SARS-CoV-2 exposure, symptoms and seroprevalence in healthcare workers in Sweden

  1. Ann-Sofie Rudberg
  2. Sebastian Havervall
  3. Anna Månberg
  4. August Jernbom Falk
  5. Katherina Aguilera
  6. Henry Ng
  7. Lena Gabrielsson
  8. Ann-Christin Salomonsson
  9. Leo Hanke
  10. Ben Murrell
  11. Gerald McInerney
  12. Jennie Olofsson
  13. Eni Andersson
  14. Cecilia Hellström
  15. Shaghayegh Bayati
  16. Sofia Bergström
  17. Elisa Pin
  18. Ronald Sjöberg
  19. Hanna Tegel
  20. My Hedhammar
  21. Mia Phillipson
  22. Peter Nilsson
  23. Sophia Hober
  24. Charlotte Thålin

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Abstract

SARS-CoV-2 may pose an occupational health risk to healthcare workers. Here, we report the seroprevalence of SARS-CoV-2 antibodies, self-reported symptoms and occupational exposure to SARS-CoV-2 among healthcare workers at a large acute care hospital in Sweden. The seroprevalence of IgG antibodies against SARS-CoV-2 was 19.1% among the 2149 healthcare workers recruited between April 14th and May 8th 2020, which was higher than the reported regional seroprevalence during the same time period. Symptoms associated with seroprevalence were anosmia (odds ratio (OR) 28.4, 95% CI 20.6–39.5) and ageusia (OR 19.2, 95% CI 14.3–26.1). Seroprevalence was also associated with patient contact (OR 2.9, 95% CI 1.9–4.5) and covid-19 patient contact (OR 3.3, 95% CI 2.2–5.3). These findings imply an occupational risk for SARS-CoV-2 infection among healthcare workers. Continued measures are warranted to assure healthcare workers safety and reduce transmission from healthcare workers to patients and to the community.

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  1. Version published to 10.1038/s41467-020-18848-0
  2. ScreenIT

    SciScore for 10.1101/2020.06.22.20137646: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: Informed consent, study inclusion and appointment for blood sampling were obtained using a smartphone-based app and verification through electronic identification and signature.
    IRB: The study protocol was approved by the Stockholm Ethical Review Board (dnr 2020-01653).
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The study also has several limitations worth noting. Seroprevalence is dynamic, and the data we present in this cohort represents the prevalence of prior or still on-going infection in April-May 2020. A new cross-sectional investigation will yield different results. Another limitation lies in the nature of self-reported data, yielding a risk of recall bias. Anosmia and ageusia have been widely pointed out as potential covid-19 symptoms in media, which may have influenced responses. Participants were asked to document symptoms over the prior 3-4 months, and it is not certain that reported symptoms were caused by SARS-CoV-2 infection in seropositive participants, who may have been infected by other respiratory viruses in addition to SARS-CoV-2 in the months prior to study inclusion. The options of occupation, patient contact and exposure to covid-19 patients were, however, objective variables. Study participation was voluntary, and a selection bias cannot be excluded. Symptomatic individuals may have been more likely to participate, and employees not at work due to illness during the study period were excluded, which could have influenced the over-all seroprevalence. However, possible selection bias would apply to all sub groups, and comparisons between groups were likely unaffected. Appointments for study inclusion were furthermore released continuously at diurnal random times throughout the study period, ensuring that various occupations, regardless of work schedule, were abl...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.06.22.20137646v1 on medRxiv