assay sensitivity. Methods: HCWs at Sheffield Teaching Hospitals NHS Foundation Trust were prospectively enrolled and sampled at two time points. We developed an in-house ELISA for testing participant serum for SARS-CoV-2 IgG and IgA reactivity against Spike and Nucleoprotein. Data were analysed using three statistical models: a seroprevalence model, an antibody kinetics model, and a heterogeneous sensitivity model. Results: Our in-house assay had a sensitivity of 99·47% and specificity of 99·56%. We found that 24·4% (n=311/1275) of HCWs were seropositive as of 12th June 2020. Of these, 39·2% (n=122/311) were asymptomatic. The highest adjusted seroprevalence was measured in HCWs on the Acute Medical Unit (41·1%, 95% CrI 30·0-52·9) and in Physiotherapists and Occupational Therapists (39·2%, 95% CrI 24·4-56·5). Older age groups showed overall higher median antibody titres. Further modelling suggests that, for a serological assay with an overall sensitivity of 80%, antibody titres may be markedly affected by differences in age, with sensitivity estimates of 89% in those over 60 years but 61% in those ≤30 years. Conclusions: HCWs in acute medical units and those working closely with COVID-19 patients were at highest risk of infection, though whether these are infections acquired from patients or other staff is unknown. Current serological assays may underestimate seroprevalence in younger age groups if validated using sera from older and/or more severe COVID-19 cases.
Collapse
Affiliation(s)
- Hayley Colton
- South Yorkshire Regional Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
| | - David Hodgson
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Hailey Hornsby
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
| | - Rebecca Brown
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
| | - Joanne Mckenzie
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
| | - Kirsty L. Bradley
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
| | - Cameron James
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
| | - Benjamin B. Lindsey
- South Yorkshire Regional Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
| | - Sarah Birch
- Academic Directorate of Communicable Diseases and Specialised Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
| | - Louise Marsh
- Academic Directorate of Communicable Diseases and Specialised Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
| | - Steven Wood
- Department of Scientific Computing and Informatics, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
| | - Martin Bayley
- Department of Scientific Computing and Informatics, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
| | - Gary Dickson
- Department of Scientific Computing and Informatics, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
| | - David C. James
- Department of Chemical and Biological Engineering, University of Sheffield, Sheffield, S10 2TN, UK
| | - Martin J. Nicklin
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
| | - Jon R. Sayers
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
- The Florey Institute for Host-Pathogen Interactions, University of Sheffield, Sheffield, S10 2TN, UK
- Sheffield Institute for Nucleic Acids, University of Sheffield, Sheffield, S10 2TN, UK
| | - Domen Zafred
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
| | - Sarah L. Rowland-Jones
- South Yorkshire Regional Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
- The Florey Institute for Host-Pathogen Interactions, University of Sheffield, Sheffield, S10 2TN, UK
| | - Goura Kudesia
- Department of Virology, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S5 7AU, UK
| | - Adam Kucharski
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - CMMID COVID-19 Working Group
- South Yorkshire Regional Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
- Academic Directorate of Communicable Diseases and Specialised Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
- Department of Scientific Computing and Informatics, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
- Department of Chemical and Biological Engineering, University of Sheffield, Sheffield, S10 2TN, UK
- The Florey Institute for Host-Pathogen Interactions, University of Sheffield, Sheffield, S10 2TN, UK
- Sheffield Institute for Nucleic Acids, University of Sheffield, Sheffield, S10 2TN, UK
- Department of Virology, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S5 7AU, UK
| | - Thomas C. Darton
- South Yorkshire Regional Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
- The Florey Institute for Host-Pathogen Interactions, University of Sheffield, Sheffield, S10 2TN, UK
| | - Thushan I. de Silva
- South Yorkshire Regional Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
- The Florey Institute for Host-Pathogen Interactions, University of Sheffield, Sheffield, S10 2TN, UK
| | - Paul J. Collini
- South Yorkshire Regional Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
- The Florey Institute for Host-Pathogen Interactions, University of Sheffield, Sheffield, S10 2TN, UK
| |
Collapse
|
15
|
Erber J, Kappler V, Haller B, Mijočević H, Galhoz A, Prazeres da Costa C, Gebhardt F, Graf N, Hoffmann D, Thaler M, Lorenz E, Roggendorf H, Kohlmayer F, Henkel A, Menden MP, Ruland J, Spinner CD, Protzer U, Knolle P, Lingor P. Infection Control Measures and Prevalence of SARS-CoV-2 IgG among 4,554 University Hospital Employees, Munich, Germany. Emerg Infect Dis 2022; 28:572-581. [PMID: 35195515 PMCID: PMC8888242 DOI: 10.3201/eid2803.204436] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
|
16
|
Korona-Głowniak I, Mielnik M, Podgajna M, Grywalska E, Hus M, Matuska K, Wojtysiak-Duma B, Duma D, Glowniak A, Malm A. SARS-CoV-2 Seroprevalence in Healthcare Workers before the Vaccination in Poland: Evolution from the First to the Second Pandemic Outbreak. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042319. [PMID: 35206504 PMCID: PMC8871845 DOI: 10.3390/ijerph19042319] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 01/30/2022] [Accepted: 02/14/2022] [Indexed: 02/04/2023]
Abstract
Healthcare workers (HCWs) are on the frontline, struggling with the pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To describe recent or past infections, the serological assays enabled the assessment of the immune response developed in coronavirus disease (COVID-19) in the period when testing was hardly available. In this study, we investigated SARS-CoV-2 seroprevalence in HCWs in a Polish teaching hospital and the Regional Occupational Medicine Center after both the first and the second waves. ELISA-based tests for anti-SARS-CoV-2 IgA and IgG were used to determine immune response to SARS-CoV-2 in volunteer HCWs who worked in those institutions in May 2020 (208 participants aged 47.1 ± 12.5, 88% women) and in December 2020 (179 participants aged 45.2 ± 12.4, 86% woman). Risk factors for seropositivity were also assessed using a questionnaire filled out by all participants. We reported a significant increase in seroprevalence after the second wave (22.9%) compared with the first outbreak (2.4%) (OR 12.1; 95%CI 4.6–31.3; p < 0.0001). An association between IgG seroprevalence and severity of infections was noted. Furthermore, we demonstrated that amongst medical personnel, nurses exhibited a proportionally higher SARS-CoV-2 seroprevalence. Moreover, given the high seroprevalence in non-clinical group of HCWs, we suggest that community transmission can play a superior role to workplace exposure.
Collapse
Affiliation(s)
- Izabela Korona-Głowniak
- Department of Pharmaceutical Microbiology, Medical University of Lublin, 20-093 Lublin, Poland; (K.M.); (A.M.)
- Correspondence:
| | - Michał Mielnik
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-081 Lublin, Poland; (M.M.); (M.H.)
| | - Martyna Podgajna
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland; (M.P.); (E.G.)
| | - Ewelina Grywalska
- Department of Experimental Immunology, Medical University of Lublin, 20-093 Lublin, Poland; (M.P.); (E.G.)
| | - Marek Hus
- Department of Hematooncology and Bone Marrow Transplantation, Medical University of Lublin, 20-081 Lublin, Poland; (M.M.); (M.H.)
| | - Katarzyna Matuska
- Department of Pharmaceutical Microbiology, Medical University of Lublin, 20-093 Lublin, Poland; (K.M.); (A.M.)
| | - Beata Wojtysiak-Duma
- Department of Laboratory Diagnostics, Medical University, 20-093 Lublin, Poland; (B.W.-D.); (D.D.)
| | - Dariusz Duma
- Department of Laboratory Diagnostics, Medical University, 20-093 Lublin, Poland; (B.W.-D.); (D.D.)
| | - Andrzej Glowniak
- Department of Cardiology, Medical University of Lublin, 20-093 Lublin, Poland;
- Clinical Department of Electrocardiology, SPSK-4 University Hospital, 20-090 Lublin, Poland
| | - Anna Malm
- Department of Pharmaceutical Microbiology, Medical University of Lublin, 20-093 Lublin, Poland; (K.M.); (A.M.)
| |
Collapse
|
17
|
Zattoni IF, Huergo LF, Gerhardt ECM, Nardin JM, Dos Santos AMF, de Moraes Rego FG, Picheth G, Moure VR, Valdameri G. Multiplexed flow cytometric approach for detection of anti-SARS-CoV-2 IgG, IgM and IgA using beads covalently coupled to the nucleocapsid protein. Lett Appl Microbiol 2022; 74:863-872. [PMID: 35148433 PMCID: PMC9115257 DOI: 10.1111/lam.13674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 11/30/2022]
Abstract
Flow cytometry has emerged as a promising technique for detection of SARS‐CoV‐2 antibodies. In this study, we developed an innovative strategy for simultaneous detection of immunoglobulin G (IgG), IgM and IgA. The SARS‐CoV‐2 nucleocapsid protein was covalently bound to functional beads surface applying sulpho‐SMCC chemistry. BUV395 anti‐IgG, BB515 anti‐IgM, biotinylated anti‐IgA1/IgA2 and BV421 streptavidin were used as fluorophore conjugated secondary antibodies. Serum and antibodies reaction conditions were optimized for each antibody isotype detection and a multiplexed detection assay was developed. This new cell‐free assay efficiently discriminate COVID‐19 negative and positive samples. The simultaneous detection of IgG, IgM and IgA showed a sensitivity of 88·5–96·2% and specificity of 100%. This novel strategy opens a new avenue for flow cytometry‐based diagnosis.
Collapse
Affiliation(s)
- Ingrid Fatima Zattoni
- Pharmaceutical Sciences Graduate Program, Laboratory of Cancer Drug Resistance, Federal University of Paraná, 80210-170, Curitiba, PR, Brazil
| | - Luciano F Huergo
- Setor Litoral, Federal University of Paraná, 83260-000, Matinhos, PR, Brazil
| | - Edileusa C M Gerhardt
- Department of Biochemistry and Molecular Biology, Federal University of Paraná, 80060-000, Curitiba, PR, Brazil
| | | | | | | | - Geraldo Picheth
- Department of Clinical Analysis, Federal University of Paraná, 80210-170, Curitiba, PR, Brazil
| | - Vivian Rotuno Moure
- Pharmaceutical Sciences Graduate Program, Laboratory of Cancer Drug Resistance, Federal University of Paraná, 80210-170, Curitiba, PR, Brazil.,Department of Clinical Analysis, Federal University of Paraná, 80210-170, Curitiba, PR, Brazil
| | - Glaucio Valdameri
- Pharmaceutical Sciences Graduate Program, Laboratory of Cancer Drug Resistance, Federal University of Paraná, 80210-170, Curitiba, PR, Brazil.,Department of Clinical Analysis, Federal University of Paraná, 80210-170, Curitiba, PR, Brazil
| |
Collapse
|
18
|
Evolution of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) seroprevalence among employees of a US academic children's hospital during coronavirus disease 2019 (COVID-19) pandemic. Infect Control Hosp Epidemiol 2021; 43:1647-1655. [PMID: 34852866 PMCID: PMC8668398 DOI: 10.1017/ice.2021.487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: To describe the cumulative seroprevalence of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) antibodies during the coronavirus disease 2019 (COVID-19) pandemic among employees of a large pediatric healthcare system. Design, setting, and participants: Prospective observational cohort study open to adult employees at the Children’s Hospital of Philadelphia, conducted April 20–December 17, 2020. Methods: Employees were recruited starting with high-risk exposure groups, utilizing e-mails, flyers, and announcements at virtual town hall meetings. At baseline, 1 month, 2 months, and 6 months, participants reported occupational and community exposures and gave a blood sample for SARS-CoV-2 antibody measurement by enzyme-linked immunosorbent assays (ELISAs). A post hoc Cox proportional hazards regression model was performed to identify factors associated with increased risk for seropositivity. Results: In total, 1,740 employees were enrolled. At 6 months, the cumulative seroprevalence was 5.3%, which was below estimated community point seroprevalence. Seroprevalence was 5.8% among employees who provided direct care and was 3.4% among employees who did not perform direct patient care. Most participants who were seropositive at baseline remained positive at follow-up assessments. In a post hoc analysis, direct patient care (hazard ratio [HR], 1.95; 95% confidence interval [CI], 1.03–3.68), Black race (HR, 2.70; 95% CI, 1.24–5.87), and exposure to a confirmed case in a nonhealthcare setting (HR, 4.32; 95% CI, 2.71–6.88) were associated with statistically significant increased risk for seropositivity. Conclusions: Employee SARS-CoV-2 seroprevalence rates remained below the point-prevalence rates of the surrounding community. Provision of direct patient care, Black race, and exposure to a confirmed case in a nonhealthcare setting conferred increased risk. These data can inform occupational protection measures to maximize protection of employees within the workplace during future COVID-19 waves or other epidemics.
Collapse
|
19
|
Lustig Y, Cohen C, Biber A, Jaber H, Becker Ilany Y, Indenbaum V, Amit S, Mandelboim M, Mendelson E, Regev-Yochay G. Immunoglobulin (Ig)A seropositivity against SARS-CoV-2 in healthcare workers in Israel, 4 April to 13 July 2020: an observational study. Euro Surveill 2021; 26. [PMID: 34857065 PMCID: PMC8641069 DOI: 10.2807/1560-7917.es.2021.26.48.2001690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction The COVID-19 pandemic has put healthcare workers (HCW) at significant risk. Presence of antibodies can confirm prior severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Aim This study investigates the prevalence of IgA and IgG antibodies against SARS-CoV-2 in HCW. Methods Performance of IgA and IgG antibody ELISA assays were initially evaluated in positive and negative SARS-CoV-2 serum samples. IgA and IgG antibodies against SARS-CoV-2 were measured in 428 asymptomatic HCW. We assessed the risk of two groups: HCW with high exposure risk outside work (HROW) residing in areas where COVID-19 was endemic (n = 162) and HCW with high exposure risk at work (HRAW) in a COVID-19 intensive care unit (ICU) (n = 97). Results Sensitivities of 80% and 81.2% and specificities of 97.2% and 98% were observed for IgA and IgG antibodies, respectively. Of the 428 HCW, three were positive for IgG and 27 for IgA. Only 3/27 (11%) IgA-positive HCW had IgG antibodies compared with 50/62 (81%) in a group of previous SARS-CoV-2-PCR-positive individuals. Consecutive samples from IgA-positive HCW demonstrated IgA persistence 18–83 days in 12/20 samples and IgG seroconversion in 1/20 samples. IgA antibodies were present in 8.6% of HROW and 2% of HRAW. Conclusions SARS-CoV-2 exposure may lead to asymptomatic transient IgA response without IgG seroconversion. The significance of these findings needs further study. Out of work exposure is a possible risk of SARS-CoV-2 infection in HCW and infection in HCW can be controlled if adequate protective equipment is implemented.
