Antibodies against SARS-CoV-2 among health care workers in a country with low burden of COVID-19

  1. Mina Psichogiou
  2. Andreas Karabinis
  3. Ioanna D. Pavlopoulou
  4. Dimitrios Basoulis
  5. Konstantinos Petsios
  6. Sotirios Roussos
  7. Maria Pratikaki
  8. Edison Jahaj
  9. Konstantinos Protopapas
  10. Konstantinos Leontis
  11. Vasiliki Rapti
  12. Anastasia Kotanidou
  13. Anastasia Antoniadou
  14. Garyphallia Poulakou
  15. Dimitrios Paraskevis
  16. Vana Sypsa
  17. Angelos Hatzakis

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Abstract

Greece is a country with limited spread of SARS-CoV-2 and cumulative infection attack rate of 0.12% (95% CI 0.06–0.26). Health care workers (HCWs) are a well-recognized risk group for COVID-19. The study aimed to estimate the seroprevalence of antibodies to SARS-CoV-2 in a nosocomial setting and assess potential risk factors.

Methods

HCWs from two hospitals participated in the study. Hospital-1 was a tertiary university affiliated center, involved in the care of COVID-19 patients while hospital-2 was a tertiary specialized cardiac surgery center not involved in the care of these patients. A validated, CE, rapid, IgM/IgG antibody point-of-care test was used. Comparative performance with a reference globally available assay was assessed.

Results

1,495 individuals consented to participate (response rate 77%). The anti-SARS-CoV-2 weighted prevalence was 1.26% (95% CI 0.43, 3.26) overall and 0.53% (95% CI 0.06, 2.78) and 2.70% (95% CI 0.57, 9.19) in hospital-1 and hospital-2, respectively although the study was underpowered to detect statistically significant differences. The overall, hospital-1, and hospital-2 seroprevalence was 10, 4 and 22 times higher than the estimated infection attack rate in general population, respectively. Suboptimal use of personal protective equipment was noted in both hospitals.

Conclusions

These data have implications for the preparedness of a second wave of COVID-19 epidemic, given the low burden of SARS-CoV-2 infection rate, in concordance with national projections.

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  1. Version published to 10.1371/journal.pone.0243025
  2. ScreenIT

    SciScore for 10.1101/2020.06.23.20137620: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementConsent: Informed consent was obtained from all participants who were interviewed using a structured questionnaire including demographics, education, position within hospital, exposure to COVID-19, use of personal protective equipment (PPE), and symptoms related to COVID-19.
    IRB: The study was approved by the Institutional Review Board of both hospitals.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    Serologic testing for SARS-CoV-2 antibodies was performed using capillary blood according to the manufacturer’s instructions (Genebody Inc.).
    SARS-CoV-2
    suggested: None

    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:
    Several study limitations are noted: 1) The sensitivity of the currently existing antibody assays is not well known since they were registered using convalescent sera from symptomatic hospitalized patients and their sensitivity was not assessed in asymptomatic or mildly symptomatic patients (18,19). 2) At present, data on post-infection immunity are lacking. Studies from the previous SARS-CoV-1 outbreak have shown a steady prevalence decrease with time (18,19) 3) Higher antibody titers are associated with infection severity (18,19). 4) The study, due to the low anti-SARS-CoV-2 prevalence, is underpowered to detect risk factors. 5) The prevalence of anti-SARS-CoV-2 in the Greek population is not known and the infection attack rate estimated from a modelling study was used as surrogate of the general population prevalence. 6) Several studies, non-peer reviewed available as preprint, were used. In conclusion, the burden of SARS-CoV-2 infection among hospital personnel in Athens is low, consistent with the low burden of infection in the country. The use of PPE was suboptimal. These findings have implications for the preparedness of a second wave of COVID-19.

    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 10.1101/2020.06.23.20137620v1 on medRxiv