SARS-CoV-2 seroprevalence and asymptomatic viral carriage in healthcare workers: a cross-sectional study
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Abstract
To determine the rates of asymptomatic viral carriage and seroprevalence of SARS-CoV-2 antibodies in healthcare workers.
Design
A cross-sectional study of asymptomatic healthcare workers undertaken on 24/25 April 2020.
Setting
University Hospitals Birmingham NHS Foundation Trust (UHBFT), UK.
Participants
545 asymptomatic healthcare workers were recruited while at work. Participants were invited to participate via the UHBFT social media. Exclusion criteria included current symptoms consistent with COVID-19. No potential participants were excluded.
Intervention
Participants volunteered a nasopharyngeal swab and a venous blood sample that were tested for SARS-CoV-2 RNA and anti-SARS-CoV-2 spike glycoprotein antibodies, respectively. Results were interpreted in the context of prior illnesses and the hospital departments in which participants worked.
Main outcome measure
Proportion of participants demonstrating infection and positive SARS-CoV-2 serology.
Results
The point prevalence of SARS-CoV-2 viral carriage was 2.4% (n=13/545). The overall seroprevalence of SARS-CoV-2 antibodies was 24.4% (n=126/516). Participants who reported prior symptomatic illness had higher seroprevalence (37.5% vs 17.1%, χ 2 =21.1034, p<0.0001) and quantitatively greater antibody responses than those who had remained asymptomatic. Seroprevalence was greatest among those working in housekeeping (34.5%), acute medicine (33.3%) and general internal medicine (30.3%), with lower rates observed in participants working in intensive care (14.8%). BAME (Black, Asian and minority ethnic) ethnicity was associated with a significantly increased risk of seropositivity (OR: 1.92, 95% CI 1.14 to 3.23, p=0.01). Working on the intensive care unit was associated with a significantly lower risk of seropositivity compared with working in other areas of the hospital (OR: 0.28, 95% CI 0.09 to 0.78, p=0.02).
Conclusions and relevance
We identify differences in the occupational risk of exposure to SARS-CoV-2 between hospital departments and confirm asymptomatic seroconversion occurs in healthcare workers. Further investigation of these observations is required to inform future infection control and occupational health practices.
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SciScore for 10.1101/2020.05.18.20105197: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: The study was approved by the London - Camden & Kings Cross Research Ethics Committee, study number 282525.
Consent: All participants provided written, informed consent prior to enrolment in the study.Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
Antibodies Sentences Resources A combined secondary layer containing horse-radish peroxidase conjugated polyclonal antibodies against IgG, IgA and IgM followed by 3,3′,5,5′-Tetramethylbenzidine development was used to detect the presence of antibodies. antibodies against IgGsuggested: NoneSoftware and Algorithms Sentences Resources Data… SciScore for 10.1101/2020.05.18.20105197: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement IRB: The study was approved by the London - Camden & Kings Cross Research Ethics Committee, study number 282525.
Consent: All participants provided written, informed consent prior to enrolment in the study.Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable not detected. Table 2: Resources
Antibodies Sentences Resources A combined secondary layer containing horse-radish peroxidase conjugated polyclonal antibodies against IgG, IgA and IgM followed by 3,3′,5,5′-Tetramethylbenzidine development was used to detect the presence of antibodies. antibodies against IgGsuggested: NoneSoftware and Algorithms Sentences Resources Data were analysed using Graph Pad Prism 8.4.2 for macOS. Graph Pad Prismsuggested: (GraphPad Prism, RRID:SCR_002798)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: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.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.
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