Collapse
Affiliation(s)
- Yaniv Lustig
- Sackler Faculty of Medicine, Tel-Aviv University, Israel
- Central Virology Laboratory, Ministry of Health, Tel-Hashomer, Israel
| | - Carmit Cohen
- Infection Prevention & Control Unit, Sheba Medical Center, Ramat-Gan, Israel
| | - Asaf Biber
- Infection Prevention & Control Unit, Sheba Medical Center, Ramat-Gan, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Israel
| | - Hanaa Jaber
- Infection Prevention & Control Unit, Sheba Medical Center, Ramat-Gan, Israel
| | - Yael Becker Ilany
- Infection Prevention & Control Unit, Sheba Medical Center, Ramat-Gan, Israel
| | | | - Sharon Amit
- Microbiology Laboratory, Sheba Medical Center, Ramat-Gan, Israel
| | - Michal Mandelboim
- Sackler Faculty of Medicine, Tel-Aviv University, Israel
- Central Virology Laboratory, Ministry of Health, Tel-Hashomer, Israel
| | - Ella Mendelson
- Sackler Faculty of Medicine, Tel-Aviv University, Israel
- Central Virology Laboratory, Ministry of Health, Tel-Hashomer, Israel
| | - Gili Regev-Yochay
- Infection Prevention & Control Unit, Sheba Medical Center, Ramat-Gan, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Israel
| |
Collapse
|
20
|
Riccò M, Gualerzi G, Ranzieri S, Peruzzi S, Valente M, Marchesi F, Bragazzi NL, Signorelli C. Occurrence of SARS-CoV-2 infection among healthcare personnel: results from an early systematic review and meta-analysis. ACTA BIO-MEDICA : ATENEI PARMENSIS 2021; 92:e2021311. [PMID: 34738585 PMCID: PMC8689308 DOI: 10.23750/abm.v92i5.10438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 08/12/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND SARS-CoV-2 infection has become a global public health concern globally. Even though Healthcare Workers (HCWs) are supposedly at increased risk for SARS-CoV-2 infection, to date no pooled evidence has been collected. MATERIALS AND METHODS We searched online electronic databases (PubMed, Embase, medRxiv.org for pre-prints) for all available contribution (up to May 20, 2019). Two Authors independently screened articles and extracted the data. The pooled prevalence of SARS-CoV-2 was analyzed using the random-effects model. The possible sources of heterogeneity were analyzed through subgroup analysis, and meta-regression. RESULTS The overall pooled prevalence of SARS-CoV-2 was 3.5% (95%CI 1.8-6.6) for studies based on molecular assays, 5.5% (95%CI 2.1-14.1) for studies based on serological assays, and 6.5% (95%CI 2.5-15.6) for point-of-care capillary blood tests. Among subgroups, serological tests identified higher risk for SARS-CoV-2 seropositivity in physicians than in nurses (OR 1.436, 95%CI 1.026 to 2.008). Regression analysis indicated the possible presence of publication bias only for molecular tests (t -3.3526, p-value 0.002648). CONCLUSIONS The overall pooled prevalence of SARS-CoV-2 was lower than previously expected, but available studies were affected by significant heterogeneity, and the molecular studies by significant publication bias. Therefore, further high-quality research in the field is warranted.
Collapse
Affiliation(s)
- Matteo Riccò
- Azienda USL di Reggio EmiliaV.le Amendola n.2 - 42122 REServizio di Prevenzione e Sicurezza negli Ambienti di Lavoro (SPSAL)Dip. di Prevenzione.
| | - Giovanni Gualerzi
- 2 Department of Medicine and Surgery, School of Medicine, University of Parma, 43123 Parma (PR), Italy.
| | - Silvia Ranzieri
- 3 Department of Medicine and Surgery, School of Occupational Medicine, University of Parma, I-43123 Parma (PR), Italy.
| | - Simona Peruzzi
- 4 AUSL-IRCCS di Reggio Emilia, Laboratorio Analisi Chimico Cliniche e Microbiologiche, Ospedale Civile di Guastalla, I-42016 Guastalla (RE), Italy.
| | - Marina Valente
- Department of Medicine and Surgery, Unit of Clinical Surgery, University of Parma, I-43123 Parma (PR), Italy.
| | - Federico Marchesi
- Department of Medicine and Surgery, Unit of Clinical Surgery, University of Parma, I-43123 Parma (PR), Italy.
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, 4700 Keele Street, Toronto, ON M3J 1P3, Canada.
| | - Carlo Signorelli
- University "Vita e Salute", San Raffaele Hospital, 20132 Milan (MI), Italy.
| |
Collapse
|
21
|
Jespersen S, Mikkelsen S, Greve T, Kaspersen KA, Tolstrup M, Boldsen JK, Redder JD, Nielsen K, Abildgaard AM, Kolstad HA, Østergaard L, Thomsen MK, Møller HJ, Erikstrup C. Severe Acute Respiratory Syndrome Coronavirus 2 Seroprevalence Survey Among 17 971 Healthcare and Administrative Personnel at Hospitals, Prehospital Services, and Specialist Practitioners in the Central Denmark Region. Clin Infect Dis 2021; 73:e2853-e2860. [PMID: 33011792 PMCID: PMC7797753 DOI: 10.1093/cid/ciaa1471] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 09/30/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The objective of this study was to perform a seroprevalence survey on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among Danish healthcare workers to identify high-risk groups. METHODS All healthcare workers and administrative personnel at the 7 hospitals, prehospital services, and specialist practitioner clinics in the Central Denmark Region were invited to be tested by a commercial SARS-CoV-2 total antibody enzyme-linked immunosorbent assay (Wantai Biological Pharmacy Enterprise Co, Ltd, Beijing, China). RESULTS A total of 25 950 participants were invited. Of these, 17 971 had samples available for SARS-CoV-2 antibody testing. After adjustment for assay sensitivity and specificity, the overall seroprevalence was 3.4% (95% confidence interval [CI], 2.5%-3.8%). The seroprevalence was higher in the western part of the region than in the eastern part (11.9% vs 1.2%; difference: 10.7 percentage points [95% CI, 9.5-12.2]). In the high-prevalence area, the emergency departments had the highest seroprevalence (29.7%), whereas departments without patients or with limited patient contact had the lowest seroprevalence (2.2%). Among the total 668 seropositive participants, 433 (64.8%) had previously been tested for SARS-CoV-2 RNA, and 50.0% had a positive reverse-transcription polymerase chain reaction (PCR) result. CONCLUSIONS We found large differences in the prevalence of SARS-CoV-2 antibodies in staff working in the healthcare sector within a small geographical area of Denmark. Half of all seropositive staff had been tested positive by PCR prior to this survey. This study raises awareness of precautions that should be taken to avoid in-hospital transmission. Regular testing of healthcare workers for SARS-CoV-2 should be considered to identify areas with increased transmission.
Collapse
Affiliation(s)
- Sanne Jespersen
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - Susan Mikkelsen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas Greve
- Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark
| | - Kathrine Agergård Kaspersen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
- Danish Big Data Centre for Environment and Health, Aarhus University, Roskilde, Denmark
| | - Martin Tolstrup
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | - Jens Kjærgaard Boldsen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
- Danish Big Data Centre for Environment and Health, Aarhus University, Roskilde, Denmark
| | | | - Kent Nielsen
- Department of Occupational Medicine, Herning Regional Hospital, Herning, Denmark
| | | | | | - Lars Østergaard
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark
| | | | - Holger Jon Møller
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| |
Collapse
|
22
|
Vaselli NM, Hungerford D, Shenton B, Khashkhusha A, Cunliffe NA, French N. The seroprevalence of SARS-CoV-2 during the first wave in Europe 2020: A systematic review. PLoS One 2021; 16:e0250541. [PMID: 34727115 PMCID: PMC8562786 DOI: 10.1371/journal.pone.0250541] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 09/23/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND A year following the onset of the COVID-19 pandemic, new infections and deaths continue to increase in Europe. Serological studies, through providing evidence of past infection, can aid understanding of the population dynamics of SARS-CoV-2 infection. OBJECTIVES This systematic review of SARS-CoV-2 seroprevalence studies in Europe was undertaken to inform public health strategies including vaccination, that aim to accelerate population immunity. METHODS We searched the databases Web of Science, MEDLINE, EMBASE, SCOPUS, Cochrane Database of Systematic Reviews and grey literature sources for studies reporting seroprevalence of SARS-CoV-2 antibodies in Europe published between 01/12/2019-30/09/20. We provide a narrative synthesis of included studies. Studies were categorized into subgroups including healthcare workers (HCWs), community, outbreaks, pregnancy and children/school. Due to heterogeneity in other subgroups, we only performed a random effects meta-analysis of the seroprevalence amongst HCWs stratified by their country. RESULTS 115 studies were included spanning 17 European countries, that estimated the seroprevalence of SARS-CoV-2 from samples obtained between November 2019 -August 2020. A total of 54/115 studies included HCWs with a reported seroprevalence among HCWs ranging from 0.7% to 45.3%, which did not differ significantly by country. In community studies significant heterogeneity was reported in the seroprevalence between different age groups and the majority of studies reported there was no significant difference by gender. CONCLUSION This review demonstrates a wide heterogeneity in reported seroprevalence of SARS-CoV-2 antibodies between populations. Continued evaluation of seroprevalence is required to understand the impact of public health measures and inform interventions including vaccination programmes.
Collapse
Affiliation(s)
- Natasha Marcella Vaselli
- Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Daniel Hungerford
- Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
- NIHR HPRU in Gastrointestinal Infections at the University of Liverpool, Liverpool, United Kingdom
- NIHR HPRU in Emerging and Zoonotic Infections at the University of Liverpool, Liverpool, United Kingdom
| | - Ben Shenton
- Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Arwa Khashkhusha
- School of Medicine, Faculty of Life Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Nigel A. Cunliffe
- Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
- NIHR HPRU in Gastrointestinal Infections at the University of Liverpool, Liverpool, United Kingdom
| | - Neil French
- Institute of Infection, Veterinary & Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
- NIHR HPRU in Emerging and Zoonotic Infections at the University of Liverpool, Liverpool, United Kingdom
| |
Collapse
|
23
|
Herzberg J, Vollmer T, Fischer B, Becher H, Becker AK, Sahly H, Honarpisheh H, Guraya SY, Strate T, Knabbe C. Half-Year Longitudinal Seroprevalence of SARS-CoV-2-Antibodies and Rule Compliance in German Hospital Employees. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010972. [PMID: 34682719 PMCID: PMC8535494 DOI: 10.3390/ijerph182010972] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 10/05/2021] [Accepted: 10/13/2021] [Indexed: 01/02/2023]
Abstract
COVID-19, which is caused by SARS-CoV-2, is an occupational health risk, especially for healthcare employees due to their higher exposure and consequently higher risk of symptomatic and asymptomatic infections. This study was designed to determine the longitudinal seroprevalence of specific immunoglobulin-G (IgG) antibodies in employees in a hospital setting. All employees in a secondary care hospital, including healthcare and non-healthcare workers, were invited to participate in this single-center study. After an initial screening, a 6-month follow-up was carried out, which included serological examination for SARS-CoV-2 IgG antibodies and a questionnaire for self-reported symptoms, self-perception, and thoughts about local and national hygiene and pandemic plans. The seroprevalence of SARS-CoV-2 IgG antibodies was 0.74% among 406 hospital employees (0.75% in healthcare workers, 0.72% in non-healthcare workers), initially recruited in April 2020, in their follow-up blood specimens in October 2020. In this study, 30.54% of the participants reported using the official German coronavirus mobile application and the majority were content with the local and national rules in relation to coronavirus-related restrictions. At the 6-month follow-up, the 0.74% seroprevalence was below the reported seroprevalence of 1.35% in the general German population. The prevalence in healthcare workers in direct patient care compared with that in workers without direct patient contact did not differ significantly. Further follow-up to monitor the seroprevalence in the high-risk healthcare sector during the ongoing global pandemic is essential.
Collapse
Affiliation(s)
- Jonas Herzberg
- Department of Surgery, Krankenhaus Reinbek St. Adolf-Stift, Hamburger Strasse 41, 21465 Reinbek, Germany; (H.H.); (T.S.)
