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Georgiou EX, Ryder V, Paget J, Banks R, Cheong YC. The new normal: a UK fertility clinic experience of universal RT-PCR SARS-CoV-2 testing. HUM FERTIL 2022:1-6. [PMID: 35196949 DOI: 10.1080/14647273.2022.2040750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Following the temporary closure of fertility clinics in 2020 in many countries across the world, the SARS-CoV-2 pandemic has meant that the sector has had to rapidly adapt to novel ways of operating. The aim of this study was to investigate the efficacy and feasibility of universal real-time polymerase chain reaction testing at an IVF clinic within a UK tertiary referral centre. Between March and December 2020, we performed 2,401 SARS-CoV-2 RT-PCR tests on 1,215 individual patients, of which eight were positive (0.3%). Appropriate positive case identification allowed for delay in treatment initiation or cancellation as applicable. This has allowed our unit to continue to operate safely and efficiently.
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Affiliation(s)
| | - Victoria Ryder
- Complete Fertility Centre, Princess Anne Hospital, Southampton, UK
| | - Julia Paget
- Complete Fertility Centre, Princess Anne Hospital, Southampton, UK
| | - Richard Banks
- Complete Fertility Centre, Princess Anne Hospital, Southampton, UK
| | - Ying C Cheong
- Complete Fertility Centre, Princess Anne Hospital, Southampton, UK.,School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
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Somboro AM, Cissoko Y, Camara I, Kodio O, Tolofoudie M, Dembele E, Togo ACG, Ba DM, Sarro YDS, Baya B, Samake S, Diallo IB, Kumar A, Traore M, Kone B, Kone A, Diarra B, Dabitao DK, Wague M, Dabo G, Doumbia S, Holl JL, Murphy RL, Diallo S, Maiga AI, Maiga M, Dao S. High SARS-CoV-2 Seroprevalence among Healthcare Workers in Bamako, Mali. Viruses 2022; 14:102. [PMID: 35062306 PMCID: PMC8780908 DOI: 10.3390/v14010102] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 12/25/2021] [Accepted: 12/27/2021] [Indexed: 02/05/2023] Open
Abstract
In Mali, a country in West Africa, cumulative confirmed COVID-19 cases and deaths among healthcare workers (HCWs) remain enigmatically low, despite a series of waves, circulation of SARS-CoV-2 variants, the country's weak healthcare system, and a general lack of adherence to public health mitigation measures. The goal of the study was to determine whether exposure is important by assessing the seroprevalence of anti-SARS-CoV-2 IgG antibodies in HCWs. The study was conducted between November 2020 and June 2021. HCWs in the major hospitals where COVID-19 cases were being cared for in the capital city, Bamako, Mali, were recruited. During the study period, vaccinations were not yet available. The ELISA of the IgG against the spike protein was optimized and quantitatively measured. A total of 240 HCWs were enrolled in the study, of which seropositivity was observed in 147 cases (61.8%). A continuous increase in the seropositivity was observed, over time, during the study period, from 50% at the beginning to 70% at the end of the study. HCWs who provided direct care to COVID-19 patients and were potentially highly exposed did not have the highest seropositivity rate. Vulnerable HCWs with comorbidities such as obesity, diabetes, and asthma had even higher seropositivity rates at 77.8%, 75.0%, and 66.7%, respectively. Overall, HCWs had high SARS-CoV-2 seroprevalence, likely reflecting a "herd" immunity level, which could be protective at some degrees. These data suggest that the low number of cases and deaths among HCWs in Mali is not due to a lack of occupational exposure to the virus but rather related to other factors that need to be investigated.
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Affiliation(s)
- Anou M. Somboro
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Private Bag X5, Durban 4001, South Africa
| | - Yacouba Cissoko
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
- Department of Infectious Diseases and Tropical Medicine, Point “G” University Teaching Hospital, Bamako PB 1805, Mali
| | - Issiaka Camara
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Ousmane Kodio
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Mohamed Tolofoudie
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Etienne Dembele
- Institute for Global Health, Northwestern University, Chicago, IL 60611, USA; (E.D.); (A.K.); (M.T.); (R.L.M.)
| | - Antieme C. G. Togo
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Djibril M. Ba
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA;
| | - Yeya dit Sadio Sarro
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Bocar Baya
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Seydou Samake
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Ibrahim B. Diallo
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Alisha Kumar
- Institute for Global Health, Northwestern University, Chicago, IL 60611, USA; (E.D.); (A.K.); (M.T.); (R.L.M.)
| | - Mohamed Traore
- Institute for Global Health, Northwestern University, Chicago, IL 60611, USA; (E.D.); (A.K.); (M.T.); (R.L.M.)
| | - Bourahima Kone
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Amadou Kone
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Bassirou Diarra
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Djeneba K. Dabitao
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Mamadou Wague
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Garan Dabo
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Seydou Doumbia
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Jane L. Holl
- Department of Neurology and Center for Healthcare Delivery Science and Innovation, University of Chicago, Chicago, IL 60611, USA;
| | - Robert L. Murphy
- Institute for Global Health, Northwestern University, Chicago, IL 60611, USA; (E.D.); (A.K.); (M.T.); (R.L.M.)
| | - Souleymane Diallo
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Almoustapha I. Maiga
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Mamoudou Maiga
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
- Institute for Global Health, Northwestern University, Chicago, IL 60611, USA; (E.D.); (A.K.); (M.T.); (R.L.M.)
