Seroprevalence and Correlates of SARS-CoV-2 Antibodies in Health Care Workers in Chicago
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Abstract
Background
Identifying factors associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among health care workers (HCWs) may help health systems optimize SARS-CoV-2 infection control strategies.
Methods
We conducted a cross-sectional analysis of baseline data from the Northwestern HCW SARS-CoV-2 Serology Cohort Study. We used the Abbott Architect Nucleocapsid IgG assay to determine seropositivity. Logistic regression models (adjusted for demographics and self-reported community exposure to coronavirus disease 2019 [COVID-19]) were fit to quantify the associations between occupation group, health care delivery tasks, and community exposure and seropositive status.
Results
A total of 6510 HCWs, including 1794 nurses and 904 non-patient-facing administrators, participated. The majority were women (79.6%), 74.9% were White, 9.7% were Asian, 7.3% were Hispanic, and 3.1% were non-Hispanic Black. The crude prevalence of seropositivity was 4.8% (95% CI, 4.6%–5.2%). Seropositivity varied by race/ethnicity as well as age, ranging from 4.2% to 9.6%. Out-of-hospital exposure to COVID-19 occurred in 9.3% of HCWs, 15.0% (95% CI, 12.2%–18.1%) of whom were seropositive; those with family members diagnosed with COVID-19 had a seropositivity rate of 54% (95% CI, 44.2%–65.2%). Support service workers (10.4%; 95% CI, 4.6%–19.4%), medical assistants (10.1%; 95% CI, 5.5%–16.6%), and nurses (7.6%; 95% CI, 6.4%–9.0%) had significantly higher seropositivity rates than administrators (referent; 3.3%; 95% CI, 2.3%–4.4%). However, after adjustment, nursing was the only occupation group with a significantly higher odds (odds ratio, 1.9; 95% CI, 1.3–2.9) of seropositivity. Exposure to patients receiving high-flow oxygen therapy and hemodialysis was significantly associated with 45% and 57% higher odds for seropositive status, respectively.
Conclusions
HCWs are at risk for SARS-CoV-2 infection from longer-duration exposures to people infected with SARS-CoV-2 within health care settings and their communities of residence.
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SciScore for 10.1101/2020.09.11.20192385: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: This study was approved by the Northwestern University Institutional Review Board and all participants gave written informed consent.
Consent: The email invitation specified 41 locations across Chicago and suburban areas where HCWs could obtain serological testing for SARS-CoV-2 and included information about the cohort study and an electronic link to consent and enroll.Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
Antibodies Sentences Resources The SARS-CoV-2 IgG assay is a qualitative, chemiluminescent microparticle immunoassay that identifies whether human serum or … SciScore for 10.1101/2020.09.11.20192385: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: This study was approved by the Northwestern University Institutional Review Board and all participants gave written informed consent.
Consent: The email invitation specified 41 locations across Chicago and suburban areas where HCWs could obtain serological testing for SARS-CoV-2 and included information about the cohort study and an electronic link to consent and enroll.Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
Antibodies Sentences Resources The SARS-CoV-2 IgG assay is a qualitative, chemiluminescent microparticle immunoassay that identifies whether human serum or plasma have IgG antibodies to SARS-CoV-2 nucleocapsid antigen. plasma have IgGsuggested: NoneSARS-CoV-2 nucleocapsid antigen.suggested: (Proteintech Cat# 28769-1-AP, RRID:AB_2881212)Software and Algorithms Sentences Resources The SARS-CoV-2 IgG assay on the high-throughput ARCHITECT i2000SR Immunoassay System from Abbott Laboratories (Abbott Park, IL) was used. Abbott Laboratoriessuggested: NoneResults 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:There are some important limitations to this study. First, these data represent a single, large health system that maintained adequate PPE throughout the crisis and launched infection control policies early on. Thus, the findings may not be generalizable to hospital systems working in communities where the burden exceeded the health system capacity. Second, while the seroprevalence reporting by race and ethnicity is consistent with national reports describing higher rates of infection in Black and Hispanic adults, we had relatively small numbers of these groups in our sample and so estimates may be unstable. Third, our data on occupation group and work-related behaviors come from survey data, which may be susceptible to recall bias, particularly in participants who received their serologic testing results prior to filling out their surveys. We did not, however, see different directions of association between work task, location, and risk for prevalent COVID-19 when we stratified the cohort by the relative timing of serologic testing and questionnaire completion, suggesting that recall bias does not explain the reported associations between work type, symptoms, and beliefs about COVID-19 infection and serologic status. Fourth, the performance of all currently-available assays for IgG detection have not been rigorously validated in community-based studies with consistent reference standard samples. Further, some individuals infected with SARS-CoV-2 may not develop a detectable ...
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.
- Thank you for including a protocol registration statement.
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