- Correspondence: ; Tel.: +49-40-7280-5375
| | - Tanja Vollmer
- Institut für Laboratoriums- und Transfusionsmedizin, Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitätsklinik der Ruhr-Universität Bochum, Georgstrasse 11, 32545 Bad Oeynhausen, Germany; (T.V.); (B.F.); (C.K.)
| | - Bastian Fischer
- Institut für Laboratoriums- und Transfusionsmedizin, Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitätsklinik der Ruhr-Universität Bochum, Georgstrasse 11, 32545 Bad Oeynhausen, Germany; (T.V.); (B.F.); (C.K.)
| | - Heiko Becher
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany;
| | - Ann-Kristin Becker
- Asklepios Klinik Harburg Abteilung für Psychiatrie und Psychotherapie, Eißendorfer Pferdeweg 52, 21075 Hamburg, Germany;
| | - Hany Sahly
- Labor Lademannbogen MVZ Hamburg, Lademannbogen 61, 22339 Hamburg, Germany;
| | - Human Honarpisheh
- Department of Surgery, Krankenhaus Reinbek St. Adolf-Stift, Hamburger Strasse 41, 21465 Reinbek, Germany; (H.H.); (T.S.)
| | - Salman Yousuf Guraya
- Clinical Sciences Department, College of Medicine, University of Sharjah, P.O. Box 27272, Sharjah, United Arab Emirates;
| | - Tim Strate
- Department of Surgery, Krankenhaus Reinbek St. Adolf-Stift, Hamburger Strasse 41, 21465 Reinbek, Germany; (H.H.); (T.S.)
| | - Cornelius Knabbe
- Institut für Laboratoriums- und Transfusionsmedizin, Herz- und Diabeteszentrum Nordrhein-Westfalen, Universitätsklinik der Ruhr-Universität Bochum, Georgstrasse 11, 32545 Bad Oeynhausen, Germany; (T.V.); (B.F.); (C.K.)
| |
Collapse
|
24
|
Yaghoubi M, Salimi M, Meskarpour-Amiri M. Systematic review of productivity loss among healthcare workers due to Covid-19. Int J Health Plann Manage 2021; 37:94-111. [PMID: 34655098 PMCID: PMC8652830 DOI: 10.1002/hpm.3351] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 09/26/2021] [Accepted: 10/01/2021] [Indexed: 12/12/2022] Open
Abstract
Objective To assess existing evidence on the effects of COVID‐19 on healthcare workers (HCWs) using the health‐related productivity loss approach. Methods A systematic search of online databases including PubMed, Scopus, Ovid, Web of Science, and EMBASE was conducted up to 25 August 2020. Following two screening stages, studies related to the effects of COVID‐19 on healthcare workers were included in the study. Results 82 studies were included in the analysis. The COVID‐19 related death rate among HCWs ranged from 0.00‐0.7%, while the positive test incidence varied between 0.00 and 24.4%. 39 evidences assessed psychological disorders. A wide range of psychological disorders observed among HCWs: 5.2 to 71.2% in anxiety, 1.00 to 88.3% in stress, 8.27 to 61.67% in insomnia, and 4.5 to 50.4% in depression. Conclusions The early evidence suggests that healthcare workers are one of the most vulnerable groups when it comes to positive COVID‐19 infection, mortality, and mental illness.
Collapse
Affiliation(s)
- Maryam Yaghoubi
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohammad Salimi
- Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | | |
Collapse
|
25
|
Dehnen D, Dehnen K, Trilling M, Fiedler M, Drexler J, Goralski M, Le-Trilling VTK, Schöler L, Jöckel KH, Heßbrügge M. Discrepancy between frequent occurrence of COVID-19-like symptoms and low seroconversion rates among healthcare workers. J Med Virol 2021; 94:951-957. [PMID: 34633099 PMCID: PMC8661860 DOI: 10.1002/jmv.27385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 09/20/2021] [Accepted: 10/06/2021] [Indexed: 11/09/2022]
Abstract
During the first wave of the pandemic, we compared the occurrence of subjectively experienced COVID‐19‐like symptoms and true severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) seroconversion rates among medical personnel in general practices. This cross‐sectional study determined the SARS‐CoV‐2‐specific immunoglobulin G (IgG) antibody status of medical staff from 100 outpatient practices in Germany. Study cohort characteristics and COVID‐19‐like symptoms were obtained by questionnaires. The initial screening for SARS‐CoV‐2‐recognizing antibodies was performed using a commercial chemiluminescence microparticle immunoassay. Positive results were controlled with another approved test. Samples with discrepant results were subjected to a third IgG‐binding assay and a neutralization test. A total of 861 participants were included, 1.7% (n = 15) of whom tested positive for SARS‐CoV‐specific IgG in the initial screening test. In 46.6% (n = 7) of positive cases, test results were confirmed by an independent test. In the eight samples with discrepant results, neither spike‐specific antibodies nor in vitro neutralizing capacity were detectable, resulting in a genuine seroprevalence rate of 0.8%. 794 participants completed the questionnaire. Intriguingly, a total of 53.7% (n = 426) of them stated episodes of COVID‐19‐like symptoms. Except for smell and taste dysfunction, there were no significant differences between the groups with and without laboratory‐confirmed SARS‐CoV‐2 seroconversion. Our results demonstrated that only 0.8% of participants acquired SARS‐CoV‐2 even though 53.7% of participants reportedly experienced COVID‐19‐like symptoms. Thus, even among medical staff, self‐diagnosis based on subjectively experienced symptoms does not have a relevant predictive value.
Collapse
Affiliation(s)
- Dorothea Dehnen
- Institute of Family Practice, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Katja Dehnen
- Institute of Family Practice, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Mirko Trilling
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Melanie Fiedler
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Julia Drexler
- Institute of Family Practice, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Marcel Goralski
- Institute of Family Practice, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | | | - Lara Schöler
- Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology (IMIBE), University Hospital Essen, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Martina Heßbrügge
- Institute of Family Practice, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| |
Collapse
|
26
|
Colton H, Hodgson D, Hornsby H, Brown R, Mckenzie J, Bradley KL, James C, Lindsey BB, Birch S, Marsh L, Wood S, Bayley M, Dickson G, James DC, Nicklin MJ, Sayers JR, Zafred D, Rowland-Jones SL, Kudesia G, Kucharski A, Darton TC, de Silva TI, Collini PJ. Risk factors for SARS-CoV-2 seroprevalence following the first pandemic wave in UK healthcare workers in a large NHS Foundation Trust. Wellcome Open Res 2021; 6:220. [PMID: 35600250 PMCID: PMC9091808 DOI: 10.12688/wellcomeopenres.17143.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2021] [Indexed: 12/23/2022] Open
Abstract
Background: We aimed to measure SARS-CoV-2 seroprevalence in a cohort of healthcare workers (HCWs) during the first UK wave of the COVID-19 pandemic, explore risk factors associated with infection, and investigate the impact of antibody titres on assay sensitivity. Methods: HCWs at Sheffield Teaching Hospitals NHS Foundation Trust were prospectively enrolled and sampled at two time points. SARS-CoV-2 antibodies were tested using an in-house assay for IgG and IgA reactivity against Spike and Nucleoprotein (sensitivity 99·47%, specificity 99·56%). Data were analysed using three statistical models: a seroprevalence model, an antibody kinetics model, and a heterogeneous sensitivity model. Results: As of 12th June 2020, 24·4% (n=311/1275) of HCWs were seropositive. Of these, 39·2% (n=122/311) were asymptomatic. The highest adjusted seroprevalence was measured in HCWs on the Acute Medical Unit (41·1%, 95% CrI 30·0-52·9) and in Physiotherapists and Occupational Therapists (39·2%, 95% CrI 24·4-56·5). Older age groups showed overall higher median antibody titres. Further modelling suggests that, for a serological assay with an overall sensitivity of 80%, antibody titres may be markedly affected by differences in age, with sensitivity estimates of 89% in those over 60 years but 61% in those ≤30 years. Conclusions: HCWs in acute medical units working closely with COVID-19 patients were at highest risk of infection, though whether these are infections acquired from patients or other staff is unknown. Current serological assays may underestimate seroprevalence in younger age groups if validated using sera from older and/or more symptomatic individuals.
Collapse
Affiliation(s)
- Hayley Colton
- South Yorkshire Regional Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
| | - David Hodgson
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Hailey Hornsby
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
| | - Rebecca Brown
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
| | - Joanne Mckenzie
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
| | - Kirsty L. Bradley
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
| | - Cameron James
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
| | - Benjamin B. Lindsey
- South Yorkshire Regional Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
| | - Sarah Birch
- Academic Directorate of Communicable Diseases and Specialised Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
| | - Louise Marsh
- Academic Directorate of Communicable Diseases and Specialised Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
| | - Steven Wood
- Department of Scientific Computing and Informatics, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
| | - Martin Bayley
- Department of Scientific Computing and Informatics, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
| | - Gary Dickson
- Department of Scientific Computing and Informatics, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
| | - David C. James
- Department of Chemical and Biological Engineering, University of Sheffield, Sheffield, S10 2TN, UK
| | - Martin J. Nicklin
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
| | - Jon R. Sayers
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
- The Florey Institute for Host-Pathogen Interactions, University of Sheffield, Sheffield, S10 2TN, UK
- Sheffield Institute for Nucleic Acids, University of Sheffield, Sheffield, S10 2TN, UK
| | - Domen Zafred
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
| | - Sarah L. Rowland-Jones
- South Yorkshire Regional Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
- The Florey Institute for Host-Pathogen Interactions, University of Sheffield, Sheffield, S10 2TN, UK
| | - Goura Kudesia
- Department of Virology, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S5 7AU, UK
| | - Adam Kucharski
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - CMMID COVID-19 Working Group
- South Yorkshire Regional Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
- Academic Directorate of Communicable Diseases and Specialised Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
- Department of Scientific Computing and Informatics, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
- Department of Chemical and Biological Engineering, University of Sheffield, Sheffield, S10 2TN, UK
- The Florey Institute for Host-Pathogen Interactions, University of Sheffield, Sheffield, S10 2TN, UK
- Sheffield Institute for Nucleic Acids, University of Sheffield, Sheffield, S10 2TN, UK
- Department of Virology, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S5 7AU, UK
| | - Thomas C. Darton
- South Yorkshire Regional Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
- The Florey Institute for Host-Pathogen Interactions, University of Sheffield, Sheffield, S10 2TN, UK
| | - Thushan I. de Silva
- South Yorkshire Regional Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
- The Florey Institute for Host-Pathogen Interactions, University of Sheffield, Sheffield, S10 2TN, UK
| | - Paul J. Collini
- South Yorkshire Regional Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals Nhs Foundation Trust, Sheffield, S10 2JF, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, S10 2TN, UK
- The Florey Institute for Host-Pathogen Interactions, University of Sheffield, Sheffield, S10 2TN, UK
| |
Collapse
|
27
|
Oliveira MSD, Lobo RD, Detta FP, Vieira-Junior JM, Castro TLDS, Zambelli DB, Cardoso LF, Borges IC, Tozetto-Mendoza TR, Costa SF, Mendes-Correa MC. SARS-Cov-2 seroprevalence and risk factors among health care workers: Estimating the risk of COVID-19 dedicated units. Am J Infect Control 2021; 49:1197-1199. [PMID: 33774104 PMCID: PMC7989199 DOI: 10.1016/j.ajic.2021.03.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/17/2021] [Accepted: 03/18/2021] [Indexed: 11/26/2022]
Abstract
We evaluated the seroprevalence of SARS-CoV-2 and risk factors among 1,996 oligo/asymptomatic health care workers. The seroprevalence was 5.5% and risk factors associated with being infected with SARS-CoV-2 was professional category of cleaning (adj odds ratio 2.22, 95% confidence interval: 1.12-4.44, P: .023) and male gender (adj odds ratio: 1.54, 95% confidence interval: 1.03-2.32, P: .035).Working at dedicated COVID-19 units (high-risk group) was not an independent risk factor for seropositivity.
Collapse
Affiliation(s)
- Maura Salaroli de Oliveira
- Department of Infection Control, Hospital Sírio Libanês, São Paulo, Brazil; Department of Infection Control, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo.
| | | | - Felippe Pires Detta
- Institute of Quality and Safety of Hospital Sírio Libanês, São Paulo, Brazil
| | | | | | | | | | - Igor Carmo Borges
- Department of Infectious Diseases, Laboratório de Investigação Médica - LIM 49 (Bacteriology) and LIM-52 (Virology), Instituto de Medicina Tropical, University of São Paulo, Brazil
| | - Tânia Regina Tozetto-Mendoza
- Department of Infectious Diseases, Laboratório de Investigação Médica - LIM 49 (Bacteriology) and LIM-52 (Virology), Instituto de Medicina Tropical, University of São Paulo, Brazil
| | - Silvia Figueiredo Costa
- Department of Infectious Diseases, Laboratório de Investigação Médica - LIM 49 (Bacteriology) and LIM-52 (Virology), Instituto de Medicina Tropical, University of São Paulo, Brazil
| | - Maria Cassia Mendes-Correa
- Department of Infectious Diseases, Laboratório de Investigação Médica - LIM 49 (Bacteriology) and LIM-52 (Virology), Instituto de Medicina Tropical, University of São Paulo, Brazil
| |
Collapse
|
28
|
Murongazvombo AS, Jones RS, Rayment M, Mughal N, Azadian B, Donaldson H, Davies GW, Moore LSP, Aiken AM. Association between SARS-CoV-2 exposure and antibody status among healthcare workers in two London hospitals: a cross-sectional study. Infect Prev Pract 2021; 3:100157. [PMID: 34316587 PMCID: PMC8217738 DOI: 10.1016/j.infpip.2021.100157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/15/2021] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Patient-facing (frontline) health-care workers (HCWs) are at high risk of repeated exposure to SARS-CoV-2. AIM We sought to determine the association between levels of frontline exposure and likelihood of SARS-CoV-2 seropositivity amongst HCW. METHODS A cross-sectional study was undertaken using purposefully collected data from HCWs at two hospitals in London, United Kingdom (UK) over eight weeks in May-June 2020. Information on sociodemographic, clinical and occupational characteristics was collected using an anonymised questionnaire. Serology was performed using split SARS-CoV-2 IgM/IgG lateral flow immunoassays. Exposure risk was categorised into five pre-defined ordered grades. Multivariable logistic regression was used to examine the association between being frontline and SARS-CoV-2 seropositivity after controlling for other risks of infection. FINDINGS 615 HCWs participated in the study. 250/615 (40.7%) were SARS-CoV-2 IgM and/or IgG positive. After controlling for other exposures, there was non-significant evidence of a modest association between being a frontline HCW (any level) and SARS-CoV-2 seropositivity compared to non-frontline status (OR 1.39, 95% CI 0.84-2.30, P=0.200). There was 15% increase in the odds of SARS-CoV-2 seropositivity for each step along the frontline exposure gradient (OR 1.15, 95% CI 1.00-1.32, P=0.043). CONCLUSION We found a high SARS-CoV-2 IgM/IgG seropositivity with modest evidence for a dose-response association between increasing levels of frontline exposure risk and seropositivity. Even in well-resourced hospital settings, appropriate use of personal protective equipment, in addition to other transmission-based precautions for inpatient care of SARS-CoV-2 patients could reduce the risk of hospital-acquired SARS-CoV-2 infection among frontline HCW.