| | - Sounkalo Dao
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
- Department of Infectious Diseases and Tropical Medicine, Point “G” University Teaching Hospital, Bamako PB 1805, Mali
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Manolea C, Capitanescu A, Borș R, Rugescu I, Bechir M, Mehedintu C, Varlas V. The prevalence of SARS-CoV-2 antibodies in triage-negative patients and staff of a fertility setting from lockdown release throughout 2020. Hum Reprod Open 2021; 2021:hoab028. [PMID: 34322605 PMCID: PMC8313405 DOI: 10.1093/hropen/hoab028] [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: 03/13/2021] [Revised: 06/10/2021] [Indexed: 12/13/2022] Open
Abstract
STUDY QUESTION What is the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies in triage-negative patients undergoing ART and fertility care providers after lockdown release and throughout 2020? SUMMARY ANSWER Out of the triage-negative patients whose blood samples were assessed for SARS-CoV-2 antibodies over 6 months, 5.2% yielded positive results with a significantly higher rate in health care workers (HCWs) and a significant month-by-month increase in those with evidence of antibodies. WHAT IS KNOWN ALREADY Patients of reproductive age are more prone to asymptomatic or minimal forms of coronavirus disease 2019 (COVID-19) as compared to older age groups, and the identification of those with active infection and those already exposed (and probably immunized) is important for safety and cost-effective use of testing resources in the fertility setting. Data on the prevalence of SARS-CoV-2 in ART patients are limited and encompass short time frames; current rates are unknown. There is also no consensus on the optimal way of screening triage-negative ART patients in moderate/high-risk areas. STUDY DESIGN SIZE DURATION A prospective longitudinal unicentric study on triage negative ART patients (n = 516) and clinical staff (n = 30) was carried out. We analyzed 705 serological tests for SARS-CoV-2 sampled between 17 May 2020 (the first working day after lockdown release) up to 1 December 2020, to assess the positivity rates for SARS-CoV-2 antibodies. PARTICIPANTS/MATERIALS SETTING METHODS We collected data on the serological status for IgM and IgG antibodies against SARS-CoV-2 in 516 triage-negative men (n = 123) and women (n = 393) undergoing ART at a private fertility center and 30 HCWs that were at work during the study period. Antibodies were detected with a capture chemiluminescence assay (CLIA) targeting the highly Immunogenic S1 and S2 domains on the virus spike protein. We also analyzed the molecular test results of the cases exhibiting a positive serology. MAIN RESULTS AND THE ROLE OF CHANCE The data showed that 5.2% of the triage-negative ART patients had a positive serological result for SARS-CoV-2, with an overall conversion rate of 2.1% for IgG and 4.6% for IgM. There was no significant difference in seroprevalence between sexes. The small cohort (n = 30) of HCWs had a markedly increased seroprevalence (12.9% for Ig M and 22.6% for IgG). The highest seropositivity in our cohort was recorded in November (16.2%). The IgM positivity rates revealed significant monthly increments, paralleling official prevalence rates based on nasopharyngeal swabs. No positive molecular tests were identified in cases exhibiting a solitary positive IgG result. We show that despite a 6-fold increase in the number of ART patients with a positive serology between May and December 2020, most of our patients remain unexposed to the virus. The study was undertaken in a high-risk area for COVID-19, with a 20-times increase in the active cases across the study period. LIMITATIONS REASONS FOR CAUTION The geographical restriction, alongside the lack of running a second, differently-targeted immunoassay (orthogonal testing), could limit the generalizability and translation of our results to other fertility settings or other immunoassays. WIDER IMPLICATIONS OF THE FINDINGS The low positivity rates for IgG against the SARS-CoV-2 spike protein seen at the end of 2020 imply that most of the fertility patients are still at risk for SARS-CoV-2 infection. Until mass vaccination and other measures effectively diminish the pandemic, risk mitigation strategies must be maintained in the fertility units in the foreseeable future. Patients with a solitary IgG+ status are most likely 'non-infectious' and can elude further testing without giving up the strict use of universal protective measures. With increasing seroprevalences owing to infection or vaccination, and with the consecutive increase in test performance, it is possible that serological screening of ART patients might be more cost-effective than PCR testing, especially for the many patients with repeat treatments/procedures in a time-frame of months. STUDY FUNDING/COMPETING INTERESTS This research received no external funding. All authors declare having no conflict of interest with regard to this trial.
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Affiliation(s)
- Corina Manolea
- Department of Obstetrics and Gynecology, ‘Carol Davila’ University of Medicine and Pharmacy, Bucharest, Romania
- Department of Assisted Reproduction, Columna Medical Center, Bucharest, Romania
| | - Andrei Capitanescu
- Hemodialysis Unit, ‘Marie Curie’ Pediatric Clinical Emergency Hospital, Bucharest, Romania
| | - Roxana Borș
- Department of Obstetrics and Gynaecology, Filantropia Clinical Hospital, Bucharest, Romania
| | - Ioana Rugescu
- Department of Cells, National Transplant Agency, Bucharest, Romania
| | - Melihan Bechir
- Department of Assisted Reproduction, Columna Medical Center, Bucharest, Romania
- Dept of Obstetrics and Gynecology, Infertility Center, Regina Maria Medical Network, Bucharest, Romania
| | - Claudia Mehedintu
- Department of Obstetrics and Gynecology, ‘Carol Davila’ University of Medicine and Pharmacy, Bucharest, Romania
- Department of Obstetrics and Gynecology, Nicolae Malaxa Clinical Hospital, Bucharest, Romania
| | - Valentin Varlas
- Department of Obstetrics and Gynecology, ‘Carol Davila’ University of Medicine and Pharmacy, Bucharest, Romania
- Department of Obstetrics and Gynaecology, Filantropia Clinical Hospital, Bucharest, Romania
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