A prospective study of risk factors associated with seroprevalence of SARS-CoV-2 antibodies in healthcare workers at a large UK teaching hospital - 13/10/22

Doi : 10.1016/j.jinf.2022.08.030

Daniel J Cooper ^1,^2,^10,^⁎ , Sara Lear ¹, Laura Watson ³, Ashley Shaw ¹, Mark Ferris ¹, Rainer Doffinger ¹, Rachel Bousfield ¹, Katherine Sharrocks ¹, Michael P. Weekes ¹, Ben Warne ¹, Dominic Sparkes ^1,⁴, Nick K Jones ^1,⁴, Lucy Rivett ^1,⁴, Matthew Routledge ^1,⁴, Afzal Chaudhry ¹, Katherine Dempsey ³, Montgomery Matson ⁵, Adil Lakha ⁵, George Gathercole ⁵, Olivia O'Connor ⁵, Emily Wilson ⁵, Orthi Shahzad ⁵, Kieran Toms ⁵, Rachel Thompson ⁵, Ian Halsall ¹, David Halsall ¹, Sally Houghton ¹, Sofia Papadia ^6,⁷, Nathalie Kingston ^6,⁸, Kathleen E Stirrups ^6,⁸, Barbara Graves ^6,⁷, Paul Townsend ⁶, Neil Walker ^6,⁸, Hannah Stark ^6,⁷,
the CITIID-NIHR BioResource COVID-19 Collaboration
Daniela De Angelis ⁹, Shaun Seaman ⁹, Gordon Dougan ^10,¹¹, John R Bradley ^1,⁶, M. Estée Török ^1,¹⁰, Ian Goodfellow ^12,^{^{†
Senior authors}}, Stephen Baker ^10,^11,^{^{†
Senior authors}}
¹ Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
² Global and Tropical Health Division, Menzies School of Heath Research and Charles Darwin University, Darwin, Northern Territory, Australia
³ NIHR Cambridge Clinical Research Facility
⁴ Clinical Microbiology and Public Health Laboratory, Public Health England, United Kingdom
⁵ University of Cambridge School of Clinical Medicine, Cambridge, UK
⁶ NIHR BioResource, NIHR Cambridge Biomedical Research Centre, Cambridge Biomedical Campus, Cambridge, UK
⁷ Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
⁸ Department of Haematology, School of Medicine, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
⁹ MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
¹⁰ Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK
¹¹ Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, UK
¹² Department of pathology, Division of virology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK

^⁎Corresponding author: Dr Daniel J Cooper, Cambridge University Hospitals NHS Foundation Trust, Hills Rd, Cambridge, UK, CB2 0QQCambridge University Hospitals NHS Foundation TrustHills RdCambridgeUKCB2 0QQ

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Highlights

•	The risk of SARS-CoV-2 infection in healthcare workers is highly heterogeneous
•	The risk of SARS-CoV-2 is significantly higher in BAME healthcare workers
•	Working in COVID-19 specific areas increases the risk of infection
•	Porters, domestic staff, and healthcare assistants are healthcare staff at highest risk of SARS-CoV-2 infection.

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Abstract

Objectives

To describe the risk factors for SARS-CoV-2 infection in UK healthcare workers (HCWs).

Methods

We conducted a prospective sero-epidemiological study of HCWs at a major UK teaching hospital using a SARS-CoV-2 immunoassay. Risk factors for seropositivity were analysed using multivariate logistic regression.

Results

410/5,698 (7·2%) staff tested positive for SARS-CoV-2 antibodies. Seroprevalence was higher in those working in designated COVID-19 areas compared with other areas (9·47% versus 6·16%) Healthcare assistants (aOR 2·06 [95%CI 1·14-3·71]; p=0·016) and domestic and portering staff (aOR 3·45 [95% CI 1·07-11·42]; p=0·039) had significantly higher seroprevalence than other staff groups after adjusting for age, sex, ethnicity and COVID-19 working location. Staff working in acute medicine and medical sub-specialities were also at higher risk (aOR 2·07 [95% CI 1·31-3·25]; p<0·002). Staff from Black, Asian and minority ethnic (BAME) backgrounds had an aOR of 1·65 (95% CI 1·32 – 2·07; p<0·001) compared to white staff; this increased risk was independent of COVID-19 area working. The only symptoms significantly associated with seropositivity in a multivariable model were loss of sense of taste or smell, fever, and myalgia; 31% of staff testing positive reported no prior symptoms.

Conclusions

Risk of SARS-CoV-2 infection amongst HCWs is highly heterogeneous and influenced by COVID-19 working location, role, age and ethnicity. Increased risk amongst BAME staff cannot be accounted for solely by occupational factors.

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Key words : SARS-CoV-2, COVID-19, sero-epidemiology, healthcare workers, risk factor analysis

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Vol 85 - N° 5

P. 557-564 - novembre 2022 Retour au numéro

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A prospective study of risk factors associated with seroprevalence of SARS-CoV-2 antibodies in healthcare workers at a large UK teaching hospital - 13/10/22

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