Collapse
Affiliation(s)
| | - Rachael S. Jones
- Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK
| | - Michael Rayment
- Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK
| | - Nabeela Mughal
- Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK
- North West London Pathology, Imperial College Healthcare NHS Trust, Fulham Palace Road, London, W6 8RF, UK
| | - Berge Azadian
- Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK
| | - Hugo Donaldson
- Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK
- North West London Pathology, Imperial College Healthcare NHS Trust, Fulham Palace Road, London, W6 8RF, UK
| | - Gary W. Davies
- Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK
| | - Luke SP. Moore
- Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK
- North West London Pathology, Imperial College Healthcare NHS Trust, Fulham Palace Road, London, W6 8RF, UK
- Imperial College London, NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Du Cane Road, London, W12 0NN, UK
| | - Alexander M. Aiken
- London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| |
Collapse
|
29
|
Chiste JA, Furuie IN, Nogueira MB, da Silva Longo J, Fugaça CA, Cavalli BM, Dino CT, Raboni SM, Sobieray NLEDC, de Carvalho NS. SARS-CoV-2 in asymptomatic pregnant women in South Brazil: RT-PCR and serological detection. J Perinat Med 2021; 49:717-722. [PMID: 34107573 DOI: 10.1515/jpm-2021-0173] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 05/26/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVES This study aims to detect the SARS-CoV-2 infection prevalence in asymptomatic pregnant women. METHODS A group of 195 asymptomatic pregnant women who attended the prenatal care outclinic and to the obstetric emergency department was tested concomitantly for SARS-CoV-2 by RT-PCR and serological tests. RESULTS The virus was detected by RT-PCR in two (1.02%) cases and 17 (8.71%) patients had antibodies detected by immunochromatographic tests. CONCLUSIONS Due to the high risk of this emerging infection in the health of pregnant women, fetuses and newborns, we suggest the universal screening of all pregnant women admitted to hospital through the combined method RT-PCR and serological.
Collapse
Affiliation(s)
- Jullie Anne Chiste
- Department of Obstetrics and Gynecology, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Isabella Naomi Furuie
- Department of Obstetrics and Gynecology, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Meri Bordignon Nogueira
- Virology Laboratory, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
- Post Graduate Program in Gynecology and Obstetrics, Federal University of Paraná (UFPR), Curitiba, Brazil
| | - Jessica da Silva Longo
- Department of Obstetrics and Gynecology, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Cyllian Arias Fugaça
- Department of Obstetrics and Gynecology, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Barbara Maria Cavalli
- Virology Laboratory, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Carolina Tanaka Dino
- Virology Laboratory, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Sonia Mara Raboni
- Virology Laboratory, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | | | - Newton Sérgio de Carvalho
- Department of Obstetrics and Gynecology, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
- Post Graduate Program in Gynecology and Obstetrics, Federal University of Paraná (UFPR), Curitiba, Brazil
| |
Collapse
|
30
|
Immune responses against SARS-CoV-2 variants after heterologous and homologous ChAdOx1 nCoV-19/BNT162b2 vaccination. Nat Med 2021; 27:1525-1529. [PMID: 34262158 PMCID: PMC8440184 DOI: 10.1038/s41591-021-01449-9] [Citation(s) in RCA: 290] [Impact Index Per Article: 96.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 06/23/2021] [Indexed: 02/08/2023]
Abstract
Currently approved viral vector-based and mRNA-based vaccine approaches against coronavirus disease 2019 (COVID-19) consider only homologous prime-boost vaccination. After reports of thromboembolic events, several European governments recommended using AstraZeneca’s ChAdOx1-nCov-19 (ChAd) only in individuals older than 60 years, leaving millions of already ChAd-primed individuals with the decision to receive either a second shot of ChAd or a heterologous boost with mRNA-based vaccines. However, such combinations have not been tested so far. We used Hannover Medical School’s COVID-19 Contact Study cohort of healthcare professionals to monitor ChAd-primed immune responses before and 3 weeks after booster with ChAd (n = 32) or BioNTech/Pfizer’s BNT162b2 (n = 55). Although both vaccines boosted prime-induced immunity, BNT162b2 induced significantly higher frequencies of spike-specific CD4+ and CD8+ T cells and, in particular, high titers of neutralizing antibodies against the B.1.1.7, B.1.351 and P.1 variants of concern of severe acute respiratory syndrome coronavirus 2. In a study of healthcare professionals previously vaccinated with ChAdOx-1 nCoV-19, booster vaccination with BNT162b2 elicited more neutralizing antibodies with greater breadth, as well as higher frequencies of virus-specific T cells, than ChAdOx-1 nCoV-19.
Collapse
|
31
|
Hodgson D, Colton H, Hornsby H, Brown R, Mckenzie J, Bradley KL, James C, Lindsey BB, Birch S, Marsh L, Wood S, Bayley M, Dickson G, James DC, Nicklin MJH, Sayers JR, Zafred D, Rowland-Jones SL, Kudesia G, Kucharski A, Darton TC, de Silva TI, Collini PJ. Risk factors for SARS-CoV-2 seroprevalence following the first pandemic wave in UK healthcare workers in a large NHS Foundation Trust. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2021:2021.07.07.21260151. [PMID: 34268521 PMCID: PMC8282110 DOI: 10.1101/2021.07.07.21260151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
BACKGROUND We aimed to measure SARS-CoV-2 seroprevalence in a cohort of healthcare workers (HCWs) during the first UK wave of the COVID-19 pandemic, explore risk factors associated with infection, and investigate the impact of antibody titres on assay sensitivity. METHODS HCWs at Sheffield Teaching Hospitals NHS Foundation Trust (STH) were prospectively enrolled and sampled at two time points. SARS-CoV-2 antibodies were tested using an in-house assay for IgG and IgA reactivity against Spike and Nucleoprotein (sensitivity 99·47%, specificity 99·56%). Data were analysed using three statistical models: a seroprevalence model, an antibody kinetics model, and a heterogeneous sensitivity model. FINDINGS As of 12th June 2020, 24·4% (n=311/1275) HCWs were seropositive. Of these, 39·2% (n=122/311) were asymptomatic. The highest adjusted seroprevalence was measured in HCWs on the Acute Medical Unit (41·1%, 95% CrI 30·0-52·9) and in Physiotherapists and Occupational Therapists (39·2%, 95% CrI 24·4-56·5). Older age groups showed overall higher median antibody titres. Further modelling suggests that, for a serological assay with an overall sensitivity of 80%, antibody titres may be markedly affected by differences in age, with sensitivity estimates of 89% in those over 60 years but 61% in those ≤30 years. INTERPRETATION HCWs in acute medical units working closely with COVID-19 patients were at highest risk of infection, though whether these are infections acquired from patients or other staff is unknown. Current serological assays may underestimate seroprevalence in younger age groups if validated using sera from older and/or more symptomatic individuals. RESEARCH IN CONTEXT Evidence before this study: We searched PubMed for studies published up to March 6th 2021, using the terms "COVID", "SARS-CoV-2", "seroprevalence", and "healthcare workers", and in addition for articles of antibody titres in different age groups against coronaviruses using "coronavirus", "SARS-CoV-2, "antibody", "antibody tires", "COVID" and "age". We included studies that used serology to estimate prevalence in healthcare workers. SARS-CoV-2 seroprevalence has been shown to be greater in healthcare workers working on acute medical units or within domestic services. Antibody levels against seasonal coronaviruses, SARS-CoV and SARS-CoV-2 were found to be higher in older adults, and patients who were hospitalised.Added value of this study: In this healthcare worker seroprevalence modelling study at a large NHS foundation trust, we confirm that those working on acute medical units, COVID-19 "Red Zones" and within domestic services are most likely to be seropositive. Furthermore, we show that physiotherapists and occupational therapists have an increased risk of COVID-19 infection. We also confirm that antibody titres are greater in older individuals, even in the context of non-hospitalised cases. Importantly, we demonstrate that this can result in age-specific sensitivity in serological assays, where lower antibody titres in younger individuals results in lower assay sensitivity.Implications of all the available evidence: There are distinct occupational roles and locations in hospitals where the risk of COVID-19 infection to healthcare workers is greatest, and this knowledge should be used to prioritise infection prevention control and other measures to protect healthcare workers. Serological assays may have different sensitivity profiles across different age groups, especially if assay validation was undertaken using samples from older and/or hospitalised patients, who tend to have higher antibody titres. Future seroprevalence studies should consider adjusting for age-specific assay sensitivities to estimate true seroprevalence rates. AUTHOR CONTRIBUTIONS
Collapse
Affiliation(s)
- David Hodgson
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, UK
| | - Hayley Colton
- South Yorkshire Regional Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, UK
| | - Hailey Hornsby
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, UK
| | - Rebecca Brown
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, UK
| | - Joanne Mckenzie
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, UK
| | - Kirsty L Bradley
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, UK
| | - Cameron James
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, UK
| | - Benjamin B Lindsey
- South Yorkshire Regional Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, UK
| | - Sarah Birch
- Academic Directorate of Communicable Diseases and Specialised Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, UK
| | - Louise Marsh
- Academic Directorate of Communicable Diseases and Specialised Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, UK
| | - Steven Wood
- Department of Scientific Computing and Informatics, Sheffield Teaching Hospitals NHS Foundation Trust, UK
| | - Martin Bayley
- Department of Scientific Computing and Informatics, Sheffield Teaching Hospitals NHS Foundation Trust, UK
| | - Gary Dickson
- Department of Scientific Computing and Informatics, Sheffield Teaching Hospitals NHS Foundation Trust, UK
| | - David C James
- Department of Chemical and Biological Engineering, University of Sheffield, UK
| | - Martin J H Nicklin
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, UK
| | - Jon R Sayers
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, UK
- The Florey Institute for Host-Pathogen Interactions, University of Sheffield, UK
- Sheffield Institute for Nucleic Acids, University of Sheffield, UK
| | - Domen Zafred
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, UK
| | - Sarah L Rowland-Jones
- South Yorkshire Regional Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, UK
- The Florey Institute for Host-Pathogen Interactions, University of Sheffield, UK
| | - Goura Kudesia
- Department of Virology, Sheffield Teaching Hospitals NHS Foundation Trust, UK
| | - Adam Kucharski
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, UK
| | - Thomas C Darton
- South Yorkshire Regional Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, UK
- The Florey Institute for Host-Pathogen Interactions, University of Sheffield, UK
| | - Thushan I de Silva
- South Yorkshire Regional Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, UK
- The Florey Institute for Host-Pathogen Interactions, University of Sheffield, UK
| | - Paul J Collini
- South Yorkshire Regional Department of Infection and Tropical Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, UK
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, UK
- The Florey Institute for Host-Pathogen Interactions, University of Sheffield, UK
| |
Collapse
|
32
|
Tuckerman J, Lee L, Wurzel D, Tosif S, Clifford V, McMinn A, O'Donaghue K, Rautenbacher K, Licciardi PV, Toh R, Daley A, Crawford NW. Seroprevalence of SARS-CoV-2 antibodies in health-care workers at a tertiary paediatric hospital. J Paediatr Child Health 2021; 57:1136-1139. [PMID: 34216170 PMCID: PMC8447152 DOI: 10.1111/jpc.15585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 05/13/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Jane Tuckerman
- Infection and ImmunityMurdoch Children's Research InstituteVictoriaAustralia,Department of PaediatricsUniversity of MelbourneVictoriaAustralia
| | - Lai‐Yang Lee
- Microbiology, Laboratory ServicesThe Royal Children's HospitalMelbourneVictoriaAustralia
| | - Danielle Wurzel
- Infection and ImmunityMurdoch Children's Research InstituteVictoriaAustralia,School of Population and Global HealthThe University of MelbourneVictoriaAustralia,Respiratory MedicineRoyal Children's HospitalMelbourneVictoriaAustralia
| | - Shidan Tosif
- Infection and ImmunityMurdoch Children's Research InstituteVictoriaAustralia,Department of PaediatricsUniversity of MelbourneVictoriaAustralia,General MedicineRoyal Children's HospitalMelbourneVictoriaAustralia,Immunisation ServiceRoyal Children's HospitalMelbourneVictoriaAustralia
| | - Vanessa Clifford
- Infection and ImmunityMurdoch Children's Research InstituteVictoriaAustralia,Department of PaediatricsUniversity of MelbourneVictoriaAustralia,Microbiology, Laboratory ServicesThe Royal Children's HospitalMelbourneVictoriaAustralia
| | - Alissa McMinn
- Infection and ImmunityMurdoch Children's Research InstituteVictoriaAustralia
| | - Kate O'Donaghue
- Infection Prevention and ControlThe Royal Children's HospitalMelbourneVictoriaAustralia
| | - Karin Rautenbacher
- Microbiology, Laboratory ServicesThe Royal Children's HospitalMelbourneVictoriaAustralia
| | - Paul V Licciardi
- Infection and ImmunityMurdoch Children's Research InstituteVictoriaAustralia,Department of PaediatricsUniversity of MelbourneVictoriaAustralia
| | - Ryan Toh
- Infection and ImmunityMurdoch Children's Research InstituteVictoriaAustralia,Department of PaediatricsUniversity of MelbourneVictoriaAustralia
| | - Andrew Daley
- Department of PaediatricsUniversity of MelbourneVictoriaAustralia,Microbiology, Laboratory ServicesThe Royal Children's HospitalMelbourneVictoriaAustralia
| | - Nigel W Crawford
- Infection and ImmunityMurdoch Children's Research InstituteVictoriaAustralia,Department of PaediatricsUniversity of MelbourneVictoriaAustralia,General MedicineRoyal Children's HospitalMelbourneVictoriaAustralia,Immunisation ServiceRoyal Children's HospitalMelbourneVictoriaAustralia
| |
Collapse
|
33
|
Larribère L, Gordejeva J, Kuhnhenn L, Kurscheidt M, Pobiruchin M, Vladimirova D, Martin M, Roser M, Schramm W, Martens UM, Eigenbrod T. Assessment of SARS-CoV-2 Infection among Healthcare Workers of a German COVID-19 Treatment Center. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7057. [PMID: 34281000 PMCID: PMC8297119 DOI: 10.3390/ijerph18137057] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 06/28/2021] [Indexed: 12/11/2022]
Abstract
To date, more than 160 million people have been infected with COVID-19 worldwide. In the present study, we investigated the history of SARS-CoV-2 infection among 3067 healthcare workers (HCW) in a German COVID-19 treatment center during the early phase of the pandemic (July 2020) based on the seroprevalence of SARS-CoV-2 antibodies and self-reported previous PCR results. The results demonstrate a low prevalence of SARS-CoV-2 infection (n = 107 [3.5%]) with no increased risk for employees with a high level of patient exposure in general or working in COVID-19-confined areas in particular. This suggests that the local hygiene standards implemented in our hospital during the first wave of COVID-19 pandemic were effective in preventing patient-to-HCW transmission. No evidence for highly mobile staff serving as a vector for SARS-CoV-2 transmission could be found. In addition, impairment of smell and/or taste was strongly associated with SARS-CoV-2 history.
Collapse
Affiliation(s)
- Lionel Larribère
- Cancer Center Heilbronn-Franken, SLK Clinics Heilbronn GmbH, 74078 Heilbronn, Germany; (D.V.); (U.M.M.)
| | - Jelizaveta Gordejeva
- GECKO Institute for Medicine, Informatics and Economics, Hochschule Heilbronn, 74081 Heilbronn, Germany; (J.G.); (M.K.); (M.P.); (W.S.)
| | - Lisa Kuhnhenn
- Institute of Laboratory Medicine, SLK Clinics Heilbronn GmbH, 74078 Heilbronn, Germany; (L.K.); (M.R.); (T.E.)
| | - Maximilian Kurscheidt
- GECKO Institute for Medicine, Informatics and Economics, Hochschule Heilbronn, 74081 Heilbronn, Germany; (J.G.); (M.K.); (M.P.); (W.S.)
| | - Monika Pobiruchin
- GECKO Institute for Medicine, Informatics and Economics, Hochschule Heilbronn, 74081 Heilbronn, Germany; (J.G.); (M.K.); (M.P.); (W.S.)
| | - Dilyana Vladimirova
- Cancer Center Heilbronn-Franken, SLK Clinics Heilbronn GmbH, 74078 Heilbronn, Germany; (D.V.); (U.M.M.)
| | - Maria Martin
- Institute for Infection Prevention and Clinical Hygiene, SLK Clinics Heilbronn GmbH, 74078 Heilbronn, Germany;
| | - Markus Roser
- Institute of Laboratory Medicine, SLK Clinics Heilbronn GmbH, 74078 Heilbronn, Germany; (L.K.); (M.R.); (T.E.)
| | - Wendelin Schramm
- GECKO Institute for Medicine, Informatics and Economics, Hochschule Heilbronn, 74081 Heilbronn, Germany; (J.G.); (M.K.); (M.P.); (W.S.)
| | - Uwe M. Martens
- Cancer Center Heilbronn-Franken, SLK Clinics Heilbronn GmbH, 74078 Heilbronn, Germany; (D.V.); (U.M.M.)
| | - Tatjana Eigenbrod
- Institute of Laboratory Medicine, SLK Clinics Heilbronn GmbH, 74078 Heilbronn, Germany; (L.K.); (M.R.); (T.E.)
| |
Collapse
|
34
|
van Bremen K, Monin M, Eis-Hübinger AM, Marx B, Aldabaggh S, Streeck H, Wasmuth JC, Menting T, Schlabe S, Rieke GJ, Schwarze-Zander C, Rockstroh JK, Boesecke C. SARS-CoV-2 seroconversions and chains of infection in healthcare professionals in a German maximum care provider (The CoSHeP study). Infection 2021; 49:1039-1043. [PMID: 34143409 PMCID: PMC8211969 DOI: 10.1007/s15010-021-01641-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 06/09/2021] [Indexed: 12/03/2022]
Abstract
Introduction The CoSHeP study provides novel data on SARS-CoV-2 seroconversion rates in healthcare professionals (HP) at risk at the University Hospital Bonn, a maximum healthcare provider in a region of 900.000 inhabitants. Methods Single-center, longitudinal observational study investigating rate of SARS-CoV-2 IgG seroconversion in HP at 2 time-points. SARS-CoV-2 IgG was measured with Roche Elecsys Anti-SARS-CoV-2 assay. Results Overall, 150 HP were included. Median age was 35 (range: 19–68). Main operational areas were intensive care unit (53%, n = 80), emergency room (31%, n = 46), and infectious disease department (16%, n = 24). SARS-CoV-2-IgG was detected in 5 participants (3%) at inclusion in May/June 2020, and in another 11 participants at follow-up (December 2020/ January 2021). Of the 16 seropositive participants, 14 had already known their SARS-CoV-2 infection because they had performed a PCR-test previously triggered by symptoms. Trailing chains of infection by self-assessment, 31% (n = 5) of infections were acquired through private contacts, 25% (n = 4) most likely through semi-private contacts during work. 13% (n = 2) were assumed to result through contact with contagious patients, further trailing was unsuccessful in 31% (n = 5). All five participants positive for SARS-CoV-2 IgG at inclusion remained positive with a median of 7 months after infection. Discussion Frontline HP caring for hospitalized patients with COVID-19 are at higher risk of SARS-CoV-2 infections. Noteworthy, based upon identified chains of infection most of the infections were acquired in private environment and semi-private contacts during work. The low rate of infection through infectious patients reveals that professional hygiene standards are effective in preventing SARS-CoV-2 infections in HP. Persisting SARS-CoV-2-IgG might indicate longer lasting immunity supporting prioritization of negative HP for vaccination.
Collapse
Affiliation(s)
- Kathrin van Bremen
- Department of Medicine I, Bonn University Hospital, Venusberg-Campus 1, 53127, Bonn, Germany.
- German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany.
| | - Malte Monin
- Department of Medicine I, Bonn University Hospital, Venusberg-Campus 1, 53127, Bonn, Germany
- German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany
| | | | - Benjamin Marx
- Institute of Virology, Medical Faculty, University of Bonn, Bonn, Germany
| | - Souhaib Aldabaggh
- Institute of Virology, Medical Faculty, University of Bonn, Bonn, Germany
| | - Hendrik Streeck
- Institute of Virology, Medical Faculty, University of Bonn, Bonn, Germany
| | - Jan-Christian Wasmuth
- Department of Medicine I, Bonn University Hospital, Venusberg-Campus 1, 53127, Bonn, Germany
- German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany
| | - Tanja Menting
- Occupational Health Service, Bonn University Hospital, Bonn, Germany
| | - Stefan Schlabe
- Department of Medicine I, Bonn University Hospital, Venusberg-Campus 1, 53127, Bonn, Germany
- German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany
| | - Gereon J Rieke
- Department of Medicine I, Bonn University Hospital, Venusberg-Campus 1, 53127, Bonn, Germany
- German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany
| | - Carolynne Schwarze-Zander
- Department of Medicine I, Bonn University Hospital, Venusberg-Campus 1, 53127, Bonn, Germany
- German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany
| | - Jürgen K Rockstroh
- Department of Medicine I, Bonn University Hospital, Venusberg-Campus 1, 53127, Bonn, Germany
- German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany
| | - Christoph Boesecke
- Department of Medicine I, Bonn University Hospital, Venusberg-Campus 1, 53127, Bonn, Germany
- German Centre for Infection Research (DZIF), Partner-site Cologne-Bonn, Bonn, Germany
| |
Collapse
|
35
|
Heffron AS, McIlwain SJ, Amjadi MF, Baker DA, Khullar S, Armbrust T, Halfmann PJ, Kawaoka Y, Sethi AK, Palmenberg AC, Shelef MA, O’Connor DH, Ong IM. The landscape of antibody binding in SARS-CoV-2 infection. PLoS Biol 2021; 19:e3001265. [PMID: 34143766 PMCID: PMC8245122 DOI: 10.1371/journal.pbio.3001265] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 06/30/2021] [Accepted: 05/06/2021] [Indexed: 02/08/2023] Open
Abstract
The search for potential antibody-based diagnostics, vaccines, and therapeutics for pandemic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has focused almost exclusively on the spike (S) and nucleocapsid (N) proteins. Coronavirus membrane (M), ORF3a, and ORF8 proteins are humoral immunogens in other coronaviruses (CoVs) but remain largely uninvestigated for SARS-CoV-2. Here, we use ultradense peptide microarray mapping to show that SARS-CoV-2 infection induces robust antibody responses to epitopes throughout the SARS-CoV-2 proteome, particularly in M, in which 1 epitope achieved excellent diagnostic accuracy. We map 79 B cell epitopes throughout the SARS-CoV-2 proteome and demonstrate that antibodies that develop in response to SARS-CoV-2 infection bind homologous peptide sequences in the 6 other known human CoVs. We also confirm reactivity against 4 of our top-ranking epitopes by enzyme-linked immunosorbent assay (ELISA). Illness severity correlated with increased reactivity to 9 SARS-CoV-2 epitopes in S, M, N, and ORF3a in our population. Our results demonstrate previously unknown, highly reactive B cell epitopes throughout the full proteome of SARS-CoV-2 and other CoV proteins.
Collapse
Affiliation(s)
- Anna S. Heffron
- Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Sean J. McIlwain
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- University of Wisconsin Carbone Comprehensive Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Maya F. Amjadi
- Department of Medicine, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - David A. Baker
- Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Saniya Khullar
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Tammy Armbrust
- Department of Pathobiological Sciences, School of Veterinary Medicine, Influenza Research Institute, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Peter J. Halfmann
- Department of Pathobiological Sciences, School of Veterinary Medicine, Influenza Research Institute, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Yoshihiro Kawaoka
- Department of Pathobiological Sciences, School of Veterinary Medicine, Influenza Research Institute, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Ajay K. Sethi
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Ann C. Palmenberg
- Department of Biochemistry, Institute for Molecular Virology, University of Wisconsin–Madison, Madison, Wisconsin, United States of America
| | - Miriam A. Shelef
- Department of Medicine, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, United States of America
| | - David H. O’Connor
- Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- Wisconsin National Primate Research Center, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| | - Irene M. Ong
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- University of Wisconsin Carbone Comprehensive Cancer Center, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
- Center for Human Genomics and Precision Medicine, University of Wisconsin-Madison, Madison, Wisconsin, United States of America
| |
Collapse
|
36
|
Stubblefield WB, Talbot HK, Feldstein LR, Tenforde MW, Ur Rasheed MA, Mills L, Lester SN, Freeman B, Thornburg NJ, Jones ID, Ward MJ, Lindsell CJ, Baughman A, Halasa N, Grijalva CG, Rice TW, Patel MM, Self WH. Seroprevalence of SARS-CoV-2 Among Frontline Healthcare Personnel During the First Month of Caring for Patients With COVID-19-Nashville, Tennessee. Clin Infect Dis 2021; 72:1645-1648. [PMID: 32628750 PMCID: PMC7454447 DOI: 10.1093/cid/ciaa936] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 07/02/2020] [Indexed: 01/13/2023] Open
Abstract
Among 249 healthcare personnel who worked in hospital units with COVID-19 patients for 1 month, 19 (7.6%) tested positive for SARS-CoV-2 antibodies. Only 11 (57.9%) of the 19 personnel with positive serology reported symptoms of a prior illness, suggesting asymptomatic healthcare personnel could be an important source of SARS-CoV-2 transmission.
Collapse
Affiliation(s)
- William B Stubblefield
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - H Keipp Talbot
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | | | | | - Lisa Mills
- CDC COVID-19 Response Team, Atlanta, Georgia, USA
| | | | | | | | - Ian D Jones
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Michael J Ward
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Christopher J Lindsell
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Adrienne Baughman
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Natasha Halasa
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Carlos G Grijalva
- Department of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Todd W Rice
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | - Wesley H Self
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| |
Collapse
|
37
|
Khan MS, Haq I, Qurieshi MA, Majid S, Bhat AA, Qazi TB, Chowdri IN, Sabah I, Kawoosa MF, Lone AA, Nabi S, Sumji IA, Obaid M, Kousar R. SARS-CoV-2 Seroprevalence Among Healthcare Workers by Workplace Exposure Risk in Kashmir, India. J Hosp Med 2021; 16:274-281. [PMID: 33929947 DOI: 10.12788/jhm.3609] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 02/14/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND SARS-CoV-2 infection (COVID-19) poses a tremendous challenge to healthcare systems across the globe. Serologic testing for SARS-CoV-2 infection in healthcare workers (HCWs) may quantify the rate of clinically significant exposure in an institutional setting and identify those HCWs who are at greatest risk. METHODS We conducted a survey and SARS-CoV-2 serologic testing among a convenience sample of HCWs from 79 non-COVID and 3 dedicated COVID hospitals in District Srinagar of Kashmir, India. In addition to testing for the presence of SARS-CoV-2-specific immunoglobulin G (IgG), we collected information on demographics, occupational group, influenza-like illness (ILI) symptoms, nasopharyngeal reverse transcription polymerase chain reaction (RT-PCR) testing status, history of close unprotected contacts, and quarantine/travel history. RESULTS Of 7,346 eligible HCWs, 2,915 (39.7%) participated in the study. The overall prevalence of SARS-CoV-2-specific IgG antibodies was 2.5% (95% CI, 2.0%-3.1%), while HCWs who had ever worked at a dedicated COVID-19 hospital had a substantially lower seroprevalence of 0.6% (95% CI, 0.2%-1.9%). Higher seroprevalence rates were observed among HCWs who reported a recent ILI (12.2%), a positive RT-PCR (27.6%), a history of being put under quarantine (4.9%), and a history of close unprotected contact with a person with COVID-19 (4.4%). Healthcare workers who ever worked at a dedicated COVID-19 hospital had a lower multivariate-adjusted risk of seropositivity (odds ratio, 0.21; 95% CI, 0.06-0.66). CONCLUSIONS Our investigation suggests that infection-control practices, including a compliance-maximizing buddy system, are valuable and effective in preventing infection within a high-risk clinical setting. Universal masking, mandatory testing of patients, and residential dormitories for HCWs at COVID-19-dedicated hospitals is an effective multifaceted approach to infection control. Moreover, given that many infections among HCWs are community-acquired, it is likely that the vigilant practices in these hospitals will have spillover effects, creating ingrained behaviors that will continue outside the hospital setting.
Collapse
Affiliation(s)
- Muhammad Salim Khan
- Department of Community Medicine, Government Medical College, Srinagar, Kashmir, India
| | - Inaamul Haq
- Department of Community Medicine, Government Medical College, Srinagar, Kashmir, India
| | - Mariya Amin Qurieshi
- Department of Community Medicine, Government Medical College, Srinagar, Kashmir, India
| | - Sabhiya Majid
- Department of Biochemistry, Government Medical College, Srinagar, Kashmir, India
| | - Arif Akbar Bhat
- Department of Biochemistry, Government Medical College, Srinagar, Kashmir, India
| | - Tanzeela Bashir Qazi
- Department of Community Medicine, Government Medical College, Srinagar, Kashmir, India
| | - Iqra Nisar Chowdri
- Department of Community Medicine, Government Medical College, Srinagar, Kashmir, India
| | - Iram Sabah
- Department of Community Medicine, Government Medical College, Srinagar, Kashmir, India
| | - Misbah Ferooz Kawoosa
- Department of Community Medicine, Government Medical College, Srinagar, Kashmir, India
| | - Abdul Aziz Lone
- Department of Community Medicine, Government Medical College, Srinagar, Kashmir, India
| | - Shahroz Nabi
- Department of Community Medicine, Government Medical College, Srinagar, Kashmir, India
| | - Ishtiyaq Ahmad Sumji
- Department of Community Medicine, Government Medical College, Srinagar, Kashmir, India
| | - Muhammad Obaid
- Department of Biochemistry, Government Medical College, Srinagar, Kashmir, India
| | - Rafiya Kousar
- Department of Community Medicine, Government Medical College, Srinagar, Kashmir, India
| |
Collapse
|
38
|
SARS-CoV-2 Antibody Screening in Healthcare Workers in Non-Infectious Hospitals in Two Different Regions of Southern Poland (Upper Silesia and Opole Voivodeships): A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084376. [PMID: 33924173 PMCID: PMC8074357 DOI: 10.3390/ijerph18084376] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/14/2021] [Accepted: 04/14/2021] [Indexed: 12/04/2022]
Abstract
(1) Background: Detection of asymptomatic or subclinical human coronavirus SARS-CoV-2 infection in healthcare workers (HCWs) is crucial for understanding the overall prevalence of the new coronavirus and its infection potential in public (non-infectious) healthcare units with emergency wards. (2) Methods: We evaluated the host serologic responses, measured with semi-quantitative ELISA tests (IgA, IgG, IgM abs) in sera of 90 individuals in Hospital no. 4 in Bytom, 84 HCWs in the University Hospital in Opole and 25 in a Miasteczko Śląskie local surgery. All volunteers had negative RT-PCR test results or had not had the RT-PCR test performed within 30 days before sampling. The ELISA test was made at two different time points (July/August 2020) with a 2-weeks gap between blood collections to avoid the “serological window” period. (3) Results: The IgG seropositivity of asymptomatic HCWs varied between 1.2% to 10% (Opole vs. Bytom, p < 0.05; all without any symptoms). IgA seropositivity in HCWs was 8.8% in Opole and 7.14% in Bytom. IgM positive levels in HCWs in Opole and Bytom was 1.11% vs. 2.38%, respectively. Individuals with IgA and IgM seropositivity results were observed only in Opole (1.19%). More studies are needed to determine whether these results are generalizable to other populations and geographic as well as socio-demographic locations. (4) Conclusions: 100% of IgG(+) volunteers were free from any symptoms of infection in the 30 days before first or second blood collection and they had no awareness of SARS-CoV-2 infection. Asymptomatic HCWs could spread SARS-CoV-2 infection to other employees and patients. Only regular HCWs RT-PCR testing can reduce the risk of SARS-CoV-2 spreading in a hospital environment. The benefit of combining the detection of specific IgA with that of combined specific IgM/IgG is still uncertain.
Collapse
|
39
|
Kindgen-Milles D, Brandenburger T, Braun JFW, Cleff C, Moussazadeh K, Mrosewski I, Timm J, Wetzchewald D. Prevalence of SARS-COV-2 positivity in 516 German intensive care and emergency physicians studied by seroprevalence of antibodies National Covid Survey Germany (NAT-COV-SURV). PLoS One 2021; 16:e0248813. [PMID: 33831032 PMCID: PMC8031427 DOI: 10.1371/journal.pone.0248813] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/06/2021] [Indexed: 11/22/2022] Open
Abstract
Healthcare personnel are at risk to aquire the corona virus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We evaluated the prevalence of SARS-CoV-2 antibodies and positive nasopharyngeal reverse transcriptase polymerase-chain reaction (RT-PCR) tests in German intensive care and emergency physicians. Physicians attending intensive care and emergency medicine training courses between June 16th and July 2nd 2020 answered a questionnaire and were screened for SARS-CoV-2 antibodies via automated electrochemiluminiscence immunoassay. We recruited 516 physicans from all parts of Germany, 445/516 (86%) worked in high risk areas, and 379/516 (73%) had treated patients with COVID-19. The overall positive rate was 18/516 (3.5%), 16/18 (89%) had antibodies against SARS-COV-2, another 2 reported previous positive RT-PCR results although antibody testing was negative. Of those positive, 7/18 (39%) were unaware of their infection. A stay abroad was stated by 173/498 (35%), mostly in Europe. 87/516 (17%) reported a febrile respiratory infection after January 1st 2020 which was related to SARS-CoV-2 in 4/87 (4.6%). Contact to COVID-19 positive relatives at home was stated by 22/502 (4.4%). This was the only significant risk factor for Covid-19 infection (Fisher´s exact test, p = 0.0005). N95 masks and eye protection devices were available for 87% and 73%, respectively. A total of 254/502 (51%) had been vaccinated against seasonal influenza. The overall SARS-CoV-2 infection rate of german physicians from intensive care and emergency medicine was low compared to reports from other countries and settings. This finding may be explained by the fact that the German health care system was not overwhelmed by the first wave of the SARS-CoV-2 pandemic.
Collapse
Affiliation(s)
- Detlef Kindgen-Milles
- Dept. of Anesthesiology, University Hospital Duesseldorf, Heinrich-Heine University Duesseldorf, Duesseldorf, Germany
- * E-mail:
| | - Timo Brandenburger
- Dept. of Anesthesiology, University Hospital Duesseldorf, Heinrich-Heine University Duesseldorf, Duesseldorf, Germany
| | - Julian F. W. Braun
- Dept. of Emergency Medicine, University Witten/Herdecke, Arnsberg, Germany
| | - Corvin Cleff
- Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, German
| | - Kian Moussazadeh
- Dept. of Anesthesiology & Intensive Care Sana Hospital Duisburg, Duisburg, Germany
| | - Ingo Mrosewski
- Department of Laboratory Medicine, MDI Limbach Berlin GmbH, Berlin, Germany
| | - Jörg Timm
- Institute of Virology, University Hospital Duesseldorf, Heinrich-Heine University Duesseldorf, Duesseldorf, Germany
| | | |
Collapse
|
40
|
Effectiveness of Preventive Measures in Keeping Low Prevalence of SARS-CoV-2 Infection in Health Care Workers in a Referral Children's Hospital in Southern Italy. Pediatr Rep 2021; 13:118-124. [PMID: 33806472 PMCID: PMC8006005 DOI: 10.3390/pediatric13010017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/08/2021] [Accepted: 03/01/2021] [Indexed: 12/24/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic now represents a major threat to public health. Health care workers (HCW) are exposed to biological risk. Little is currently known about the risk of HCW operating in pediatric wards for SARS-CoV-2 infection. The aim is to assess the prevalence of SARS-CoV-2 infection in HCW in a third-level children's hospital in Southern Italy. An observational cohort study of all asymptomatic HCW (physician, technicians, nurses, and logistic and support operators) was conducted. HCW were screened, on a voluntary basis, for SARS-CoV-2 by RT-PCR on nasopharyngeal swab performed during the first wave of COVID-19. The study was then repeated, with the same modalities, at a 7-month interval, during the "second wave" of the COVID-19 pandemic. At the initial screening between 7 and 24 April 2020, 525 HCW were tested. None of them tested positive. At the repeated screening, conducted between 9 and 20 November 2020, 627 HCW were tested, including 61 additional ones resulting from COVID-emergency recruitment. At this second screening, eight subjects (1.3%) tested positive, thus being diagnosed as asymptomatic carriers of SARS-CoV-2. They were one physician, five nurses, and two HCW from the logistic/support services. They were employed in eight different wards/services. In all cases, the epidemiological investigation showed convincing evidence that the infection was acquired through social contacts. The study revealed a very low circulation of SARS-CoV-2 infection in HCW tested with RT-PCR. All the infections documented in the second wave of epidemic of SARS-CoV-2 were acquired outside of the workplace, confirming that in a pediatric hospital setting, HCW education, correct use of personal protective equipment, and separation of the COVID-patient pathway and staff flow may minimize the risk derived from occupational exposure.
Collapse
|
41
|
SARS-CoV-2 Seroprevalence in Healthcare Workers of Kaunas Hospitals during the First Wave of the COVID-19 Pandemic. MEDICINA-LITHUANIA 2021; 57:medicina57020148. [PMID: 33562085 PMCID: PMC7915158 DOI: 10.3390/medicina57020148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/19/2021] [Accepted: 02/02/2021] [Indexed: 11/26/2022]
Abstract
Background and objective: Serologic testing is a useful additional method for the diagnosis of COVID-19. It is also used for population-based seroepidemiological studies. The objective of the study was to determine SARS-CoV-2 seroprevalence in healthcare workers of Kaunas hospitals and to compare two methods for specific SARS-CoV-2 antibody testing. Materials and Methods: A total of 432 healthcare workers in Kaunas hospitals were enrolled in this study. Each participant filled a questionnaire including questions about their demographics, contact with suspected or confirmed COVID-19, acute respiratory symptoms, and whether they contacted their general practitioner, could not come to work, or had to be hospitalized. Capillary blood was used to test for SARS-CoV-2 specific immunoglobulin G (IgG) and immunoglobulin M (IgM) a lateral flow immunoassay. Serum samples were used to test for specific IgG and IgA class immunoglobulins using semiquantitative enzyme-linked immunosorbent assay (ELISA) method. Results: 24.77% of study participants had direct contact with a suspected or confirmed case of COVID-19. A total of 64.81% of studied individuals had at least one symptom representing acute respiratory infection, compatible with COVID-19. Lateral flow immunoassay detected SARS-CoV-2 specific IgG class immunoglobulins in 1.16% of the tested group. Fever, cough, dyspnea, nausea, diarrhea, headache, conjunctivitis, muscle pain, and loss of smell and taste predominated in the anti-SARS-CoV-2 IgG-positive group. Using ELISA, specific IgG were detected in 1.32% of the tested samples. Diarrhea, loss of appetite, and loss of smell and taste sensations were the most predominant symptoms in anti-SARS-CoV-2 IgG-positive group. The positive percent agreement of the two testing methods was 50%, and negative percent agreement was 99.66%. Conclusions: 1.16% of tested healthcare workers of Kaunas hospitals were anti-SARS-CoV-2 IgG-positive. The negative percent agreement of the lateral flow immunoassay and ELISA exceeded 99%.
Collapse
|
42
|
Grossberg AN, Koza LA, Ledreux A, Prusmack C, Krishnamurthy HK, Jayaraman V, Granholm AC, Linseman DA. A multiplex chemiluminescent immunoassay for serological profiling of COVID-19-positive symptomatic and asymptomatic patients. Nat Commun 2021; 12:740. [PMID: 33531472 PMCID: PMC7854643 DOI: 10.1038/s41467-021-21040-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 01/11/2021] [Indexed: 12/15/2022] Open
Abstract
The COVID-19 pandemic affects more than 81 million people worldwide with over 1.7 million deaths. As the population returns to work, it is critical to develop tests that reliably detect SARS-CoV-2-specific antibodies. Here we present results from a multiplex serology test for assessing the antibody responses to COVID-19. In an initial large cohort, this test shows greater than 99% agreement with COVID-19 PCR test. In a second outpatient cohort consisting of adults and children in Colorado, the IgG responses are more robust in positive/symptomatic participants than in positive/asymptomatic participants, the IgM responses in symptomatic participants are transient and largely fall below the detection limit 30 days after symptom onset, and the levels of IgA against SARS-CoV-2 receptor binding domain are significantly increased in participants with moderate-to-severe symptoms compared to those with mild-to-moderate symptoms or asymptomatic individuals. Our results thus provide insight into serology profiling and the immune response to COVID-19.
Collapse
Affiliation(s)
- Allison N Grossberg
- Knoebel Institute for Healthy Aging, University of Denver, Denver, CO, USA
- Department of Biological Sciences, University of Denver, Denver, CO, USA
| | - Lilia A Koza
- Knoebel Institute for Healthy Aging, University of Denver, Denver, CO, USA
- Department of Biological Sciences, University of Denver, Denver, CO, USA
| | - Aurélie Ledreux
- Knoebel Institute for Healthy Aging, University of Denver, Denver, CO, USA
| | | | | | | | | | - Daniel A Linseman
- Knoebel Institute for Healthy Aging, University of Denver, Denver, CO, USA.
- Department of Biological Sciences, University of Denver, Denver, CO, USA.
- Eleanor Roosevelt Institute, University of Denver, Denver, CO, USA.
| |
Collapse
|
43
|
Galanis P, Vraka I, Fragkou D, Bilali A, Kaitelidou D. Seroprevalence of SARS-CoV-2 antibodies and associated factors in healthcare workers: a systematic review and meta-analysis. J Hosp Infect 2021; 108:120-134. [PMID: 33212126 PMCID: PMC7668234 DOI: 10.1016/j.jhin.2020.11.008] [Citation(s) in RCA: 217] [Impact Index Per Article: 72.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 11/10/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Healthcare workers (HCWs) represent a high-risk population for infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). AIM To determine the seroprevalence of SARS-CoV-2 antibodies among HCWs, and identify the factors associated with this seroprevalence. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were applied for this systematic review and meta-analysis. Databases including PubMed/MEDLINE and preprint services (medRχiv and bioRχiv) were searched from inception to 24th August 2020. FINDINGS Forty-nine studies including 127,480 HCWs met the inclusion criteria. The estimated overall seroprevalence of SARS-CoV-2 antibodies among HCWs was 8.7% (95% confidence interval 6.7-10.9%). Seroprevalence was higher in studies conducted in North America (12.7%) compared with those conducted in Europe (8.5%), Africa (8.2) and Asia (4%). Meta-regression showed that increased sensitivity of antibody tests was associated with increased seroprevalence. The following factors were associated with seropositivity: male gender; Black, Asian and Hispanic HCWs; work in a coronavirus disease 2019 (COVID-19) unit; patient-related work; front-line HCWs; healthcare assistants; shortage of personal protective equipment; self-reported belief of previous SARS-CoV-2 infection; previous positive polymerase chain reaction test; and household contact with suspected or confirmed cases of COVID-19. CONCLUSION The seroprevalence of SARS-CoV-2 antibodies among HCWs is high. Excellent adherence to infection prevention and control measures; sufficient and adequate personal protective equipment; and early recognition, identification and isolation of HCWs infected with SARS-CoV-2 are imperative to decrease the risk of SARS-CoV-2 infection.
Collapse
Affiliation(s)
- P Galanis
- Faculty of Nursing, Centre for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece.
| | - I Vraka
- Department of Radiology, P & A Kyriakou Children's Hospital, Athens, Greece
| | - D Fragkou
- Faculty of Nursing, Centre for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece
| | - A Bilali
- Hospital Waste Management Unit, P & A Kyriakou Children's Hospital, Athens, Greece
| | - D Kaitelidou
- Faculty of Nursing, Centre for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
44
|
Sociodemographic risk factors for coronavirus disease 2019 (COVID-19) infection among Massachusetts healthcare workers: A retrospective cohort study. Infect Control Hosp Epidemiol 2021; 42:1473-1478. [PMID: 33504372 PMCID: PMC8185417 DOI: 10.1017/ice.2021.17] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To better understand coronavirus disease 2019 (COVID-19) transmission among healthcare workers (HCWs), we investigated occupational and nonoccupational risk factors associated with cumulative COVID-19 incidence among a Massachusetts HCW cohort. DESIGN, SETTING, AND PARTICIPANTS The retrospective cohort study included adult HCWs in a single healthcare system from March 9 to June 3, 2020. METHODS The SARS-CoV-2 nasopharyngeal RT-PCR results and demographics of the study participants were deidentified and extracted from an established occupational health, COVID-19 database at the healthcare system. HCWs from each particular job grouping had been categorized into frontline or nonfrontline workers. Incidence rate ratios (IRRs) and odds ratios (ORs) were used to compare subgroups after excluding HCWs involved in early infection clusters before universal masking began. A sensitivity analysis was performed comparing jobs with the greatest potential occupational risks with others. RESULTS Of 5,177 HCWs, 152 (2.94%) were diagnosed with COVID-19. Affected HCWs resided in areas with higher community attack rates (median, 1,755.2 vs 1,412.4 cases per 100,000; P < .001; multivariate-adjusted IRR, 1.89; 95% CI, 1.03-3.44 comparing fifth to first quintile of community rates). After multivariate adjustment, African-American and Hispanic HCWs had higher incidence of COVID-19 than non-Hispanic white HCWs (IRR, 2.78; 95% CI, 1.78-4.33; and IRR, 2.41, 95% CI, 1.42-4.07, respectively). After adjusting for race and residential rates, frontline HCWs had a higher IRR (1.73, 95% CI, 1.16-2.54) than nonfrontline HCWs overall, but not within specific job categories nor when comparing the highest risk jobs to others. CONCLUSIONS After universal masking was instituted, the strongest risk factors associated with HCW COVID-19 infection were residential community infection rate and race.
Collapse
|
45
|
Heffron AS, McIlwain SJ, Amjadi MF, Baker DA, Khullar S, Sethi AK, Palmenberg AC, Shelef MA, O'Connor DH, Ong IM. The landscape of antibody binding in SARS-CoV-2 infection. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2021:2020.10.10.334292. [PMID: 33052349 PMCID: PMC7553183 DOI: 10.1101/2020.10.10.334292] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The search for potential antibody-based diagnostics, vaccines, and therapeutics for pandemic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has focused almost exclusively on the spike (S) and nucleocapsid (N) proteins. Coronavirus membrane (M), ORF3a, and ORF8 proteins are humoral immunogens in other coronaviruses (CoVs) but remain largely uninvestigated for SARS-CoV-2. Here we use ultradense peptide microarray mapping to show that SARS-CoV-2 infection induces robust antibody responses to epitopes throughout the SARS-CoV-2 proteome, particularly in M, in which one epitope achieved excellent diagnostic accuracy. We map 79 B cell epitopes throughout the SARS-CoV-2 proteome and demonstrate that antibodies that develop in response to SARS-CoV-2 infection bind homologous peptide sequences in the six other known human CoVs. We also confirm reactivity against four of our top-ranking epitopes by enzyme-linked immunosorbent assay (ELISA). Illness severity correlated with increased reactivity to nine SARS-CoV-2 epitopes in S, M, N, and ORF3a in our population. Our results demonstrate previously unknown, highly reactive B cell epitopes throughout the full proteome of SARS-CoV-2 and other CoV proteins.
Collapse
|
46
|
Goldblatt D, Johnson M, Falup-Pecurariu O, Ivaskeviciene I, Spoulou V, Tamm E, Wagner M, Zar HJ, Bleotu L, Ivaskevicius R, Papadatou I, Jõgi P, Lischka J, Franckling-Smith Z, Isarova D, Grandjean L, Zavadska D. Cross-sectional prevalence of SARS-CoV-2 antibodies in healthcare workers in paediatric facilities in eight countries. J Hosp Infect 2021; 110:60-66. [PMID: 33422589 PMCID: PMC7836791 DOI: 10.1016/j.jhin.2020.12.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/24/2020] [Accepted: 12/26/2020] [Indexed: 12/11/2022]
Abstract
Background Healthcare workers (HCWs) have been disproportionately affected by coronavirus disease 2019 (COVID-19), which may be driven, in part, by nosocomial exposure. If HCW exposure is predominantly nosocomial, HCWs in paediatric facilities, where few patients are admitted with COVID-19, may lack antibodies to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and be at increased risk during the current resurgence. Aim To compare the seroprevalence of SARS-CoV-2 amongst HCWs in paediatric facilities in seven European countries and South Africa (N=8). Methods All categories of paediatric HCWs were invited to participate in the study, irrespective of previous symptoms. A single blood sample was taken and data about previous symptoms were documented. Serum was shipped to a central laboratory in London where SARS-CoV-2 immunoglobulin G was measured. Findings In total, 4114 HCWs were recruited between 1st May and mid-July 2020. The range of seroprevalence was 0–16.93%. The highest seroprevalence was found in London (16.93%), followed by Cape Town, South Africa (10.36%). There were no positive HCWs in the Austrian, Estonian and Latvian cohorts; 2/300 [0.66%, 95% confidence interval (CI) 0.18–2.4] HCWs tested positive in Lithuania; 1/124 (0.81%, 95% CI 0.14–4.3) HCWs tested positive in Romania; and 1/76 (1.3%, 95% CI 0.23–7.0) HCWs tested positive in Greece. Conclusion Overall seroprevalence amongst paediatric HCWs is similar to their national populations and linked to the national COVID-19 burden. Staff working in paediatric facilities in low-burden countries have very low seroprevalence rates and thus are likely to be susceptible to COVID-19. Their susceptibility to infection may affect their ability to provide care in the face of increasing cases of COVID-19, and this highlights the need for appropriate preventative strategies in paediatric healthcare settings.
Collapse
Affiliation(s)
- D Goldblatt
- Great Ormond Street Institute of Child Health, University College London, London, UK; Great Ormond Street Children's Hospital NHS Foundation Trust, London, UK.
| | - M Johnson
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - O Falup-Pecurariu
- Children's Clinic Hospital, Faculty of Medicine, Transilvania University, Brasov, Romania
| | - I Ivaskeviciene
- Paediatric Centre, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - V Spoulou
- 'Agia Sophia' Children's Hospital of Athens, Athens, Greece
| | - E Tamm
- Children's Clinic of Tartu University Hospital, Tartu, Estonia
| | - M Wagner
- Division of Neonatology, Paediatric Intensive Care and Neuropaediatrics, Department of Paediatrics, Comprehensive Centre for Paediatrics, Medical University of Vienna, Vienna, Austria
| | - H J Zar
- Department of Paediatrics and Child Health, Red Cross Children's Hospital, and SA-MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - L Bleotu
- Children's Clinic Hospital, Faculty of Medicine, Transilvania University, Brasov, Romania
| | - R Ivaskevicius
- Paediatric Centre, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - I Papadatou
- Immunobiology and Vaccinology Research Laboratory, National and Kapodistrian University of Athens, Athens, Greece
| | - P Jõgi
- Children's Clinic of Tartu University Hospital, Tartu, Estonia
| | - J Lischka
- Clinical Division of Paediatric Pulmonology, Allergology and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre for Paediatrics, Medical University of Vienna, Vienna, Austria
| | - Z Franckling-Smith
- Department of Paediatrics and Child Health, Red Cross Children's Hospital, and SA-MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - D Isarova
- Children's Clinical University Hospital, Riga, Latvia
| | - L Grandjean
- Great Ormond Street Institute of Child Health, University College London, London, UK; Great Ormond Street Children's Hospital NHS Foundation Trust, London, UK
| | - D Zavadska
- Children's Clinical University Hospital, Riga, Latvia
| |
Collapse
|
47
|
Gómez-Ochoa SA, Franco OH, Rojas LZ, Raguindin PF, Roa-Díaz ZM, Wyssmann BM, Guevara SLR, Echeverría LE, Glisic M, Muka T. COVID-19 in Health-Care Workers: A Living Systematic Review and Meta-Analysis of Prevalence, Risk Factors, Clinical Characteristics, and Outcomes. Am J Epidemiol 2021; 190:161-175. [PMID: 32870978 PMCID: PMC7499478 DOI: 10.1093/aje/kwaa191] [Citation(s) in RCA: 434] [Impact Index Per Article: 144.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/25/2020] [Accepted: 08/28/2020] [Indexed: 12/16/2022] Open
Abstract
Health care workers (HCW) are at the frontline response to the new coronavirus disease 2019 (COVID-19), being at a higher risk of acquiring the disease, and subsequently, exposing patients and colleagues. Searches in eight bibliographic databases were performed to systematically review the evidence on the prevalence, risk factors, clinical characteristics, and prognosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among HCW. Ninety-seven studies (All published in 2020), including 230,398 HCW, met the inclusion criteria. From the screened HCW using RT-PCR and the presence of antibodies, the estimated prevalence of SARS-CoV-2 infection was 11% (95%CI; 7%-15%) and 7% (95% CI; 4%-11%), respectively. The most frequently affected personnel were the nurses (48%. 95%CI; 41%-56%), while most of the COVID-19 positive medical personnel were working in hospitalization/non-emergency wards during the screening (43%, 95%CI;28%-59%). Anosmia, fever and myalgia were identified as the only symptoms associated with HCW SARS-CoV-2 positivity. Among RT-PCR positive HCW, 40% (95%CI;17%-65%) did not show symptoms at the time of diagnosis. Finally, 5% (95%CI;3%-8%) of the COVID-19 positive HCW developed severe clinical complications, and 0.5% (95% CI; 0.02%-1.3%) died. HCW suffer a significant burden from COVID-19, with HCW working in hospitalization/non-emergency wards and nurses being the most infected personnel.
Collapse
Affiliation(s)
- Sergio Alejandro Gómez-Ochoa
- Research Division, Cardiovascular Foundation of Colombia, Floridablanca, Colombia
- Public Health and Epidemiological Studies Group, Cardiovascular Foundation of Colombia, Floridablanca, Colombia
| | - Oscar H Franco
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Lyda Z Rojas
- Research Division, Cardiovascular Foundation of Colombia, Floridablanca, Colombia
- Research Group and Development of Nursing Knowledge (GIDCEN-FCV), Research Institute, Cardiovascular Foundation of Colombia, Floriadablanca, Santander, Colombia
| | - Peter Francis Raguindin
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Institute of Child Health and Human Development (ICHHD), National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | - Zayne Milena Roa-Díaz
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Research Group and Development of Nursing Knowledge (GIDCEN-FCV), Research Institute, Cardiovascular Foundation of Colombia, Floriadablanca, Santander, Colombia
| | - Beatrice Minder Wyssmann
- Public Health & Primary Care Library, University Library of Bern, University of Bern, Bern, Switzerland
| | | | | | - Marija Glisic
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Swiss Paraplegic Research, Nottwil, Switzerland
| | - Taulant Muka
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
- Correspondence to Dr. Taulant Muka, MD, MPH, PhD; Institute of Social and Preventive Medicine (ISPM), University of Bern, Mittelstrasse 43, 3012, Bern, Switzerland (e-mail: )
| |
Collapse
|
48
|
Lan FY, Christophi CA, Buley J, Iliaki E, Bruno-Murtha LA, Sayah AJ, Kales SN. Effects of universal masking on Massachusetts healthcare workers' COVID-19 incidence. Occup Med (Lond) 2020; 70:606-609. [PMID: 33225363 PMCID: PMC7665621 DOI: 10.1093/occmed/kqaa179] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background Healthcare workers (HCWs) and other essential workers are at risk of occupational infection during the COVID-19 pandemic. Several infection control strategies have been implemented. Evidence shows that universal masking can mitigate COVID-19 infection, though existing research is limited by secular trend bias. Aims To investigate the effect of hospital universal masking on COVID-19 incidence among HCWs compared to the general population. Methods We compared the 7-day average incidence rates between a Massachusetts (USA) healthcare system and Massachusetts residents statewide. The study period was from 17 March (the date of first incident case in the healthcare system) to 6 May (the date Massachusetts implemented public masking). The healthcare system implemented universal masking on 26 March, we allotted a 5-day lag for effect onset and peak COVID-19 incidence in Massachusetts was 20 April. Thus, we categorized 17–31 March as the pre-intervention phase, 1–20 April the intervention phase and 21 April to 6 May the epidemic decline phase. Temporal incidence trends (i.e. 7-day average slopes) were compared using standardized coefficients from linear regression models. Results The standardized coefficients were similar between the healthcare system and the state in both the pre-intervention and epidemic decline phases. During the intervention phase, the healthcare system’s epidemic slope became negative (standardized β: −0.68, 95% CI: −1.06 to −0.31), while Massachusetts’ slope remained positive (standardized β: 0.99, 95% CI: 0.94 to 1.05). Conclusions Universal masking was associated with a decreasing COVID-19 incidence trend among HCWs, while the infection rate continued to rise in the surrounding community.
Collapse
Affiliation(s)
- F-Y Lan
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA, USA.,Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - C A Christophi
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA, USA.,Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - J Buley
- Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA
| | - E Iliaki
- Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA.,Infection Prevention, Infectious Diseases, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA
| | - L A Bruno-Murtha
- Infection Prevention, Infectious Diseases, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA
| | - A J Sayah
- Emergency Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA.,Cambridge Department of Public Health, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA
| | - S N Kales
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health, Boston, MA, USA.,Occupational Medicine, Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, USA
| |
Collapse
|
49
|
Capasso N, Palladino R, Montella E, Pennino F, Lanzillo R, Carotenuto A, Petracca M, Iodice R, Iovino A, Aruta F, Pastore V, Buonomo AR, Zappulo E, Gentile I, Triassi M, Brescia Morra V, Moccia M. Prevalence of SARS-CoV-2 Antibodies in Multiple Sclerosis: The Hidden Part of the Iceberg. J Clin Med 2020; 9:E4066. [PMID: 33339402 PMCID: PMC7766741 DOI: 10.3390/jcm9124066] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/09/2020] [Accepted: 12/13/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND We compared the prevalence of SARS-CoV-2 IgG/IgM in multiple sclerosis (MS), low-risk, and high-risk populations and explored possible clinical correlates. METHODS In this cross-sectional study, we recruited MS patients, low-risk (university staff from non-clinical departments), and high-risk individuals (healthcare staff from COVID-19 wards) from 11 May to 15 June 2020. We used lateral flow immunoassay to detect SARS-CoV-2 IgG and IgM. We used t-test, Fisher's exact test, chi square test, or McNemar's test, as appropriate, to evaluate between-group differences. RESULTS We recruited 310 MS patients (42.3 ± 12.4 years; females 67.1%), 862 low-risk individuals (42.9 ± 13.3 years; females 47.8%), and 235 high-risk individuals (39.4 ± 10.9 years; females 54.5%). The prevalence of SARS-CoV-2 IgG/IgM in MS patients (n = 9, 2.9%) was significantly lower than in the high-risk population (n = 25, 10.6%) (p < 0.001), and similar to the low-risk population (n = 11, 1.3%) (p = 0.057); these results were also confirmed after random matching by age and sex (1:1:1). No significant differences were found in demographic, clinical, treatment, and laboratory features. Among MS patients positive to SARS-CoV-2 IgG/IgM (n = 9), only two patients retrospectively reported mild and short-lasting COVID-19 symptoms. CONCLUSIONS MS patients have similar risk of SARS-CoV-2 infection to the general population, and can be asymptomatic from COVID-19, also if using treatments with systemic immunosuppression.
Collapse
Affiliation(s)
- Nicola Capasso
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80138 Naples, Italy; (N.C.); (R.L.); (A.C.); (M.P.); (R.I.); (A.I.); (F.A.); (V.B.M.)
| | - Raffaele Palladino
- Department of Public Health, University of Naples “Federico II”, 80138 Naples, Italy; (R.P.); (F.P.); (V.P.); (M.T.)
- Department of Primary Care and Public Health, Imperial College London, London W68RP, UK
| | - Emma Montella
- Department of Hygiene, Preventive and Industrial Medicine, University Hospital “Federico II”, 80138 Naples, Italy;
| | - Francesca Pennino
- Department of Public Health, University of Naples “Federico II”, 80138 Naples, Italy; (R.P.); (F.P.); (V.P.); (M.T.)
| | - Roberta Lanzillo
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80138 Naples, Italy; (N.C.); (R.L.); (A.C.); (M.P.); (R.I.); (A.I.); (F.A.); (V.B.M.)
| | - Antonio Carotenuto
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80138 Naples, Italy; (N.C.); (R.L.); (A.C.); (M.P.); (R.I.); (A.I.); (F.A.); (V.B.M.)
| | - Maria Petracca
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80138 Naples, Italy; (N.C.); (R.L.); (A.C.); (M.P.); (R.I.); (A.I.); (F.A.); (V.B.M.)
| | - Rosa Iodice
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80138 Naples, Italy; (N.C.); (R.L.); (A.C.); (M.P.); (R.I.); (A.I.); (F.A.); (V.B.M.)
| | - Aniello Iovino
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80138 Naples, Italy; (N.C.); (R.L.); (A.C.); (M.P.); (R.I.); (A.I.); (F.A.); (V.B.M.)
| | - Francesco Aruta
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80138 Naples, Italy; (N.C.); (R.L.); (A.C.); (M.P.); (R.I.); (A.I.); (F.A.); (V.B.M.)
| | - Viviana Pastore
- Department of Public Health, University of Naples “Federico II”, 80138 Naples, Italy; (R.P.); (F.P.); (V.P.); (M.T.)
| | - Antonio Riccardo Buonomo
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80138 Naples, Italy; (A.R.B.); (E.Z.); (I.G.)
| | - Emanuela Zappulo
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80138 Naples, Italy; (A.R.B.); (E.Z.); (I.G.)
| | - Ivan Gentile
- Section of Infectious Diseases, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80138 Naples, Italy; (A.R.B.); (E.Z.); (I.G.)
- UNESCO Chair on Health Education and Sustainable Development, University of Naples “Federico II”, 80138 Naples, Italy
| | - Maria Triassi
- Department of Public Health, University of Naples “Federico II”, 80138 Naples, Italy; (R.P.); (F.P.); (V.P.); (M.T.)
| | - Vincenzo Brescia Morra
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80138 Naples, Italy; (N.C.); (R.L.); (A.C.); (M.P.); (R.I.); (A.I.); (F.A.); (V.B.M.)
| | - Marcello Moccia
- Multiple Sclerosis Clinical Care and Research Centre, Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80138 Naples, Italy; (N.C.); (R.L.); (A.C.); (M.P.); (R.I.); (A.I.); (F.A.); (V.B.M.)
| |
Collapse
|
50
|
De Carlo A, Lo Caputo S, Paolillo C, Rosa AM, D’Orsi U, De Palma M, Reveglia P, Lacedonia D, Cinnella G, Foschino MP, Margaglione M, Mirabella L, Santantonio TA, Corso G, Dattoli V. SARS-COV-2 Serological Profile in Healthcare Professionals of a Southern Italy Hospital. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9324. [PMID: 33322150 PMCID: PMC7764094 DOI: 10.3390/ijerph17249324] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/26/2020] [Accepted: 12/08/2020] [Indexed: 12/15/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the first coronavirus that has caused a pandemic. Assessing the prevalence of anti-SARS-CoV-2 in healthcare worker groups offers a unique opportunity to study the correlation between seroconversion and immunization because of their occupational exposure and a higher risk of contagion. The study enrolled 3242 asymptomatic employees of "Policlinico Riuniti", Foggia. After the first screening, we collected sequential serum samples for up to 23 weeks from the same subjects. In order to perform a longitudinal follow-up study and get information about the titration of IgG levels, we analyzed data from subjects (33) with at least two consecutive serological IgG-positive tests; 62 (1.9%; 95% CI: 1.4-2.3) tested positive for at least one anti-SARS-CoV-2 antibody. The seroprevalence was lower in the high-risk group 1.4% (6/428; 95% CI: 0.5-2.6) vs. the intermediate-risk group 2.0% (55/2736; 95% CI: 1.5-2.5). Overall, within eight weeks, we detected a mean reduction of -17% in IgG levels. Our data suggest a reduction of about 9.27 AU/mL every week (R2 = 0.35, p = 0.0003). This study revealed the prevalence of SARS-CoV-2 antibodies among Foggia's hospital healthcare staff (1.9%). Moreover, the IgG level reduction suggests that the serological response fades fast in asymptomatic infections.
Collapse
Affiliation(s)
- Armando De Carlo
- Azienda Ospedaliera-Universitaria Policlinico Riuniti di Foggia, 71122 Foggia, Italy; (A.D.C.); (S.L.C.); (A.M.R.); (U.D.); (M.D.P.); (D.L.); (G.C.); (M.P.F.); (M.M.); (L.M.); (T.A.S.); (V.D.)
| | - Sergio Lo Caputo
- Azienda Ospedaliera-Universitaria Policlinico Riuniti di Foggia, 71122 Foggia, Italy; (A.D.C.); (S.L.C.); (A.M.R.); (U.D.); (M.D.P.); (D.L.); (G.C.); (M.P.F.); (M.M.); (L.M.); (T.A.S.); (V.D.)
- Dipartimento di Medicina Clinica e Sperimentale, Università di Foggia, 71122 Foggia, Italy; (C.P.); (P.R.)
| | - Carmela Paolillo
- Dipartimento di Medicina Clinica e Sperimentale, Università di Foggia, 71122 Foggia, Italy; (C.P.); (P.R.)
| | - Anna Maria Rosa
- Azienda Ospedaliera-Universitaria Policlinico Riuniti di Foggia, 71122 Foggia, Italy; (A.D.C.); (S.L.C.); (A.M.R.); (U.D.); (M.D.P.); (D.L.); (G.C.); (M.P.F.); (M.M.); (L.M.); (T.A.S.); (V.D.)
| | - Umberto D’Orsi
- Azienda Ospedaliera-Universitaria Policlinico Riuniti di Foggia, 71122 Foggia, Italy; (A.D.C.); (S.L.C.); (A.M.R.); (U.D.); (M.D.P.); (D.L.); (G.C.); (M.P.F.); (M.M.); (L.M.); (T.A.S.); (V.D.)
| | - Maria De Palma
- Azienda Ospedaliera-Universitaria Policlinico Riuniti di Foggia, 71122 Foggia, Italy; (A.D.C.); (S.L.C.); (A.M.R.); (U.D.); (M.D.P.); (D.L.); (G.C.); (M.P.F.); (M.M.); (L.M.); (T.A.S.); (V.D.)
| | - Pierluigi Reveglia
- Dipartimento di Medicina Clinica e Sperimentale, Università di Foggia, 71122 Foggia, Italy; (C.P.); (P.R.)
| | - Donato Lacedonia
- Azienda Ospedaliera-Universitaria Policlinico Riuniti di Foggia, 71122 Foggia, Italy; (A.D.C.); (S.L.C.); (A.M.R.); (U.D.); (M.D.P.); (D.L.); (G.C.); (M.P.F.); (M.M.); (L.M.); (T.A.S.); (V.D.)
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Foggia, 71122 Foggia, Italy
| | - Gilda Cinnella
- Azienda Ospedaliera-Universitaria Policlinico Riuniti di Foggia, 71122 Foggia, Italy; (A.D.C.); (S.L.C.); (A.M.R.); (U.D.); (M.D.P.); (D.L.); (G.C.); (M.P.F.); (M.M.); (L.M.); (T.A.S.); (V.D.)
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Foggia, 71122 Foggia, Italy
| | - Maria Pia Foschino
- Azienda Ospedaliera-Universitaria Policlinico Riuniti di Foggia, 71122 Foggia, Italy; (A.D.C.); (S.L.C.); (A.M.R.); (U.D.); (M.D.P.); (D.L.); (G.C.); (M.P.F.); (M.M.); (L.M.); (T.A.S.); (V.D.)
- Dipartimento di Scienze Mediche e Chirurgiche, Università di Foggia, 71122 Foggia, Italy
| | - Maurizio Margaglione
- Azienda Ospedaliera-Universitaria Policlinico Riuniti di Foggia, 71122 Foggia, Italy; (A.D.C.); (S.L.C.); (A.M.R.); (U.D.); (M.D.P.); (D.L.); (G.C.); (M.P.F.); (M.M.); (L.M.); (T.A.S.); (V.D.)
- Dipartimento di Medicina Clinica e Sperimentale, Università di Foggia, 71122 Foggia, Italy; (C.P.); (P.R.)
| | - Lucia Mirabella
- Azienda Ospedaliera-Universitaria Policlinico Riuniti di Foggia, 71122 Foggia, Italy; (A.D.C.); (S.L.C.); (A.M.R.); (U.D.); (M.D.P.); (D.L.); (G.C.); (M.P.F.); (M.M.); (L.M.); (T.A.S.); (V.D.)
| | - Teresa Antonia Santantonio
- Azienda Ospedaliera-Universitaria Policlinico Riuniti di Foggia, 71122 Foggia, Italy; (A.D.C.); (S.L.C.); (A.M.R.); (U.D.); (M.D.P.); (D.L.); (G.C.); (M.P.F.); (M.M.); (L.M.); (T.A.S.); (V.D.)
- Dipartimento di Medicina Clinica e Sperimentale, Università di Foggia, 71122 Foggia, Italy; (C.P.); (P.R.)
| | - Gaetano Corso
- Azienda Ospedaliera-Universitaria Policlinico Riuniti di Foggia, 71122 Foggia, Italy; (A.D.C.); (S.L.C.); (A.M.R.); (U.D.); (M.D.P.); (D.L.); (G.C.); (M.P.F.); (M.M.); (L.M.); (T.A.S.); (V.D.)
- Dipartimento di Medicina Clinica e Sperimentale, Università di Foggia, 71122 Foggia, Italy; (C.P.); (P.R.)
| | - Vitangelo Dattoli
- Azienda Ospedaliera-Universitaria Policlinico Riuniti di Foggia, 71122 Foggia, Italy; (A.D.C.); (S.L.C.); (A.M.R.); (U.D.); (M.D.P.); (D.L.); (G.C.); (M.P.F.); (M.M.); (L.M.); (T.A.S.); (V.D.)
| |
Collapse
|